Coming together to identify health-workforce needs in small countries


The WHO Small Countries Initiative has released 2 sets of micro case studies, illustrating the experiences of 11 small countries and 1 region in strengthening their health workforces in the areas of postgraduate training and monitoring and managing health workforce mobility.

Challenges to the health workforce in small countries are further influenced by their size, context and dynamics. Their smallness means that challenges in this area, such as a brain drain or lack of specialized health professionals, are revealed sooner than would be the case in larger countries where they often manifest themselves at a later stage.

Improving postgraduate and speciality training and the monitoring and management of health-workforce mobility are two of the areas covered by the micro case studies in addressing challenges related to the health workforce.

The collection of micro case studies was undertaken by the Working Group on Human Resources for Health in Small Countries in the WHO European Region.

Postgraduate and specialty training: a varied and rich solution

The micro case studies highlighted many ways in which improved postgraduate training contributes to strengthening the health workforce. Some small countries have capitalized on these, for example, by using data collected through the shared-medical-record system in assessing future postgraduate-training needs. Others have established collaboration with hospitals in other countries to improve their access to speciality training.

Small countries know what works in general and when to seek guidance on addressing challenges in this area. The availability of more timely and coordinated data would, however, strengthen this resource and, in turn, enable a higher level of information-sharing.

A mobile workforce

The micro case-studies also demonstrate that data on the mobility and migration of health professionals are not available to all practising professionals. Furthermore, they find that use of the “WHO Global Code of Practice on the International Recruitment of Health Personnel” varies among small countries/regions. Different financial and other incentives are used to retain health professionals or encourage them to return home, for example, after studies abroad.

The case studies also reveal that data represent only one of several key elements needed for the effective planning of human resources for health, and illustrate how small countries are able to identify areas of cooperation to this end.

Looking ahead

In highlighting ways in which countries can continue to learn from one another towards building a sustainable health workforce, this document offers suggestions on how to recruit and retain the necessary health professionals, attract young people to health-related professions, and address shortages of certain medical specialties.

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