African governments have agreed on a 10-year agenda to overhaul how the continent trains, deploys, and retains its health workforce. The agenda positions education reform, governance, and labour-market alignment at the centre of Africa’s health-system competitiveness, ahead of the agenda’s formal launch in 2026.
The scale of Africa’s healthcare worker problem is stark. WHO warns of a projected shortfall of 6.1 million health workers by 2030, even as the region’s headcount rose from 1.6 million in 2013 to 5.1 million in 2022.
The Agenda’s architects have framed the shortage as “a market and fiscal failure.” Needs-based modelling places required health workers at roughly 9.75 million in 2022, rising to more than 11.8 million by 2030.
“If we do not act boldly and collectively, the gap between what our health systems need and the workers available will only widen,” according to Dr Adelheid Onyango of WHO-AFRO, framing Pretoria as a hinge moment for investment and system reform.
The agenda’s five priorities include governance, modernised education, employment and retention, an investment charter, and labour-market intelligence, which were chosen to close the loop between training outputs and absorptive capacity. That loop is where most countries stumble; they can train graduates, but cannot always pay or deploy them.
According to sector analysts, the consensus signals a shift from “training for supply” to “training for service readiness.”
“This agenda is significant because it forces governments to confront the full chain, from training to employment to retention,” explained Charles Oluoch, the KMPDU regional lead for Western Region, in a virtual interview.
“We cannot keep graduating clinicians into unemployment or exporting them by default. If countries follow through on this framework, we can finally stabilise staffing, negotiate from a stronger fiscal position, and build working conditions that keep workers in the system.”
Africa’s brain-drain problem underscores the urgency of the problem. According to the National Health Institutes, over the last five years, more than 75,000 Nigerian nurses and midwives have migrated to countries such as the United States and the United Kingdom. At the same time, local population levels have risen sharply, intensifying continental demand.
According to WHO, the number of Ghanaian nurses seeking verification to practise abroad rose from 2,678 in 2020 to 6,208 in 2022, a 232% increase that signals sharply rising intent to emigrate.
fA recent study published in BMC Nursing, shows Kenya receives an average of 840 certificate-verification applications annually from nurses intending to migrate. While this is far below union estimates of several thousand departures each year, it still represents a significant drain on a health system already struggling to absorb new graduates.
In fact, WHO’s latest analysis estimates that eight of the world’s top 10 health-worker emigration hotspots are African countries, a trend that risks deepening shortages even as training numbers rise.
Yet even against this backdrop of rising shortages and migration, several countries are starting to show what course correction looks like.
Rwanda illustrates how digital learning can shift training capacity. The government, in May 2025, launched an AI-powered platform that replaces cascade, in-person training with a flipped-classroom model and real-time remote support for its 58,567 community health workers.
The platform integrates with the community electronic medical record system, using AI to flag cases, track CHW performance and recommend targeted refresher modules, a move designed to boost diagnostic accuracy and reduce supervision gaps.
“This capacity-building platform is a game-changer for Rwanda’s health system,” said Prof Claude Mambo Muvunyi, Director General of the Rwanda Biomedical Centre.
“By harnessing AI and digital tools, we’re ensuring CHWs have the support they need to save lives, efficiently, equitably and at scale.”
Nigeria is also advancing a sweeping set of nursing and midwifery reforms to strengthen frontline staffing. The new 2025–2030 Strategic Directions for Nursing and Midwifery expands school enrolment from 28,000 to 115,000 students, approves the recruitment of 20,000 health workers, 60% of them nurses and midwives, and introduces a national retention strategy to stabilise primary care. The plan’s six pillars cover education expansion, deployment and retention, regulation, leadership, data systems and service delivery.
According to Ministry officials, the framework is designed to fix uneven distribution and raise the quality of training.
“The strategy aims to boost training, strengthen regulation, and place qualified professionals where needed most,” said Prof Muhammad Ali Pate, Nigeria’s Coordinating Minister of Health.
The Nursing and Midwifery Council is also digitising accreditation and tightening standards, backed by WHO-supported investments in simulation labs, ICT equipment, and school accreditation systems.
South Africa is also pursuing a structural fix through its 2030 Human Resources for Health Strategy. According to the strategy, the National Department of Health will establish a permanent health‑workforce planning unit and a national stakeholder platform, the Health Workforce Consultative and Advisory Forum (HWCAF), to synchronise training, regulation, data, and budgeting.
The architecture aims to enable integrated planning across national, provincial, district, and facility levels and support a comprehensive health workforce information system.
The strategy highlights that nearly 97,000 additional health workers will be needed to achieve equitable distribution, including a significant number of community health workers.
According to Oluoch, if the Agenda succeeds, Africa stands to gain a more productive health workforce, lower service costs through task-sharing and digital support, and a measurable narrowing of the 6.1-million gap by 2030.
“If it falters, the cycle of training without hiring, and migration without retention, could deepen.”
“This agenda provides the roadmap. However, its impact will depend on the budgets and boards that carry it forward.”
bird story agency
