Global Shortage of Health Workers: A Comparative Analysis of Workforce Strategies in Countries with Different Income Levels (2015–2025)

Introduction: Healthcare workforce provision has evolved from a national management issue into a persistent global challenge. According to WHO estimates, the overall shortage of healthcare workers could reach 11.1 million by 2030, with the bulk of this shortage occurring in low- and middle-income countries. At least 67 countries are at risk of not maintaining their current level of healthcare. Experts cite the aging workforce as a separate "hidden crisis": nearly one in four doctors worldwide is over 55 years old. Moreover, the response of healthcare systems to the shortage remains extremely uneven and is largely determined by a country's economic, regulatory, and educational resources. Objectives: To systematize and compare human resource strategies implemented in countries with different income levels between 2015 and 2025, identify measures with proven effectiveness, and determine the conditions under which the transfer of management practices between countries is appropriate or, conversely, counterproductive. Methods: The work was carried out in the format of an integrative literature review with elements of bibliometric analysis. The search was conducted in the scientific databases PubMed / MEDLINE, eLIBRARY.RU and CyberLeninka, Scopus, Web of Science, Cochrane Library, as well as repositories and official publications of the WHO, OECD, World Bank, and national ministries of health for the period 2015–2025. Search queries on the topics “health” were used «workforce shortage», «medical staffing», «retention of "physicians" "healthcare workforce," and "physician shortage." The review included original studies, systematic reviews, and reports containing quantitative indicators of workforce availability or assessments of the effectiveness of specific measures; publications without descriptions of methods and materials, as well as duplicate data, were excluded. Countries are grouped according to the World Bank classification; the analysis is comparative. Results: In high-income countries, the emphasis is on expanding enrollment in medical schools, accelerated programs for graduates from non-medical fields, delegating some medical functions to mid-level personnel and paramedics, developing telemedicine and flexible forms of employment that retain specialists with family responsibilities. These measures increase the capacity of the system but have a delayed effect and have little impact on the spatial distribution of doctors. In low- and middle-income countries, targeted training for rural areas, scholarships with mandatory work experience, material and housing incentives, as well as reliance on diaspora networks and international partnerships, were predominantly used. Their common constraint is financial dependence on donors and weak primary care infrastructure. A common problem for all groups is burnout and early retirement, as well as international migration, which redistributes but does not alleviate the global deficit. Conclusions: A successful HR policy requires a combination of measures for the "production," deployment, and retention of specialists, with a mandatory focus on the primary level; mechanically copying the solutions of wealthy countries under resource constraints is ineffective. The need for international agreements on ethical recruitment and national forecasting models of personnel needs is emphasized.