National Health Workforce Accounts (NHWA) Resource pack for the WHO European Region (2019)

What is the NHWA?

The NHWA is a system by which countries can progressively improve the availability, quality and use of health workforce data. It comprises a set of 78 indicators that support effective monitoring, management and governance to deliver a transformed and effective health workforce within strengthened health systems.

The NHWA was developed in consultation with experts including academics, national health workforce and information systems specialists, policy planners, international organizations and health professionals.

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Why is the NHWA important in the European Region?

The health workforce has a critical role to play in tackling 21st-century health challenges related to demographic, epidemiological and technological changes, as well as those resulting from conflict and natural and human-made disasters. Health workers must be at the forefront of meeting these challenges, mitigating the effects of the social determinants of health, and providing health promotion, disease prevention and integrated people-centred health services across the delivery of care.

Effective health and care in the Region can only be achieved fully with a sustainable, resilient health workforce equipped with the knowledge, skills, values, ethics and behaviours to address existing, emerging and new health challenges. Planned investment in the health workforce is a key enabler for health system strengthening in the Region.

In 2017, the 67th session of the WHO Regional Committee for Europe adopted the resolution “Towards a sustainable health workforce in the WHO European Region: framework for action”, also referred to as the European Framework for Action. It translates and builds on the visions set out in the Global Strategy on Human Resources for Health: Workforce 2030 and by the United Nations High-Level Commission on Health Employment and Economic Growth.

The Framework for Action is grounded in the labour market framework approach. It sets out key strategic objectives for European Member States related to education and performance, planning and investment, capacity-building, and analysis and monitoring.

The success of all these strategies depends on evidence-informed national, regional and global policies, which in turn require rigorous data that can be analysed in terms of the health labour market framework for universal health coverage. As the NHWA is closely aligned with the health labour market framework, it provides the most comprehensive picture of the key health labour market domains (education and training, labour market dynamics, financing, governance and regulation).

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Who are the health workforce?

The Global Strategy on Human Resources for Health: Workforce 2030 and the European Framework for Action adopt a broad and inclusive definition of the health workforce. It covers all workers in health services, public health and related areas, and workers who provide support to these activities.

This broad scope usually includes, but is not limited to, health professionals, other health- and social-care workers, informal carers, support staff, administrators and managers. Such workers can operate in one or more environments, such as public health, primary and community care, long-term care, secondary and tertiary care, or in support functions.

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How can the NHWA assist European Member States to achieve national health policy objectives?

Information generated by the NHWA can assist Member States to develop health workforce policies, strategies and planning options to support the delivery of national health policy objectives. Progressive implementation of the NHWA will enable:

  • a better understanding of the health workforce, including its characteristics, size and distribution;
  • strengthened human resources information systems and research to guide policy decisions;
  • multistakeholder and intersectoral policy dialogue for health workforce strengthening; and
  • improved prioritization and planning of investment in the development of a sustainable health workforce towards universal health coverage.

WHO/Europe has prepared a series of policy scenarios to assist Member States in considering how the NHWA can support them to address health workforce challenges and to design health workforce policies and strategies. These are available in the resource pack below.

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How can European Member States implement the NHWA?

Implementation of the NHWA is a country-led activity. It builds on existing national systems and mechanisms to progressively improve country capacity to collect, analyse, use and report health workforce data to inform policy-making. It is a collaborative activity that brings together multiple stakeholders who should work closely with the nominated NHWA focal point.

WHO developed the NHWA Implementation Guide to help countries implement the NHWA in a sustainable manner. It proposes 8 nonsequential steps over 3 phases to strengthen health workforce data availability, quality and use.

To facilitate data gathering and use in a timely and effective manner, WHO also developed the NHWA online data platform. It enables countries to record, analyse and visualize health workforce information primarily for their own use.

In the European Region, health workforce information collected through the Organisation for Economic Co-operation and Development–Eurostat–WHO/Europe Joint Questionnaire on Non-Monetary Health Care Statistics is mirrored in the NHWA portal.

Member States can nominate NHWA focal points and request access to the data platform by contacting

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NHWA Links

More resources and videos are available here

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