Scenario simulations

Method used to quantify the projected gaps in health workers in Saudi Arabia

The gap analysis for Saudi Arabia focuses on the shortages between the predicted numbers of Saudi physicians (generalists and specialists) and Saudi nurses (including only bachelor and advanced nurses, not diploma nurses) and their predicted need-based demand and health labor market demand. The focus on Saudi nationals stems from the strategic goals outlined in the National Transformation Program for increasing health workforce Saudization. Additional adjustments were made to account for the relative lower productivity of Saudi health workers (irrespective of public or private sector employment), and diploma nurses were excluded from the overall projected supply of nurses given that their scope of work is more similar to health technicians than to health workers who provide direct patient care. in combination, these adjustments yield results that better inform health workforce policies in Saudi Arabia in line with strategic goals for ensuring that there are adequate numbers of Saudi health workers with the necessary skills to meet the needs and demands of the health system.

SCENARIO SIMULATIONS

comparing need- and demand-based projections underscores the importance of understanding whether a shortage stems from supply or economic demand constraints, or both. in areas where supply and demand may both be low, there may be neither enough fiscal capacity to employ more health workers nor adequate numbers of health workers to deliver the priority health services needed by the population. The health workforce projections resulting from the above methods assume no changes in the technology or efficiency of the health care delivery system—that there will be no changes in the organization of the health care delivery system, or in worker productivity or technology. Thus, these projections do not account for potential changes in productivity due to the engagement of other types and levels of health workers, such as physician assistants, community health workers, and other categories of workers.

However, there is likely to be considerable scope for augmenting the production of workers, improving the efficiency of service delivery, and increasing health worker productivity. For example, propagating service delivery models that use more low-skilled cadres (for example, community health workers, nurses, midwives) may achieve greater coverage for essential primary care services with the same resources used to produce higher skilled, but fewer, physicians and specialists. increases in productivity might also be achieved through technological advances that could reduce the overall number of health workers demanded or shift demand more toward different types of health workers.

The supply projections also do not take into account attrition rates in the existing stock of health workers, and the additional number of workers who will need to be educated and employed to replace those who exit the labor market. Also not considered are the dynamics of the international migration of health workers, particularly foreign health workers, which future health workforce planning may seek to change. These different scenarios for future supply, demand, and need could be simulated to understand the likely direction and magnitude of effects for various intervention measures. Examples of simulation scenarios are provided in table 2.4.