Health Workers & Training

Skilled, supported health workers are the engine of a strong health system – but Africa is facing an acute shortage of health personnel. Amref Health Africa is working to change that.

The Challenge

Africa currently faces a critical shortage of health workers. The continent carries a quarter of the global disease burden – but is home to only 3% of the world’s health workforce.

The WHO recommends a minimum of 4.45 doctors, nurses and midwives for every 1,000 members of the population. Only one country in sub-Saharan Africa currently meets this target. In fact, each health worker on the African continent cares for an average of 635 people.

The shortage – most acute in rural areas – is expected to reach 6 million by 2030. One of the most urgent gaps is in the ‘missing middle’: the nurses, midwives, and clinical officers who deliver primary care at community level.

The problem is compounded by a lack of accessible, affordable training opportunities, as well as tough working conditions and low pay. Higher education and vocational training are out of reach for many of the people most motivated to serve — especially those from rural or underserved areas. Young women are disproportionately excluded from health education and deprived of the chance to sit at the table where decisions are made.

Every missing health worker means hundreds – or even thousands – of people going without the care they need and deserve.

Did you know?

Each health worker on the African continent cares for an average of 635 people.

According to the World Bank, in 2022, there were 4.5 physicians and 18.8 nurses and midwives for every 1,000 people living in Switzerland.

The same year, there were 0.3 physicians for every 1,000 people living in Kenya, 0.2 physicians for every 1,000 people living in Uganda, and fewer than 0.1 physicians for every 1,000 people living in South Sudan.

A 2022 WHO study found that the European region had 3.4 million medical doctors and 7.4 million nurses. Comparatively, the African region had around 300,000 doctors and 1.2 million nurses.

Our Solution

In response to these pressing challenges, Amref Health Africa:

Trains health workers at all levels of the health system, with a particular focus on the ‘missing middle’: the nurses, midwives, and clinical officers who deliver primary care at community level.

Develops innovative and tailored mobile and e-learning solutions that mean health workers don’t have to time to take time away from work as they build their skills.

Advocates for the recognition and remuneration of Community Health Workers, who in so many countries are the link between a community and the formal health system: yet at the moment, only 14% of them are paid.

Advocates for improved working conditions and increased investment in training opportunities.

Equips policy-makers and training institutions to prevent, prepare for, manage, and contain disease outbreaks like mpox, COVID-19, and Ebola: all of which has an impact on global health security.

Supports Ministries of Health with training in leadership and governance as well as technical support with data collection and management.

Ensures health workers’ perspectives are reflected in policy-making and budget allocation.

Runs a world-class health sciences university, Amref International University (AMIU), attracting students from across the continent – 90% of whom stay in Africa after graduation.

Amref works to ensure that Africa’s health workforce is trained, equipped, supported, recognised, and paid for the work they do to serve their unique communities. With every additional trained health worker, we close the gap between people and the health services that they need.

“Training one nurse has a huge impact because of the number of people they are able to reach – and, crucially, the number of diseases they are able to prevent. Indeed, a well-functioning Primary Health Care system can meet 80% of a community’s needs.”

Dr George Kimathi, Director, Institute of Capacity Development (ICD), Amref Health Africa

Our impact

In 2025, with your support, Amref Health Africa:

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Amref Health Africa trained a total of health workers

of them were community-based, and 30,393 were facility-based

More than students from across the continent were enrolled at Amref International University (AMIU)

First-person: Lawrencia, trainee midwife, South Sudan

At independence in 2011, South Sudan had the world’s highest maternal mortality rate – and was home to fewer than 10 trained midwives.

Although the country has made huge strides since then, progress has not kept pace with trends across the region, and South Sudan remains one of the most dangerous places in the world to be pregnant. Just 19% of births take place with skilled medical support.

Maridi Health Sciences Institute, near the border with the Democratic Republic of the Congo, has been training midwives since 2008. Lawrencia Emmanuel is part of the school’s most recent intake: the first that has been eligible for scholarships from Amref International University (AMIU).

“If they train me, as one person […] if I go back, I will train more. Because in a hospital someone cannot work alone: you work together […] So if they train me, I will also train my people.”

Hear more from Lawrencia

Note: Amref Health Africa has had a constant presence in South Sudan for more than 50 years. Our work there began long before it achieved independence from Sudan in 2011, following a referendum held in 2009. 2026 will see the country mark 15 years of independence amidst conflict and an acute hunger crisis, both of which are putting huge pressure on an already-fragile health system.

Donate today to train more life-savers like Lawrencia

4,000 CHF fully funds one year of an Amref International University (AMIU) student’s education

16,000 CHF fully funds one student’s four-year education at AMIU