A study from the International Labour Organisation estimates that 50 million decent jobs are missing in order to address essential global health requirements. These requirements are present through the need for universal health coverage (UHC) and to ensure human security, particularly with respect to highly infectious diseases like Ebola. Demographic ageing over the next 15 years is expected to further increase employment needs in the global health supply chain by 84 million jobs.
The report, entitled Health workforce: A global supply chain approach, provides new data on the employment effects of health economies in 185 countries. It takes an unprecedented approach by including all workers in the wider economy contributing to the delivery of health care and services within and across countries in global health supply chains.
The data provides evidence that a large invisible workforce of globally 57 million unpaid workers fills in for the huge shortages of skilled health workers. Most of them are women who gave up employment to provide care, for example to older family members.
According to the study, globally some 234 million workers are working towards the achievement of health targets such as universal health coverage (UHC). This number includes 27 million doctors and nurses and other workers in health occupations employed in the public and private sector. However, the large majority of the workforce – 106 million workers representing 70 per cent of the health economy workforce – have jobs in non-health occupations. The latter include the 57 million unpaid family workers already mentioned, and another 45.5 million often low paid workers in jobs lacking decent working conditions, mainly in the areas of maintenance, cleaning, administrative support and informal care.
“The Fourth Industrial Revolution may make some jobs obsolete and displace employment, but health care services are going to generate millions of jobs,” said Isabel Ortiz, director of ILO Social Protection Department. “The creation of the missing millions of jobs will improve living standards, economic growth and development, especially in countries with high levels of unemployment among lower-skilled workers and lacking health services.”
According to the author of the report, Xenia Scheil-Adlung, ILO health policy coordinator, this is due to the fact that 91 per cent of the health employment potential exists in lower-middle and low income countries of Africa and Asia where jobs would boost inclusive economic growth and contribute to achieving full employment. In Africa, currently about 15 million workers could be employed in the formal economy if sufficient investments in UHC were made available. In Asia, the current employment potential amounts to 29 million workers in health and non-health occupations. By 2030, employment in Africa could be increased by additionally 27 million and in Asia by 39 million jobs.
Applying the global supply chain and health economy perspective reveals the multiplier employment effects of investments in UHC across economic sectors and professions in the wider economy. The study finds that each investment in a job for a physician or a nurse is resulting in jobs for 2.3 workers without a health profession.
The study suggests that in meeting health needs full consideration should be given to the large number of people working in the broader health economy in non-health occupations, particularly unpaid workers. For achieving sustainable results and progress towards the UN’s Sustainable Development Goals (SDGs) , it will be crucial to focus on decent working conditions for all workers in global health supply chains and national health economies, including the payment of adequate salaries and social protection coverage.
“We need a rethinking of current policies to achieve universal health coverage by unlocking the potential of decent employment,” concludes Scheil-Adlung.
The study highlights the need for transforming informal unpaid care giving into sufficient numbers of jobs for skilled workers with decent working conditions. This would have a direct positive impact on the economy and on millions of women who gave up formal jobs to provide care to older family members in the absence of skilled care workers.