Not enough and too many: professional personhood among Africa's paradoxically surplus health workers

By 2030, it is anticipated that Africa will face a shortage of nearly 6.1 million health workers. Simultaneously, approximately 700,000 health workers on the continent are expected to be without formal employment. Under current projections, this paradoxical surplus of health workers will comprise almost a quarter of Africa’s health workforce. "Not Enough and Too Many" is a bold mixed-methods study across West, East and Southern Africa. It asks: what are the global, national and local contingencies that have led to this paradoxical surplus; what are the consequences for individuals and services; and how can we enable the incorporation of this surplus into health systems? Drawing together scholars and methods from anthropology and public health, we will explore how unemployment, underemployment and precarious employment among health workers intersects with personhood and socio-economic relations; map the informal livelihood opportunities offered by pluralistic health systems; and examine the political economy underpinning policy on health worker employment in Uganda, Nigeria and Zambia. Our ultimate goals are to change narratives so that the paradoxical surplus of health workers takes its place as a critical issue in global health, and to support collaborations between academics, policy-makers, activists and health workers to reverse the trend.