Human resources for health in Peru: recent trends (2007–2013) in the labour market for physicians, nurses and midwives

Abstract

BackgroundMost analyses of gaps in human resources for health (HRH) do not consider training and the transition of graduates into the labour market. This study aims to explore the labour market for Peru’s recent medical, nursing, and midwifery graduates as well as their transition into employment in the Ministry of Health’s (MOH) system.MethodsData from four different datasets, covering 2007–2013, was used to characterize the patterns of recently trained physicians, nurses, midwives, and postgraduate-trained physicians that enter employment in the MOH system, and scenario analyses were used to describe how this rate of entry needs to adapt in order to fill current HRH shortages.ResultsHRH graduates have been increasing from 2007 to 2011, but the proportions that enter employment in the MOH system 2 years later range from 8 to 45% and less than 10% of newly trained medical specialists. Scenario analyses indicate that the gap for physicians and nurses will be met in 2027 and 2024, respectively, while midwives in 2017. However, if the number of HRH graduates entering the MOH system doubles, these gaps could be filled as early as 2020 for physicians and 2019 for nurses. In this latter scenario, the MOH system would still only utilize 56% of newly qualified physicians, 74% of nurses, and 66% of midwives available in the labour market.ConclusionAt 2013 training rates, Peru has the number of physicians, nurses, and midwives it needs to address HRH shortages and meet estimated HRH gaps in the national MOH system during the next decade. However, a significant number of newly qualified health professionals do not work for the MOH system within 2 years of graduation. These analyses highlight the importance of building adequate incentive structures to improve the entry and retention of HRH into the public sector.

Knowledge of Cervical Cancer Prevention Among Women in Amazonian Peru

“…Although the examination is free at Yantalo's Center of Health, it is acknowledged that there is a shortage of women's health providers, the available providers face a volume of patients that is above facility capacity, and that wait times for visits are long. This shortage of women's health providers reported in the Peruvian Amazon is consistent with prior literature, [17][18][19][20] as is the high cost. 12,20 Moyobamba is a local city with a higher volume of women's health providers with increased availability, but many of these health facilities charge a fee per visit and transportation costs to Moyobamba must also be considered.…”

Lack of access to paediatric cardiology services in the public health system in four major urban centres in Perú

“…27 Physicians were reported to be five times, and nurses and midwives 14 times, more likely to favour a job in urban areas over more rural and remote areas. 27,29 The current distribution of the health care workforce in Peru is substantially skewed towards the urban areas, especially in Lima. There are 7.7 doctors per 10,000 people in Lima, whereas the majority of rural areas have fewer than four doctors per 10,000 and some regions are near two per 10,000.…”

“…Following graduation, only 8-45% of physicians, nurses, and midwives are entering the public health care sector. 27 This is particularly problematic for clinical specialists, as only~10% of those who completed their residency stayed in the public sector. This has created a large gap of~45% between the demand and the current pool of medical specialists, both clinical and surgical, in Peru.…”

“…17 This is not because of lack of trained graduates, but a problem of recruitment and retention, including health care workers leaving for the private sector or emigrating. 27 The national university census conducted in 2010 reported that 78% of medical students, 67% of nursing students, and 60% of midwifery students intend to migrate from Peru. 24 However, emigration may decline as a result of increased private health care expenditure.…”

Tendencias en el número de médicos titulados anualmente en el Perú, 2007-2016

“…Sin embargo, es posible que esto suceda antes debido al incremento observado del número de médicos titulados anualmente. De forma similar, los médicos suelen concentrarse en ciudades grandes, donde posiblemente ya exista una sobreoferta de estos profesionales [17] . El incremento del número de médicos sin una adecuada distribución de la oferta laboral podría estar causando problemas de desempleo, subempleo, multiempleo, bajas remuneraciones [18] , insatisfacción laboral y migración al extranjero [19][20][21][22] .…”