International conference on Census microdata: findings and futures1-3 September 2008 — Manchester, United Kingdom

Uses of census microdata for health workforce assessment

in low and middle income countries

Neeru Gupta Mario R. Dal Poz

René Lavallée

Uses of census microdata for HRH assessment2 |

OutlineOutline

Objectives

Data and methods

Selected findings

Next steps

Uses of census microdata for HRH assessment3 |

ObjectivesObjectives

Examine strengths and limitations of census microdata for human resources for health (HRH) assessment.

Present findings from recent research on HRH metrics using microdata from the 2000 round of censuses for selected low & middle income countries.

Explore opportunities for strengthening global health workforce analyses in the upcoming 2010 round.

Uses of census microdata for HRH assessment4 |

Data and methodsData and methods

Source: Integrated Public Use Microdata Series (IPUMS)-International databank [www.ipums.umn.edu/].

Methods: enumeration of all persons active in the labour force with a health-related occupation and/or working in the health services industry at the time of the census.

Enhancing comparability: mapping to international standard classifications for social & economic statistics

– Classification of occupations (ISCO)– Classification of education (ISCED)– Industrial classification of all economic activities (ISIC).

Uses of census microdata for HRH assessment5 |

Selected findingsSelected findings

Density of workers with a health occupation, selected countries

(around 2000)

Density of workers with a health occupation, selected countries

(around 2000)

Uses of census microdata for HRH assessment6 |

Selected findingsSelected findings

Skills mix of the health workforce, selected

countries (around 2000)

Skills mix of the health workforce, selected

countries (around 2000)

0% 20% 40% 60% 80% 100%

Ecuador

Viet Nam

Rwanda

Philippines

South Africa

Venezuela

Cambodia

Romania

Uganda

Percent of the health workforce

Health professionals Nursing & midwifery personnelOther health service occupations Health management & support

Uses of census microdata for HRH assessment7 |

Selected findingsSelected findings

Geographical imbalances in the health workforce –Mexico (2000) and Viet Nam (1999)

Gupta N, et al.: Uses of population census data for monitoring geographical imbalance in the health workforce,

International Journal for Equity in Health, 2003, 2:11 [http://www.equityhealthj.com/content/2/1/11].

Uses of census microdata for HRH assessment8 |

0 2 4 6 8 10 12 14 16

Cambodia

Rwanda

Viet Nam

Brazil

Uganda

Philippines

Mexico

Venezuela

Ecuador

South Africa

Romania

Ratio of females to males

Other health serviceoccupationsNursing & midwiferypersonnelHealth professionals (exc.nursing & midwifery)

Selected findingsSelected findings

Gender imbalances in the health workforce,

selected countries (around 2000)

Gender imbalances in the health workforce,

selected countries (around 2000)

Lavallee R, Hanvoravongchai P: Uses of population census data for gender analysis of the health workforce,

Handbook on monitoring and evaluation of human resources for health [WHO, World Bank & USAID, forthcoming].

Uses of census microdata for HRH assessment9 |

Selected findingsSelected findings

Relationship between gender ratio in tertiary

level educational attainment and health

professional work activity, selected

countries (around 2000)

Relationship between gender ratio in tertiary

level educational attainment and health

professional work activity, selected

countries (around 2000)

Uses of census microdata for HRH assessment10 |

Conclusions and next stepsConclusions and next steps

Strengths of census data:

– Full enumeration of HRH stock (public/private, health services/ other, employed/unemployed, …);

– Disaggregation by sex & other characteristics of health workers.

Limitations: periodicity; content; access to - and use of - microdata for health systems research.

"Wish list" for public use microdata samples: data on occupation, place of work & field of advanced education disaggregated to lowest level.

Uses of census microdata for HRH assessment11 |

Next stepsNext steps

Ongoing feeding of the Global Atlas of the Health Workforce [www.who.int/globalatlas/] as new census microdata releases become available.

Technical consultations with countries and partners to optimize census uses for HRH assessment in the upcoming 2010 round

(e.g. Handbook on monitoring and evaluation of HRH, with special applications in low and middle income countries).