Health & Care Workforce

1754 BCE · about 3,800 years ago

The Code of Hammurabi set out rules governing physicians' fees and liability for treatment

The Babylonian legal code specified payments owed to physicians for successful treatment and penalties for harm caused by malpractice, among the earliest known formal regulation of medical practice as an occupation.

427 · around 1,600 years ago

Nalanda opened as a major seat of learning in India, teaching medicine among other subjects

The monastic university drew students and scholars from across Asia, including China and Central Asia, for centuries before its destruction around 1200, an early example of formal training that included medicine attracting learners across borders.

1550s · about 470 years ago

The Ottoman Empire founded a formal medical madrasa within the Süleymaniye complex in Istanbul

The institution trained physicians alongside a functioning hospital, combining structured medical education with clinical practice under state patronage, part of a wider Ottoman network of endowed medical schools and hospitals.

1858 · 168 years ago

The United Kingdom passed the Medical Act establishing a national register of qualified doctors

The act created the General Medical Council and required practitioners to hold recognised qualifications, an early model for state regulation of who could call themselves a doctor that other countries later adapted.

1860 · 166 years ago

Florence Nightingale founded a formal training school for nurses at St Thomas' Hospital

Drawing on statistical analysis of hospital mortality from the Crimean War, the school established structured, supervised training as the basis of professional nursing, a model subsequently adopted by hospitals across Europe, the Americas and European colonial territories.

1910 · 116 years ago

The Flexner Report forced sweeping reform of North American medical education

The Carnegie Foundation-commissioned review found many medical schools poorly equipped and unscientific, leading to mass closures and a standardised, university-based, science-grounded model of training that spread internationally over the following decades.

• The stricter accreditation standards forced the closure of most of the era's Black medical schools

1917 · 109 years ago

The Rockefeller Foundation funded the founding of Peking Union Medical College

The American philanthropy built a Western-style medical school and teaching hospital in Beijing intended to train a cadre of Chinese physicians to modern scientific standards, part of a wider early twentieth-century push to build medical training capacity outside Europe and North America.

1948 · 78 years ago

The World Health Organization was founded

The new United Nations agency took on coordination of global health workforce standards among its responsibilities, later publishing recommended minimum ratios of doctors and nurses to population that became widely used benchmarks.

1965 · 61 years ago

China launched the barefoot doctors programme

Villagers given several months of basic medical training were sent to work in rural communities lacking any formal healthcare, dramatically extending the reach of basic care and becoming an internationally influential model for task-shifting to lower-trained health workers.

• The World Health Organization later cited the programme as an influence on global primary healthcare and community health worker strategy

1980s · around 40 years ago

World Bank and IMF-mandated structural adjustment programmes weakened public health staffing across much of Africa

Public sector hiring freezes and wage caps imposed as conditions of international lending curbed government health budgets across many African countries, a period widely cited as contributing to the region's long-term shortage of doctors and nurses.

2006 · 20 years ago

World Health Organization defined health human resources and named them one of six core health system building blocks in the World Health Report 2006

The WHO's World Health Report 2006 defined health human resources as all people engaged in actions whose primary intent is to enhance positive health outcomes. It identified human resources for health as one of the six core building blocks of a health system, giving the field a shared conceptual framework for workforce planning and policy.

2006 · 20 years ago

World Health Organization estimated a global shortage of 4.3 million health workers

The WHO published a landmark estimate of a shortfall of almost 4.3 million physicians, midwives, nurses and support workers needed to meet the Millennium Development Goals, with sub-Saharan Africa worst affected. The figure raised the profile of health human resources as a global health concern.

2006 · 20 years ago

World Health Organization declared a global health workforce crisis on World Health Day

On World Health Day 2006 the situation was declared a health workforce crisis, attributed to decades of underinvestment in health worker education, training, wages, working environments and management. The declaration framed workforce capacity as a systemic failure rather than a local shortfall.

2025 · last year

US hospitals saw travel-nurse pay premiums ease from pandemic peaks

Staffing costs fell back from the extremes of the pandemic years, but chronic shortages persisted in rural areas and certain specialties, with a shortage of nursing faculty, rather than a lack of applicants, cited as a continuing bottleneck on training capacity.

2025 · last year

The United Kingdom moved to end overseas recruitment for some care and health support roles

An immigration white paper set out plans to stop recruiting from abroad for some lower-paid health and social care roles, following earlier increases to visa salary thresholds, prompting warnings from care providers already struggling to fill vacancies domestically.

2025 · last year

Rural clinics in China adopted AI-assisted diagnostic tools to extend scarce physician capacity

Hospitals in under-served counties expanded use of AI-supported screening for conditions such as diabetic retinopathy and certain cancers, intended to let a limited pool of specialists support far more patients than in-person consultation alone would allow.

2025 · last year

The World Health Organization kept flagging Africa's share of the global health workforce as far below its share of disease burden

Reporting under the health workforce support and safeguards framework continued to show the region with only a small fraction of the world's doctors and nurses relative to the scale of illness it manages, a mismatch the organisation said active international recruitment risked worsening.

• The WHO safeguards list named countries where active international recruitment was discouraged

2025 · last year

India kept expanding medical college capacity

Regulators continued approving new medical colleges and additional MBBS seats, particularly in government institutions, part of a sustained effort to raise the number of doctors trained domestically and narrow the gap with the World Health Organization's recommended workforce density.

2025 · last year

The Philippines kept losing large numbers of trained nurses to emigration despite retention incentives

Higher pay and clearer career paths in the United States, the Gulf, the United Kingdom and Germany continued to draw Filipino nurses abroad faster than domestic hospitals could replace them, even as government salary increases and return-service programmes tried to slow the outflow.

2024–2025 · last year

Healthcare workers in Gaza were killed and detained in unusually high numbers over the course of the conflict

The World Health Organization's tracking of attacks on healthcare described the toll among doctors, nurses and paramedics as among the highest recorded in any recent conflict, alongside repeated damage to hospitals that further reduced the territory's treatment capacity.

• Most hospitals in Gaza were left partially or fully out of service

2024–2025 · last year

The United States kept pressuring Cuba's medical mission programme

Visa and sanctions measures targeting officials linked to Cuba's overseas medical brigades continued, with Washington characterising aspects of the programme as exploitative, while Havana defended it as a major source of export earnings and medical diplomacy.

2024–2025 · last year

Saudi Arabia and the United Arab Emirates kept recruiting large numbers of foreign doctors and nurses

Hospital expansion tied to Vision 2030 and similar national strategies continued to depend heavily on healthcare workers recruited from India, the Philippines, Egypt and other countries, alongside slower-moving efforts to raise the share of citizens in clinical roles.

2024–2025 · last year

Nigeria continued debating mandatory service requirements for newly trained doctors

Proposals to require several years of domestic practice before doctors could obtain a licence to work abroad remained contentious, as medical associations warned such measures would not address the pay and working conditions driving emigration, widely described in Nigeria as the japa exodus.

• The United Kingdom and Gulf states continued actively recruiting Nigerian-trained doctors and nurses

2022 · 4 years ago

Study of physician pay documented a 24% gender pay gap among doctors

A 2022 study found that female doctors earn on average 24% less than their male colleagues. Alongside the finding that women form over 70% of the health workforce but held only 25% of leadership positions as of 2023, it highlighted structural inequities within health human resources.

2022 · 4 years ago

WHO poll found pandemic stress led 40% of health personnel to consider quitting

A WHO poll conducted in 2022 found that stress associated with the pandemic caused up to 40% of health personnel to consider leaving their jobs. The finding underlined retention as a central constraint on workforce capacity following Covid-19.

2010 · 16 years ago

WHO's 63rd World Health Assembly adopted the Global Code of Practice on the International Recruitment of Health Personnel

The World Health Assembly adopted the Global Code of Practice on the International Recruitment of Health Personnel, which became the main international policy framework for addressing shortages and maldistribution of health professionals. It governs how states recruit health workers across borders, constraining the drain of personnel from low-income countries.