Examining the supply and need of health workforce in Ethiopia: A foundation for strategic investment in human resources for health

We conducted a Health Labour Market Analysis (HLMA) to evaluate the alignment of health workforce supply with population health needs and fiscal sustainability through 2030. A quantitative study design using secondary data was based on the World Health Organization (WHO) HLMA Framework and the 2021 WHO HLMA Guidebook. Quantitative data were gathered from the Human Resources Information System (HRIS), professional associations, training institutions, and national accounts, supplemented by grey literature and stakeholder consultations. Workforce supply and demand projections for 2024–2030 considered an attrition rate of 3.5%, a 20% unemployment rate for new graduates, and an 80% absorption rate. Financial analyses were aligned with Gross Dometic Product (GDP) and fiscal projections from the World Bank, International Monetary Fund (IMF), and the National Bank of Ethiopia. Data quality assurance included multi-level validation using a standardized Ministry of Health (MOH) tool, with outlier checks and stakeholder verification. The supply of health professionals is projected to increase steadily, reaching approximately 74,693 nurses, 30,980 midwives, and 25,576 general practitioners by 2030. Despite these gains, significant shortages persist relative to Essential Health Services Package (EHSP)–based requirements, particularly among medical specialists, nurses, anesthetists, and laboratory professionals. Financial analysis indicates that cumulative fiscal space is projected at USD 945 million by 2030, while the cost of employing the available workforce is estimated at USD 1.08 billion, and the EHSP-aligned requirement at USD 1.8 billion. This results in an annual financing gap of USD 20–30 million for workforce absorption and over USD 800 million relative to service needs. Ethiopia's HLMA highlights gaps between workforce supply, health needs, and fiscal capacity. Despite an increase in graduates, unemployment persists. Improving Human Resource for Health (HRH) governance, expanding fiscal resources, and ensuring fair deployment are vital for effective workforce utilization and advancing universal health coverage.