Lao PDR health center workforce survey : findings from a nationally-representative health center and health center worker survey

While on-track for child health and maternal health MDGs, Lao PDR continues to have some of the worst maternal and child health (MCH) outcomes, both globally and in the East Asia and Pacific (EAP) region. Under-five and infant mortality rates are high relative to GDP per capita, and utilization of essential health services is low, given significant demand-side barriers including physical access, cultural, and financial barriers. Furthermore, about a third of all children under-five remain underweight and almost half are stunted. Lao PDR is hence off-track on the nutrition-related MDG. In addition to poor aggregate measures, there are significant economic, urban rural, geographic, and ethnic group-related inequalities in health and nutrition outcomes. This policy note provides a snapshot of human resources for health (HRH) in health centers in the Lao People’s Democratic Republic (Lao PDR) based on an analysis of a health facility survey (the UFGE-CNP health center survey) that collected information from a nationally-representative sample of 120 public health centers (HCs) from 2013 to 2014. This survey was conducted as a baseline for health sector reform plans, to inform policymaking as Lao PDR scales-up programs to attain health-related MDGs, expand basic health services, and attain universal health coverage (UHC). This note complements a related health financing note which includes health center financing data from the same survey. Key findings from that note include low government health spending, associated with a high reliance on out-of-pocket (OOP) spending and external financing, which translates to underfunding of HCs (especially non-wage recurrent expenditure) and dependence on OOP revenue from revolving drug funds (RDFs).