Regional Inequality in the Distribution of the Primary Health Care Workforce in Libya: A Gini Index and Lorenz Curve Analysis

Abstract

Background: Equitable distribution of the health workforce is fundamental to achieving Universal Health Coverage (UHC) and ensuring equitable access to quality health services. While Libya has invested substantially in expanding its health workforce over recent decades, evidence regarding the geographical equity of workforce distribution remains limited. Quantitative assessment of workforce inequality is essential for informing evidence-based human resource planning and strengthening the health system.
Objective: This study aimed to evaluate regional inequality in the distribution of the primary healthcare workforce across Libya using the Gini Index and Lorenz Curve and to identify professional categories requiring priority policy interventions.
Methods: A cross-sectional analytical study was conducted using national health workforce data obtained from the Health Information and Documentation Center (HIDC) of the Libyan Ministry of Health for 2023. Six professional categories were included: physicians, dentists, pharmacists, nurses, technicians, and administrative personnel. Regional inequality was quantified using the Gini Index and graphically illustrated through Lorenz Curves. Descriptive statistics were used to summarize workforce distribution across Libya's six geographical regions.
Results: Considerable geographical variation was observed among professional categories. Dentists exhibited the highest level of inequality (Gini = 0.534), followed by pharmacists (0.445) and technicians (0.419). Physicians demonstrated moderate inequality (0.387), while administrative staff showed relatively lower inequality (0.305). Nurses presented the most equitable regional distribution (0.269). Lorenz Curves confirmed substantial deviations from perfect equality for dentists, pharmacists, and technicians, whereas nurses showed only minimal deviation.
Conclusion: Although Libya possesses a relatively large health workforce, significant regional maldistribution persists, particularly among specialized health professionals. Routine monitoring using Gini Index and Lorenz Curve analysis should be integrated into national health workforce planning to promote equitable deployment and improve access to primary healthcare services.