The trend in density of skilled health personnel in BRICS countries: Implication for China and India

Objective: The similarities and differences in workforce trends in BRICS (Brazil, Russia, India, China, and South Africa) may offer reciprocal lessons for emerging economies. Methods: We used the Global Health Observatory data to assess the secular trends between 2001 and 2017 in the number of skilled health personnel (SHP: doctors, nurses/midwives) in BRICS compared to the average of Organization for Economic Co-operation and Development (OECD) countries. Results: Substantial efforts have been made in BRICS to increase SHP availability, as demonstrated by an average exponential growth rate (AEGR) > 0.03 in Brazil, China, and India compared to 0.01 in OECD. With an AEGR as high as 0.07 after 2008, China reached the level of SHP availability commensurate with the sustainable development goals (SDGs) in 2017. Other than China, BRICS countries had a mean number of nurses and midwives per doctor between 2001 and 2017 higher than or comparable to the OECD average (2.78). The corresponding number in China was 1.04 in 2017, lower than 2.21 in India in 2001. Conclusions: With China as the exception, BRICS countries maintained a sustainable skills mix of SHPs. China reached the level of SHP availability commensurate with the SDGs, but SHP's skill mix was imbalanced.