Abstract
This study reports the simulation results of area-based network allocations for the health workforce
in all hospitals under the Office of the Permanent Secretary of the Ministry of Public Health. The objective
was to understand the workforce shortage status and results from alternative network allocations
in the health regions to mitigate the shortage of health workforce.
As of September 1, 2019, the weighted shortage intensity index shows 31%, 29%, and 26% shortage
on average for nurses, dentists, and medical doctors. This study found 80% of hospitals had nurses,
dentists, and medical doctors less than the minimum manpower requirements. The weighted average
shortages of nurses were 68 per hospital, and shortages of doctors and dentists are 10 and 3 per hospital,
respectively. The total shortages were 16,000 nurses, 3,400 doctors, and 1,000 dentists. There was a
severe nurse shortage in sub-district health promoting hospitals and tertiary hospitals, but no shortage
at secondary-level hospitals. Furthermore, the medical doctor shortage was severe at the secondarylevel
hospitals.
The empirical results show that area-based healthcare networking within the same hospital level
could not mitigate the shortage due to high workforce scarcity. However, the networking of the primary-
level with the first-and middle-secondary-level hospitals in the same districts could alleviate the nurse
shortage. This decreased the weighted shortage intensity index for nurses from an average of 69% in the
primary hospitals (status quo) to an average of 25% (ex-ante). Similarly, the networking of middle and
high levels of hospitals at the provincial and regional levels could also alleviate the shortage in medical
doctors. However, the area-based networking alternatives could not mitigate the shortage in dentists and
pharmacists.
