برآورد دستمزد سلامتی کارگر جهانی: تحلیل اقتصاد سنجی از درآمدهای جهانی Global health worker salary estimates: an econometric analysis of global earnings data

Background Te sustainable development goals (SDGs) represent an ambitious post-2015 agenda. From a health perspective, the broadening of global priorities beyond the millennium development goal (MDG) conditions, as well as the introduction of a target specifc to Universal Health Coverage (UHC), indicate growing demands placed on the health system in every country [1, 2]. A background paper for the recent High Level Commission on Health Employment and Economic Growth showed projections indicating an estimated shortfall of approximately 18 million health workers by 2030 [3]. Such projections are an important contributor to the policy dialogue; however, important concerns about the related increase in domestic and external fnancial resources needed to support these required additional health staf remain unanswered [4]. Human resources are consistently cited as a leading contributor to health care costs, responsible for approximately 57% of total expenditure on health according to unpublished ‘raw’ country data in the Global Health Expenditure Database (GHED) (e.g. uncorrected for on-budget donor assistance) [5, 6] In published studies, human resources have been found to account for between 42% and 46% of total health expenditure [7, 8]. Despite the importance of the contribution of human resources to health fnancing needs, policy makers and academics are often unable to identify consistent sources of earnings estimates for cost analysis, leading to information gaps in the global policy arena [9]. Te demand for the cost analysis of health interventions has increased as governments seek to make informed decisions about how to allocate resources and manage their budgets in low resource settings [10]. Cross country estimates on the cost of health interventions help in this respect both donor agencies such as Gavi and the Global Fund, and international organizations, such as the World Health Organization. Recognizing a need for publicly available information on the costs and cost-efectiveness for health interventions, the WHO-CHOICE programme has made available since 2000, a database of price estimates of various intervention inputs for use in the economic and fnancial analyses of health care interventions [11]. Te availability of internationally comparable data on health worker earnings for all countries has nevertheless persisted as a challenge. Tis paper describes an econometric model that uses cross sectional occupational wage data from the International Labour Organization [12] that WHO-CHOICE has used to prepare estimates of health worker wages (in 2010 USD) for all WHO member states by skill level. It is hoped that these estimates will support robust health care intervention costings and projections of resources needs over the SDG period. Te aim of this paper is frstly to provide a comparative global database of health worker salary data that can be used in global or regional resource needs assessments. Tese types of analyses are most useful for multilateral agencies, such as WHO, who provide normative estimates of “global price tags” or for global health initiatives such as GAVI and Te Global Fund who make resource allocation decisions at the global level and require a database of prices estimated with a consistent methodology.