Global Review of 96 Health Workforce Planning Tools Finds No Single Best Model

Health systems around the world live and die by their workforce. Doctors, nurses, midwives, community health workers and countless other staff are the machinery through which every policy, budget line and clinical guideline ultimately passes, and when the numbers of these workers are misjudged the consequences are measured in waiting lists, burnout and preventable deaths. Yet despite decades of attention, many countries still struggle with a deceptively simple question: how many health workers of which kinds do we need, where, and doing what? A new systematic review published in BMC Health Services Research by a team led by Gail Tomblin Murphy of Dalhousie University’s WHO/PAHO Collaborating Centre on Health Workforce Planning and Research, working with colleagues at the World Health Organization and Nova Scotia Health, takes the most comprehensive look yet at the tools designed to answer that question, and its findings are both encouraging and sobering.

The research was commissioned to inform the World Health Organization’s efforts to develop a practical toolkit for human resources for health planning, often abbreviated as HRH planning. The stakes are considerable. Effective planning ensures a balance between the workforce and patient needs, optimizing both the quality of care and the job satisfaction of health and care workers. A diverse mix of approaches and methodologies tailored to different health-system contexts has been developed over the years, but the authors note that many health systems have simply not implemented them effectively. The gap between what the planning literature offers and what ministries of health actually use has persisted through pandemics, economic shocks and sweeping health reforms, and closing it requires knowing precisely what tools exist, what they demand of their users and where their blind spots lie.

To map that landscape, the team employed a rapid review methodology, a streamlined form of systematic review designed to deliver rigorous evidence under time constraints. Working in consultation with experienced library scientists, the researchers developed both a database search strategy and a targeted grey literature search strategy, the latter capturing reports, manuals and working papers that never appear in peer-reviewed journals but often document the real-world use of planning models. Only documents written in English or French were included, and each source was carefully screened against explicit inclusion criteria. Relevant articles were then extracted, and the resulting data were used to classify the tools into distinct planning approaches, such as needs-based models, and to rate them along five domains: accessibility, capacity, adaptability, usability and applicability.

The scale of the resulting inventory is striking. From 123 articles that passed screening, the team identified a total of 96 distinct planning tools that have been applied across 184 countries. That figure alone tells a story: workforce planning is not a niche technical exercise but a genuinely global undertaking, with tools deployed in high-income countries and low- and middle-income countries alike. The tools were classified into eight planning approaches and assessed against ten criteria spanning the five assessment domains. Among the well-known models captured in the review are the Workload Indicators for Staffing Need method, widely used to translate service workload into staffing requirements, and Health Labour Market Analysis, which examines the supply of and demand for health workers as an economic system rather than a static headcount.

The headline finding, however, is a negative one: no tool received a high score across all assessment criteria. Every instrument in the review, no matter how sophisticated or widely adopted, carries trade-offs. Some models that excel at projecting future requirements demand granular, disaggregated data that many countries cannot readily produce. Others are easy to use but too rigid to adapt to different epidemiological profiles, service delivery models or professional mixes. The review also found no consensus, either within the review itself or among the broader HRH community, on a single best planning tool. This absence of a clear winner is not a failure of the field so much as a reflection of the diversity of contexts in which planning takes place; a tool calibrated for a data-rich national health service may be poorly matched to a decentralized system with fragmented information systems.

Still, the analysis did identify a small group of standouts. Four tools received high ratings on five key criteria: capacity for multi-professional and scenario-based planning, opportunity to engage stakeholders, adaptability across settings, and utility of results. These are exactly the qualities planners prize. Multi-professional capacity means a model can account for the full team, from physicians to community health aides, rather than optimizing one cadre in isolation. Scenario-based planning allows users to test how demographic change, task-shifting or new treatment guidelines might alter future requirements. Stakeholder engagement ensures that the people who must implement the resulting plans, including professional associations, educators and service managers, have a voice in the assumptions that drive the numbers. And adaptability determines whether a tool built in one country can be meaningfully applied in another with a very different disease burden and resource base.

Yet even these top performers come with caveats that matter enormously for real-world uptake. The four leading models require moderate user capacity and substantial data, necessitating disaggregate data for model operation and some prior knowledge of HRH planning from the user. In practice, this means the tools most likely to produce useful, credible results are also the tools most likely to stall in settings where workforce information systems are weak or where planning expertise is concentrated in a handful of national officials. The review’s authors are candid about this tension, and it shapes their central recommendation: the value of the project depends greatly on the WHO’s complementary capacity-building initiatives, which they describe as essential for real-world uptake by countries. A toolkit, in other words, cannot simply be published and downloaded; it must be accompanied by training, data-system investment and sustained technical support.

The technical details of the assessment framework deserve attention from anyone who plans or evaluates planning tools. By rating each instrument on ten criteria across the five domains of accessibility, capacity, adaptability, usability and applicability, the review creates a common vocabulary for comparing tools that were previously described in incompatible ways. Accessibility speaks to how easily a country can obtain and license the tool. Capacity captures the skills and data the user must bring. Adaptability measures how well the model can be reconfigured for new contexts. Usability reflects the learning curve and the clarity of documentation. Applicability, perhaps the most consequential criterion, asks whether the outputs are actually useful for decision-making. This structure allows the forthcoming WHO toolkit to guide users toward tools matched to their own capacity and data realities rather than toward a one-size-fits-all recommendation that the evidence does not support.

The timing of the review is significant. Health workforces worldwide emerged from the COVID-19 pandemic depleted and demoralized, with the WHO and its member states confronting projected shortfalls of millions of health and care workers concentrated disproportionately in low- and middle-income countries. Planning tools are among the few levers that can turn anxiety about shortages into concrete strategies for education, recruitment, retention and deployment. By cataloguing 96 tools and their applications across 184 countries, the review provides an evidence base for countries seeking to expand beyond their traditional planning processes and work towards sustained improvements in their health systems, as the authors put it. It also signals a shift in emphasis at the global level: from producing yet another planning model to curating, assessing and supporting the use of the many models that already exist.

For health planners, the practical message is to start from an honest appraisal of local data and capacity before selecting a tool, to favour models that support multi-professional, scenario-based planning and stakeholder engagement where capacity permits, and to pair any tool with the training and data investments it requires. For researchers, the review exposes persistent gaps, including the lack of consensus on best practice and the untested assumption that high-scoring tools translate into better workforce outcomes on the ground. For the WHO, the findings set a clear specification for the guidance toolkit now under development: it must help countries match tools to context, build the user capacity those tools demand, and integrate planning into the routine machinery of health-system governance. The full open-access article, published on 6 October 2026 in BMC Health Services Research, offers the detailed assessments that will underpin that work.

Subject of Research: Systematic review of human resources for health planning tools to inform WHO guidance for health workforce planning

Article Title: A comprehensive review and analysis of human resources for health planning tools to inform the development of a guidance toolkit for HRH planning

Article References: Tomblin Murphy, G., Sampalli, T., Diallo, K., Chamberland-Rowe, C., Nair, T. S., Lawrence, L., Murdoch, J., Kunjumen, T., Boniol, M., Rigby, J., MacInnis, M., & Murphy-Boyle, K. (2026). A comprehensive review and analysis of human resources for health planning tools to inform the development of a guidance toolkit for HRH planning. BMC Health Services Research. https://doi.org/10.1186/s12913-026-14326-3

Image Credits: AI Generated

DOI: 10.1186/s12913-026-14326-3

Keywords: health workforce, human resources for health, HRH planning, systematic review, World Health Organization, planning tools, health systems, workforce planning, rapid review, health policy, capacity building, BMC Health Services Research