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

2. 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

3. 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

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

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

6. 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

7. 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.

8. Health professionals in urban and rural （ per 1000 population ）

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

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

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

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

13. Distribution of beds by region （ per 1000 population ）

14. Distribution of health workforce by the ownership of institution PersonsHealth Professionals PhysiciansAssistant physicians Overall （ million ） 5.244.271.460.38 Ownership of institutions (%) State 82.380.681.670.6 Collective 10.811.510.119.7 Joint-venture 0.20.30.2 Private 5.36.26.68.1 Others 1.31.4 1.5

15. 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

16. Health professionals by gender, age group Overall UrbanRuralEastMiddleWest Gender （ % ） M36.233.241.834.937.337.2 F63.866.858.265.162.762.8 Age group （ % ） <25 10.610.311.111.410.49.4 25-34 40.139.141.940.240.339.7 35-44 26.927.326.225.427.828.4 45-54 19.119.917.619.418.419.4 55 or above 3.3 3.63.13.0

17. Health professional by education attainment and region OverallUrbanRuralEastMiddleWest Education （ % ） Bachelor or + 14.118.75.516.712.212.1 Associate26.628.123.924.630.125.5 Vocational46.942.954.346.745.948.6 Middle school 12.410.316.312.011.813.8

18. Health professional by academic title OverallUrbanRuralEastMiddleWest Title (% ） Associate prof. or prof. 6.18.02.67.15.94.8 Senior lecturer 25.527.921.024.126.726.2 Attend. /assist. 40.639.941.940.939.441.5 Junior27.824.234.627.9 27.5

19. 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. 230000, 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.

20.  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)

21. Unreasonable distribution of HRH  Majority of HRH in medical sectors and hospitals  94% in medical sectors, shortage in public health  Only 52000 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)

22.  Health management is not yet professional, the quality of management need to be improved  370000 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)

23. Thank you very much!