The Pan American Health Organization (PAHO) warned on April 29, 2026 that critical inequalities persist in the availability and distribution of health personnel across nine South American countries, with workers concentrated in capitals and large cities while rural and underserved areas face shortages, according to a press release by PAHO. The findings appear in a new regional report offering the first comparative overview of the subregion’s health labor market. PAHO called for strengthening training, retention, and working conditions for health personnel. The gaps directly affect the availability of specialists and the continuity of services. The report frames the issue as central to advancing equitable health systems.
The report, titled “Overview of the health labor market in nine South American countries,” analyzes Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, and Uruguay. It examines the main inequalities shaping how health systems function in the subregion. Human resources for health densities range widely, from fewer than 40 professionals per 10,000 inhabitants in some contexts to nearly 118 in others. The analysis highlights regional asymmetries between and within countries. It pays particular attention to the primary care level.
Common challenges identified across the nine countries include an increasing number of professionals holding multiple jobs, migration of health personnel, concentration in urban areas, misalignment between educational supply and health system needs, and marked differences in working conditions between sectors and territories. Bolivia concentrates 73% of health personnel in three departments, while Peru concentrates 85% of personnel in urban areas and has an estimated shortage of more than 54,000 health workers. Argentina shows a strong concentration of doctors in Buenos Aires and growing gaps in residency programs. Brazil reports lower availability in the north and northeast. Chile reports a shortage of specialists and difficulties filling vacancies in remote areas.
Country-specific findings also show that Colombia presents marked territorial gaps and an educational supply concentrated in large cities, Ecuador faces high turnover in remote areas and concentration of personnel in Quito, Guayaquil, and Cuenca, Paraguay maintains unfilled vacancies in the public sector and low training in family medicine, and Uruguay shows high concentration in Montevideo with wage differences between sectors.
“The region will not be able to move toward more equitable health systems if gaps in availability, distribution, and working conditions of health personnel are not addressed,” said Dr. Jarbas Barbosa, PAHO Director.
He added that the report provides key evidence to guide public policy decisions. James Fitzgerald, Director of Health Systems and Services at PAHO, stressed the need for stronger information systems. He called for comprehensive policies covering training, hiring, distribution, and retention.
PAHO urged governments to invest in training and retaining health personnel, improve working conditions, and strengthen workforce planning, with special attention to primary care and areas with the greatest needs. The report also underscores the importance of coordinating actions between the health, education, and finance sectors. It promotes ethical migration policies that protect both health workers and health systems. Five years before the deadline for achieving the Sustainable Development Goals (SDGs), PAHO reaffirmed that placing health personnel at the center of public policy decisions is key to advancing toward universal health coverage. The organization positions the workforce as central to regional progress.
