The Development of Human Resources for Health and Challenges in China Junhua ZHANG Health Human Resource Development Center, Ministry of Health

Overviews  Quantity and trends of HRH in China  Distribution and characteristics of HRH in China  Structure of HRH in China  Problems and challenges of HRH in China

A. Quantity and trends of HRH in China （ As of December 2005 ） Health workforce in health sectors: 5.43 million health professionals4.46 million among which: licensure physicians (assistant ） 1.94 million Licensure nurses1.35 million Physicians and health workers in rural areas ： 0.92 million Total 6.35 million

The trends of health workforce in health sectors and health professionals in China （ 10,000 ）

The trends of licensure physicians and nurses in China （ 10,000 ）

B. Distribution and characteristics of HRH in China  Distribution in urban and rural  Progress of urbanization  The trends of HRH in urban and rural  Distribution by regions  Eastern, Middle and Western Regions  The trends of HRH by region  Distribution by the ownership of institutions

Urbanization-the trends of proportion of urban population （ % ） In 2005, the number of migration from rural to urban was 150 million, who left rural areas at least three months.

Health professionals in urban and rural （ per 1000 population ）

Distribution of licensure physicians in urban and rural （ per 1000 population ）

Distribution of licensure nurses in urban and rural （ per 1000 population ）

The distribution of licensure physicians by region (p er 1000 population ）

The distribution of licensure nurses by region (p er 1000 population ）

Distribution of beds by region （ per 1000 population ）

Distribution of health workforce by the ownership of institution PersonsHealth Professionals PhysiciansAssistant physicians Overall （ million ） Ownership of institutions (%) State Collective Joint-venture Private Others

C. The structure of HRH in China  Health professional by gender  Health professional by age group  Health professional by education attainment  Health professional by academic title

Health professionals by gender, age group Overall UrbanRuralEastMiddleWest Gender （ % ） M F Age group （ % ） < or above

Health professional by education attainment and region OverallUrbanRuralEastMiddleWest Education （ % ） Bachelor or Associate Vocational Middle school

Health professional by academic title OverallUrbanRuralEastMiddleWest Title (% ） Associate prof. or prof Senior lecturer Attend. /assist Junior

D. Problems and challenges of HRH in China (1)  Overall low qualification of HRH in China  Majority with associate degree or vocational education, 74%  Shortage of senior health professionals ： prof. or associate prof , only 1.1% with master and doctor degree  460,000 persons did not have formal health professional training, 12.3% of total health professionals  Low coverage of continuous education and on-service education ： 12% of physicians accept standardized attending physician training ， only 28% of physicians accept continuous education.

 Regional HRH unbalance, coexistence of shortage and wastage of HRH  The density of HRH is more in east than in west （ in 2004, 3.98 per 1000 population, 3.27 in the middle and 3.00 in the west ； bachelor or above in east is 16.7% ， 4.5 percentage higher than middle and west ）， however, the utilization of HRH in west is more efficient than the middle region.  There is big gap on HRH between urban and rural (47% of population in urban area have occupied 67% of total HRH. In rural areas the health institutions have 300,000 employees, who did not have formal health professional training (65% of HRH in rural areas) 。 D. Problems and challenges of HRH in China (2)

Unreasonable distribution of HRH  Majority of HRH in medical sectors and hospitals  94% in medical sectors, shortage in public health  Only GPs ， community health service is backward  Inverse ratio of physicians to nurses  In hospital 1:0.97  In township health station 1:0.40 D. Problems and challenges of HRH in China (3)

 Health management is not yet professional, the quality of management need to be improved  health administrators ， 43% of them with medical and health background  85% of administrative managers (presidents, directors etc) are medical graduates ， it means that before they took administrative posts, they were medical professionals.  The leaders usually “ full time doing health professionals, part time doing management ” ， lack of management knowledge and expertise D. Problems and challenges of HRH in China (4)

Thank you very much!