The global health workforce has undergone a remarkable transformation over the past three decades, with women playing a pivotal role in this evolution. Despite substantial growth, significant shortages persist, highlighting the need for continued investment in healthcare professionals worldwide.
From 1990 to 2026, the number of health workers nearly tripled, reaching 122.1 million. This expansion was largely driven by women, who accounted for 71.4% of the growth and comprised 68.9% of the total health workforce in 2026. However, these gains have not been evenly distributed, and substantial gaps remain in achieving universal health coverage.
The gender dynamics of health workforce expansion
Women have been instrumental in the growth of the health workforce, particularly in nursing, midwifery, and community health roles. In 2026, women made up 80.7% of nurses, 96.0% of midwives, and 89.5% of community health workers. However, their representation in higher-paying and leadership positions remains limited, with women constituting only 43.9% of doctors and being more likely to work as assistants in dentistry and pharmacy.
Megan Knight, a researcher at the Institute for Health Metrics and Evaluation (IHME), emphasized the need for equitable opportunities in the health workforce. ‘Women have transformed the global health workforce over the past three decades, but they continue to be concentrated in professions that generally offer lower pay and fewer opportunities for leadership,’ Knight stated. ‘Building stronger health systems will require not only expanding the workforce but also creating equitable opportunities for career advancement, leadership, and safe, supportive working environments.’
Persistent shortages in the global health workforce
Despite the significant growth in the health workforce, an estimated 34.4 million more workers are needed to achieve moderate levels of universal health coverage. This shortage includes 23.9 million nurses and midwives, 7.1 million doctors, 1.8 million dentists, and 1.6 million pharmacists. The most severe shortages are observed in South Asia and sub-Saharan Africa, where the need for healthcare professionals is most acute.
In South Asia, an additional 10 million nurses and midwives and 2.6 million doctors are required to meet the benchmark for universal health coverage. Sub-Saharan Africa faces a similar challenge, needing 5.7 million more nurses and midwives and 2.5 million more doctors. The disparity in nursing density is particularly striking, with high-income countries averaging 121.8 nurses per 10,000 people, compared to just 14.5 in sub-Saharan Africa.
Challenges in achieving universal health coverage
The analysis highlights the complex nature of workforce shortages and the need for a nuanced approach to addressing them. The study identified minimum workforce densities required for moderate universal health coverage, including 23.8 doctors, 64.5 nurses and midwives, 5.2 dentists, and 5.6 pharmacists per 10,000 people. However, these benchmarks are not one-size-fits-all solutions, as countries organize their health services differently.
The World Health Organization (WHO) has published a lower shortage estimate based on a different method and level of ambition. The authors of the study describe their figure as a guide for longer-term planning, emphasizing the need for sustained investments in health worker education, recruitment, retention, and working conditions. Gender-responsive policies, including leadership development, workplace protections, paid parental leave, and flexible work arrangements, are also crucial for supporting the predominantly female health workforce.
As the world continues to strive for universal health coverage, addressing the gender disparities and workforce shortages in the health sector will be essential. By investing in the education, recruitment, and retention of health workers, particularly women, countries can build stronger health systems capable of meeting the health needs of their populations.
