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Building a stronger health workforce

Efficiency review finds opportunity to double educational capacity while reducing per-student costs by 50 percent.


Our client, the health ministry of an African country, faced an ongoing shortage of trained health workers. This was one of the biggest obstacles to improving public health outcomes, particularly in remote areas of the country.

Over the course of 6 years, we had worked closely with the ministry on a series of projects: helping to identify the biggest opportunities for improved health outcomes, assessing the size of the health worker shortfall, and determining the level of investment required to address the issue. This work had resulted in a successful application for assistance from the UN Global Fund.

With funding in place, the government asked for McKinsey's help to assess what it would take to dramatically scale up the training capacity for healthcare workers and to double student intake to more than 10,000 annually.


The team conducted a first wave of assessments at nine campuses across the country. These institutions accounted for about 20 percent of the country's health worker training capacity and showed a representative range of opportunities and challenges.

The McKinsey team worked with local administrators and educators to identify practical steps to maximize training capacity, such as streamlining bottlenecks, undertaking facility reconfiguration or renovation, and making procurement improvements.

Ideas for how to increase capacity emerged. For example, with better facilities and additional support staff, tutors could teach twice as many students with no reduction in the quality of instruction. Both boosting the productivity of highly qualified educators and maximizing the use of existing clinicians in training could reduce per-student costs. Building new, larger classrooms would also allow schools to inexpensively convert older buildings into labs, libraries, IT centers, and other facilities.

The team also investigated campus classroom capacity and discovered further opportunities to increase capacity through facility sharing at a low cost. In one case, a health training school requiring additional classroom space found that a neighboring school had eight times more capacity than it needed. Sharing facilities enabled both schools to expand student intake.

Working in partnership with educators and administrators, the team developed detailed plans to dramatically increase training capacity at all nine campuses, including approaches that could also be applied across the system as a whole.


The plans met the government's target to double the number of health workers who could be trained per year. Increasing the utilization of existing facilities, making carefully targeted investments in new infrastructure, and increasing teacher support all factored into meeting the goal.

By increasing utilization and productivity, the plan would also reduce per-student costs by almost half—from $19,000 to $10,000—saving more than $90 million over the life of the expansion program.

McKinsey is also working with the ministry on an initiative to enhance the performance of its own organization. Efforts include creating a performance management unit to improve program management and implementation and a more decentralized accountability structure for schools management. This work will help the country keep the momentum in scaling up its health workforce.