Is World Health Organization(WHO)'s 1:1000 Doctor to Patient Ratio a Reality or Myth?

In 2022, Dr. Joe Phaahla disclosed that the patient-to-doctor ratio stood at 1:3198, notably higher than the World Health Organization's (WHO) suggested ratio of 1:1000. However, it appears that this "recommendation" cited by the minister may not actually be grounded in existing WHO guidelines, as reported by the Economic Web.

Minister Phaahla is not alone in endorsing these non-existent recommendations. In May 2018, Kenya’s health secretary, Sicily Kariuki, stated that a deal to hire specialist doctors from Cuba was "the first step" in fulfilling the "World Health Organization recommendation," referring to the doctor-to-patient ratio of 1:1000. Many of us have likely cited this ratio in numerous debates. In fact, if you tune into discussions about healthcare workers on TV or radio, you'll often hear mention of the "golden ratio" rule.

The quest for this elusive recommendation has been ongoing since at least 2017, yet it appears that no one has managed to locate its source. Perhaps it is buried within the extensive literature of the World Health Organization, but as of now, we are still awaiting its discovery.

They all attribute this to the World Health Organization, but the organization has denied ever making such a recommendation. Dr. Mathieu Boniol, a statistician general from the World Health Organization, outright denied that WHO has prescribed any ideal ratio when interviewed by AfricaCheck. He mentioned that while the WHO may have published some estimates, these were intended for research purposes or benchmarking. Additionally, Boniol emphasized that a country's number of healthcare workers should be tailored to its specific needs and the characteristics of its national health labor market.

https://africacheck.org/fact-checks/spotchecks/nonexistent-who-ratio-widely-quoted-uproar-over-nigerias-doctor-brain-drain

This reminds me of the famous "ten thousand hours" concept popularized by Malcolm Gladwell in his bestseller "The Tipping Point". This now debunked "rule" suggests that people need ten thousand hours of extensive training to master high-level skills. However, the scientists to whom this "rule" is attributed deny making such a claim. Nonetheless, an entire industry had already been built around the ten thousand-hour rule. Organizations embedded it into their training programs, providing them with a false sense of certainty.

There are many such rules, one being the "five-second rule," which suggests that food picked up from the floor within five seconds is safe for consumption. This notion has caused concern among food scientists because it can be potentially harmful. While some of these rules serve as handy shortcuts for us to remember certain things, creating policies based on them is cause for concern. Understaffing is a significant issue worldwide, and all efforts to address it should be welcomed, but shouldn't our approach be more fact-based? It appears that our policymakers are crafting policies based on non-existent recommendations.

The notion of a healthcare worker to population ratio seems to have emerged from the 2004 findings of the Joint Learning Initiative, a network of global health leaders supported by Harvard University. According to the report, a density of 2.5 workers per 1,000 people could potentially lower child and maternal mortality rates. However, it did not establish this as a universal healthcare staffing target.

The World Health Organization (WHO) itself compiles data on medical doctors per capita. However, it's important to note that they don't provide a single, recommended doctor to patient ratio.

Here's where you can find WHO's data on doctor availability:

• WHO Global Health Observatory data on medical doctors https://www.who.int/data/gho/data/indicators/indicator-details/GHO/medical-doctors-%28per-10-000-population%29

This resource offers insights into global doctor distribution and highlights disparities between regions.

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