Background Methodology to project the epidemiological need for physicians and

BACKGROUND

An effective health care workforce is critical to successfully treat the health needs of a population. Human resources play a crucial role in delivering health services. From a policy- and country-level perspective, health planners and decision-makers must ensure that the right number of people, with the right skills, deliver health services appropriate for the population’s health needs. Given the substantial training and resources required to develop a health workforce, planners who can anticipate future health workforce needs will be better equipped to match these resources to the particular demographic and health characteristics of the particular population.

A foundational component to understanding the overall workforce that is needed is an estimate of the health conditions of the population. Several strategies have been proposed to arrive at estimates of an ideal volume and skill mix of the health workforce, and most begin with trying to understand the population’s morbidities that are amenable to cost-effective health care treatments and interventions. Some countries, for instance, have a demographically “grayer” population with a predominance of chronic diseases as the leading causes of disability and death. Other populations may have a greater prevalence of risk behaviors (for example, smoking) that produce a unique “signature” of associated illnesses. regardless of a country’s specific demographic and health behavior profile, the planning for an efficient health workforce should involve matching the health workforce to the distribution of health conditions in the population that health workers will address.

Previous estimates of global benchmarks of health worker concentration may not apply to Saudi Arabia. Two previous estimates of physicians and nurses (per 1,000 population) that are needed have been widely used in the literature. These estimates include 2.28 physicians, midwives, and nurses per 1,000 population, taken from the World Health Organization’s (WHO’s) 2006 World Health Report (WHO 2006), and 4.5 physicians, nurses, and midwives per 1,000 population, taken from the WHO’s 2016 Sustainable development Goals report (WHO 2016). These benchmarks, however, may not apply to any specific country, or to Saudi Arabia, given that they were derived from a regression-based exercise using population averages of data on 110 countries, before 2010, and mostly in low- and middle-income contexts with a high burden of infectious diseases. in addition, the 4.5 value assumes a national strategy of universal health care coverage in which health care access, even for nonpriority health conditions, is subsidized by the federal government. neither the 4.5 nor the 2.28 estimate, moreover, is based on detailed epidemiological evidence on the prevalence of health conditions in a particular country. For these reasons, the relevance of these benchmarks to the need-based estimates of health workers in Saudi Arabia is unknown.

An epidemiological need-based approach was applied to estimate, to 2030, the number of physicians and nurses needed to treat the current and anticipated burden of disease in Saudi Arabia. This approach is well established and enjoys widespread use by governmental and nongovernmental organizations. A needbased approach uses the prevalence of priority health conditions as its foundation to drive estimates of the size of the health workforce (bruckner et al. 2011; Scheffler et al. 2009). importantly, this approach is in contrast to economic or willingness-to-pay approaches that consider the economic aspects of price, supply, and demand