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Appendix A. Economics of Health Labor Markets in Sub-Saharan Africa Supply The supply of health workers is measured by the stock of health workers willing to enter the health labor market; that is, the number of individuals with the necessary qualifications able and willing to work in the health sector, not the number of individuals actually working in this sector or the number of individuals qualified to do so.

Demand HRH demand refers to the actual demand for health worker service by governments, health facilities, and/or individuals (employers). Demand is sometimes said to be determined less by “what is required or needed by a particular health service or health output” and rather by social, political, and economic factors beyond the needs of the population (Vujicic 2007).1 By definition, labor market demand is determined by the existence, willingness, and ability of an employer to hire health workers. Some argue that HRH planning in countries has failed largely because it has focused only on determining the needs-based HRH level—what “ought to be.” HRH planning has ignored the actual behavior of those individuals and institutions who hire health care professionals.

Market intervention and restrictions: the impact on supply and demand Health labor markets in Sub-Saharan Africa impose many restrictions affecting the supply-side and demand-side behavior of health workers. What influences market behavior varies among countries. And factors such as quotas, training costs, professional regulation, licensure examination, and educational requirements are involved in each case. In some countries, health workers may be subjected to compulsory government service (Fields 2008) or may be unable to work in another country because they cannot obtain exit visas. For demand, the health labor market model assumes employers can operate in the most advantageous fashion. Health facilities are often compelled to operate in locations with a less favorable balance of productivity and cost. Further, although this model assumes that health facilities should have an optimal number of health workers to meet facility goals, in the not-for-profit health sector the aim is to cover as many people as possible while in the for-profit sector it is to maximize profit. Many times, markers of quality are not integrated in the optimal skill mix.

Notes 1. h p://www3.interscience.wiley.com/cgi-bin/fulltext/112652606/PDFSTART.

The Human Resources for Health Crisis in Zambia  

Despite reporting some health gains since the 1990s, health outcomes remain poor in Zambia and it will be very challenging to achieve the he...

The Human Resources for Health Crisis in Zambia  

Despite reporting some health gains since the 1990s, health outcomes remain poor in Zambia and it will be very challenging to achieve the he...