International conference on Census microdata: findings and futures 1-3 September 2008 Manchester, United Kingdom Uses of census microdata for health workforce assessment in low and middle income countries Neeru Gupta Mario R. Dal Poz René Lavallée

Uses of census microdata for HRH assessment 2 |2 | Outline Objectives Data and methods Selected findings Next steps

Uses of census microdata for HRH assessment 3 |3 | Objectives Examine strengths and limitations of census microdata for human resources for health (HRH) assessment. Present findings from recent research on HRH metrics using microdata from the 2000 round of censuses for selected low & middle income countries. Explore opportunities for strengthening global health workforce analyses in the upcoming 2010 round.

Uses of census microdata for HRH assessment 4 |4 | Data and methods Source: Integrated Public Use Microdata Series (IPUMS)- International databank [ Methods: enumeration of all persons active in the labour force with a health-related occupation and/or working in the health services industry at the time of the census. Enhancing comparability: mapping to international standard classifications for social & economic statistics –Classification of occupations (ISCO) –Classification of education (ISCED) –Industrial classification of all economic activities (ISIC).

Uses of census microdata for HRH assessment 5 |5 | Selected findings Density of workers with a health occupation, selected countries (around 2000)

Uses of census microdata for HRH assessment 6 |6 | Selected findings Skills mix of the health workforce, selected countries (around 2000)

Uses of census microdata for HRH assessment 7 |7 | Selected findings Geographical imbalances in the health workforce – Mexico (2000) and Viet Nam (1999) Gupta N, et al.: Uses of population census data for monitoring geographical imbalance in the health workforce, International Journal for Equity in Health, 2003, 2:11 [

Uses of census microdata for HRH assessment 8 |8 | Selected findings Gender imbalances in the health workforce, selected countries (around 2000) Lavallee R, Hanvoravongchai P: Uses of population census data for gender analysis of the health workforce, Handbook on monitoring and evaluation of human resources for health [WHO, World Bank & USAID, forthcoming].

Uses of census microdata for HRH assessment 9 |9 | Selected findings Relationship between gender ratio in tertiary level educational attainment and health professional work activity, selected countries (around 2000)

Uses of census microdata for HRH assessment 10 | Conclusions and next steps Strengths of census data: –Full enumeration of HRH stock (public/private, health services/ other, employed/unemployed, …); –Disaggregation by sex & other characteristics of health workers. Limitations: periodicity; content; access to - and use of - microdata for health systems research. "Wish list" for public use microdata samples: data on occupation, place of work & field of advanced education disaggregated to lowest level.

Uses of census microdata for HRH assessment 11 | Next steps Ongoing feeding of the Global Atlas of the Health Workforce [ as new census microdata releases become available. Technical consultations with countries and partners to optimize census uses for HRH assessment in the upcoming 2010 round (e.g. Handbook on monitoring and evaluation of HRH, with special applications in low and middle income countries).