Critical unemployment or shortage of the health workforce in West Africa? Unravelling the health labour market puzzle in Guinea, 2024
8 affiliations
- 1Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
- 2Health Policy Unit, Department of Public Health, Institute of Tropical Medicine of Antwerp, Antwerp, Belgium
- 3Ministry of Health and Public Hygiene. Maferinyah National Training and Research Centre in Rural Health, Forécariah, Guinea
- 4African Centre of Excellence in the Prevention and Control of Communicable Diseases, University of Conakry, Conakry, Guinea
- 5International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
- 6Centre for Research in Health System Performance, Yong Loo Lin School of Medicine, National University of Singapore, city-state of Singapore, Singapore
- 7Health Equity Unit, Department of Public Health, Institute of Tropical Medicine of Antwerp, Antwerp, Belgium
- 8Institute for Global Health & Development, Queen Margaret University, Edinburgh, Scotland
Abstract
Introduction: The 2016 global strategy on health human resources highlights the health workforce as a cornerstone of sustainable and resilient health systems. Over the last decade, Guinea has launched great reforms to tackle critical health workforce challenges, including shortages and geographical imbalances. We undertook this study to understand the implications of these reforms on the availability, distribution, gender composition, and employment of the workforce in rural areas.
Methods: We conducted a health labour market analysis focusing on HRH data in two regions—N’zérékoré and Kindia—using mixed-methods approach. Data were collected from private and public health facilities and training institutions, complemented by policy documents and literature published between 2018 and 2024. The analysis focused on key indicators of workforce production, availability, distribution, employment and gender equity.
Results: In 2024, the two study regions reported 9,545 skilled health workers across ten health professions, predominantly state-registered nurses (36.7%), auxiliary nurses (29.7%), and midwives (17.8%), with medical doctors constituting only 4.4%. This reflects a density of 2.0 skilled health workers per 1,000 population in the regional health system—triple the official statistics of 2022. However, 61.2% of this workforce was concentrated in urban and peri-urban areas, serving 28% of the population. Health workforce density varied widely across districts, from 3.9 per 1,000 in N’zérékoré to 0.9 in Beyla. Despite increased production, local absorption and employment outcomes remain poor. Of the 21,208 health workers trained locally since 2016, only 23.7% were absorbed by the regional health system, and 64.1% remain unemployed. The overall health worker unemployment rate reached 74.8%, with nurses, midwives, and nurse-aides most affected. Gender disparities were also notable, as women make up 64.4% of the workforce, yet men disproportionately occupy higher-paying roles such as medical doctors, pharmacists, and managers, and represent 77.4% of specialists.
Conclusion: Guinea has made significant progress in skilled health workforce production and availability in rural regions. However, high unemployment and persistent gender inequities threaten the long-term sustainability of these gains. Addressing these challenges will require strengthening the health workforce reporting and financing systems.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12960-026-01087-7.
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BibTeX
@article{kolie2026critical,
title = {{Critical unemployment or shortage of the health workforce in West Africa? Unravelling the health labour market puzzle in Guinea, 2024}},
author = {Delphin Kolié and Remco Van De Pas and Josefien Van Olmen and Alexandre Delamou and Karina Kielmann and Wim Van Damme},
journal = {Human Resources for Health},
year = {2026},
month = aug,
doi = {10.1186/s12960-026-01087-7},
url = {https://doi.org/10.1186/s12960-026-01087-7},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Critical unemployment or shortage of the health workforce in West Africa? Unravelling the health labour market puzzle in Guinea, 2024
AU - Delphin Kolié
AU - Remco Van De Pas
AU - Josefien Van Olmen
AU - Alexandre Delamou
AU - Karina Kielmann
AU - Wim Van Damme
PY - 2026
DA - 2026/08/07
JO - Human Resources for Health
DO - 10.1186/s12960-026-01087-7
UR - https://doi.org/10.1186/s12960-026-01087-7
AB - Introduction: The 2016 global strategy on health human resources highlights the health workforce as a cornerstone of sustainable and resilient health systems. Over the last decade, Guinea has launched great reforms to tackle critical health workforce challenges, including shortages and geographical imbalances. We undertook this study to understand the implications of these reforms on the availability, distribution, gender composition, and employment of the workforce in rural areas. Methods: We conducted a health labour market analysis focusing on HRH data in two regions—N’zérékoré and Kindia—using mixed-methods approach. Data were collected from private and public health facilities and training institutions, complemented by policy documents and literature published between 2018 and 2024. The analysis focused on key indicators of workforce production, availability, distribution, employment and gender equity. Results: In 2024, the two study regions reported 9,545 skilled health workers across ten health professions, predominantly state-registered nurses (36.7%), auxiliary nurses (29.7%), and midwives (17.8%), with medical doctors constituting only 4.4%. This reflects a density of 2.0 skilled health workers per 1,000 population in the regional health system—triple the official statistics of 2022. However, 61.2% of this workforce was concentrated in urban and peri-urban areas, serving 28% of the population. Health workforce density varied widely across districts, from 3.9 per 1,000 in N’zérékoré to 0.9 in Beyla. Despite increased production, local absorption and employment outcomes remain poor. Of the 21,208 health workers trained locally since 2016, only 23.7% were absorbed by the regional health system, and 64.1% remain unemployed. The overall health worker unemployment rate reached 74.8%, with nurses, midwives, and nurse-aides most affected. Gender disparities were also notable, as women make up 64.4% of the workforce, yet men disproportionately occupy higher-paying roles such as medical doctors, pharmacists, and managers, and represent 77.4% of specialists. Conclusion: Guinea has made significant progress in skilled health workforce production and availability in rural regions. However, high unemployment and persistent gender inequities threaten the long-term sustainability of these gains. Addressing these challenges will require strengthening the health workforce reporting and financing systems. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12960-026-01087-7.
SN - 1478-4491
ER -