There is a growing recognition that the increased demand for health services brought about by population growth, aging, and economic development is putting greater emphasis on how countries train, recruit, deploy, retain, and manage their health workforce. This has resulted in an unprecedented and much-needed focus on health workforce policy, planning, production, deployment, and ongoing professional development, while taking labour market factors into account. Low- and middle-income countries (L&MICs) must develop effective strategies to optimize health workforce supply while also supporting recruitment, deployment, retention, and performance in order to address their health workforce challenges. The challenge ahead is to decide on what to do and, more importantly, how to do it. This Chapter focuses on the use of labour market dynamics concepts and frameworks in developing policies and strategies to address the current workforce challenges in L&MICs.

The chapter analyses the 60-year evolution of the health workforce as it responded to the evolving demands of various branches of health service delivery. The analysis encompasses the limiting and enabling factors that determined the evolution of the profile of the health workforce. This includes societal education levels, economic growth, and demographic and population behavioural patterns, as well as macroeconomic and health policies. Included also is the influence of governance measures and leadership in shaping the key characteristics of the health workforce and, in turn, the influence of the competence and mobility of the health workforce on equitable access to healthcare services and the satisfaction of clients. The complex but iterative relationship between production and utilisation of the health workforce is explored.