The association between density of human resources for health and the burden of non-communicable diseases: a panel data analysis of 162 countries

Non-communicable diseases (NCDs) have increasingly become a significant global public health challenge and a leading cause of premature death. Research has shown that a higher density of healthcare workers can reduce the overall burden of disease. This study explores the association between the density of human resources for health (HRH) and the burden of NCDs. We utilized the data on disability-adjusted life years (DALYs) for NCDs from 2010 to 2019 in the 2019 Global Burden of Disease Database (GBD) provided by the Institute for Health Metrics and Evaluation (IHME). Meanwhile, data from the World Health Organization (WHO) regarding the number of medical doctors, nursing and midwifery personnel, and pharmaceutical personnel (per 10,000 population) over the same period was also available. Covariates were sourced from the World Bank Database. We analyzed the association between the density of health human resources and DALYs for NCDs based on ordinary least squares (OLS) regression and panel regression models. Additionally, we examined the correlation between human resource density for health and the burden of NCDs across countries with different income levels to assess heterogeneity. The density of medical doctors (coefficient = -4.543, P < 0.001) and pharmaceutical personnel (coefficient = -8.721, P < 0.001) was found to be negatively correlated with the burden of NCDs. An increase of one point in the density of medical doctors per 10,000 population will, on average, reduce the burden of NCDs by 4.543 points (95% CI: -6.212, 2.874). Additionally, each increase of one point in the density of pharmaceutical personnel per 10,000 population will decrease the burden of NCDs by 8.721 points (95% CI: -13.265, 4.177). Heterogeneity analysis revealed that medical doctor density is negatively associated with the burden of NCDs across all countries ( P < 0.001). Pharmaceutical personnel density is negatively associated with NCD burden in high-income countries ( P < 0.05). Nursing and midwifery personnel density is negatively associated with NCD burden in low- and lower-middle-income countries ( P < 0.05). The density of HRH plays a crucial role in mitigating the burden of NCDs. However, countries globally generally face the challenges of uneven distribution and unbalanced development of HRH. Nations should prioritize the training of medical doctors and pharmacists, and increase the density of nurses and midwives in low and lower-middle-income countries. These measures are key to achieving universal health coverage (UHC).