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Introduction
Structure of the Publication The document has four main chapters. After this introduction, the second section sets out a broad framework that needs to be used when examining health care labor markets. This includes outlining how health workers are related to the rest of the health care system, and to other social and economic determinants of population health and well-being. The purpose here is to show that the health workforce is only one part of improving population health and well-being, and that there may be other more cost-effective ways to improve health than by scaling up the health workforce. We then address the question of why market forces cannot be relied on to solve health worker shortages. Government intervention and regulation are required due to broader and well-recognized market failures in health care and health workforce labor markets, though the scale and types of government intervention can vary across countries for a range of reasons. The third section summarizes the key issues surrounding the demand and supply of health workers and how these interact in the health worker labor market. Demand-side issues include pay-setting arrangements and skill mix and task substitution. Supply-side issues include retention, geographic distribution, sectoral distribution (including dual practice), and performance and motivation. Discussion of these issues is followed by a brief summary of the evidence from health care labor markets in high-income countries, and a more detailed summary of the evidence from LMICs. The review of evidence from LMICs was undertaken using a search strategy to identify recent work in English that could broadly be defined as using health labor market analysis or elements of it in LMIC contexts. A primary focus is the recent literature so as to reflect an interest in the current depiction of health labor markets, recognizing that these, and the factors influencing them, change quite rapidly. Databases searched included Science Direct, Google Scholar, World Bank archives, the Health Systems 2020, and HRH Global Resource Center databases. The date range searched was 2006 to 2013, although some references prior to 2006 were identified through the citations of those articles as particularly relevant. A count of the geographic focus of studies from LMICs used in this document (and listed in the References) is in figure 1.1. This classification is quite rough: different elements of some studies are reported in more than one paper, and papers that covered a general class of countries (for example “developing”) or a whole continent were excluded from the count, while ones covering a distinctive list of countries or areas within one or more countries were included. Our focus is primarily on LMICs and it is not surprising that the bulk of this literature is focused on countries that are deemed to be in human resource crisis, usually according to the standard advanced by The World Health Report 2006, of which the great majority are in Africa (WHO 2006). It is also unsurprising that in a review restricted to English language publication, Anglophone countries are more strongly represented than Francophone and Lusophone ones. The fourth section summarizes the broad analytical approaches used in economics, focusing on issues of causality and labor market dynamics. This also Analyzing Markets for Health Workers • http://dx.doi.org/10.1596/978-1-4648-0224-9