The 4th progress report WHA75(14) on the WHO Code implementation noted that the negative health, economic and social impact of COVID-19, coupled with the increasing demand for health and care workers in high-income countries, might be increasing vulnerabilities within countries already suffering from low health workforce densities. Accordingly, the EAG was re-convened to review all countries with low workforce density to consider how COVID-related disruptions, particularly health-related vulnerabilities, might require the revision and extension of safeguards against active international recruitment.
Following the findings and recommendations of the EAG report, the WHO Secretariat prepared the Health workforce support and safeguards List (SSL), 2023. It comprises 55 countries, identified on the basis of the methodology advised by the EAG. These countries face the most pressing health workforce challenges related to Universal Health Coverage (UHC). In particular, these countries have 1) a density of doctors, nurses and midwives below the global median (i.e., 49 per 10,000 population) and 2) a UHC Service Coverage Index (SCI) below 55.
The indicators used to determine criteria to be in the SSL are the same as SSL 2020 but the threshold of UHC SCI has been increased from 50 to 55 to account for the disruptions in service delivery due to the COVID-19 pandemic because the updated data on the UHC SCI is not yet available. As a result, eight new countries have been in the SSL 2023 compared to SSL 2020.
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