4.G. Round table: Addressing health workforce challenges facing small countries to ensure health system sustainability
Year: 2025
Type: article
Abstract: The health workforce plays a critical role in achieving sustainable and resilient health systems, but small countries (with a population of under 2 million) face shortages in their health workforces triggering imbalances in the distribution of health workers across territories or specialisations. Small countries have a range of income levels that shape their ability to attract and retain health workers trained elsewhere to mitigate shortages, or to offer sufficiently competitive wages to retain those trained locally. However, due to their small population size, small countries share capacity constraints in providing sufficient domestic training opportunities for health workers and ensuring continuous professional development. This has implications for maintaining high standards of care, but also reinforces difficulties in retaining staff as it limits career development opportunities. In this session we will draw on the work of the WHO Regional Office for Europe Small Countries Initiative to outline the unique challenges these countries face in training, recruiting and retaining health workers. We will then highlight policy responses in four small countries. This workshop will provide a platform for sharing knowledge and building solidarity in health workforce planning across Europe. The objectives of the workshop are to i) highlight cross-cutting themes and approaches, and ii) establish opportunities for cross-country research and learning. The workshop will consist of four short presentations, followed by a broad discussion with audience interventions to bring in the experience of other countries. Each panel member will make a short presentation: firstly outlining transnational health workforce planning initiatives under the Small Countries Initiative, then moving to descriptions of health workforce challenges and recent policy innovations in, Cyprus, Luxembourg, North Macedonia and the Caribbean Netherlands respectively. Half the workshop will be dedicated to a moderated discussion encouraging participants to share experiences from their own country to emphasise the potential for cross-country learning - identifying those policy choices being developed specifically in small countries that nevertheless have relevance for the rest of Europe. Presentations on specific policy initiatives draw on the latest Health Systems Reviews for Cyprus, Luxembourg, North Macedonia and the Caribbean Netherlands. Health System Reviews are a core part of country monitoring undertaken by the European Observatory on Health Systems and Policies. These Reviews are routinely updated and provide a systematic description of the functioning of health systems in countries as well as reform and policy initiatives in progress or under development. As these are in-depth descriptions which detail the intricacies of health systems and an assessment of their performance, they provide the ideal basis for understanding the complex health workforce challenges small countries face. Key messages • Small countries face unique challenges in training, recruiting and retaining health workers and this undermines the sustainability of their health systems. • The workshop will identify themes and approaches to strengthening health workforce planning from a cross-country perspective that has resonance for countries of all sizes. Speakers/Panellists Natasha Azzopardi Muscat WHO, Msida, Malta Anne-Charlotte Lorcy National Health Observatory, Strassen, Luxembourg Gemma Williams European Observatory on Health Systems and Policies, London, UK Bernd Rechel European Observatory on Health Systems and Policies, London, UK Nathan Shuftan Berlin University of Technology, Berlin, Germany
Authors: Organised by: European Observatory on Health Systems and Policies, Chair persons: Erica Richardson (UK), Ewout Van Ginneken (Germany)
Language: English
Subfield: Emergency Medical Services
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,181
OpenAlex ID: W7101426686
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