Global trends and career development of human resources for paediatrics: a systematic review.

Authors

Xiaokang Yao, Zishuo Wang, Tao Xiong, Mingrui Tao, Xiaotian Hu

Published in

Journal of global health. Volume 16. Pages 04186. Jul 24, 2026. Epub Jul 24, 2026.

Abstract

The paediatric workforce plays a central role in health systems worldwide. National reports and studies have described its size and structure, as well as the retention of staff within the paediatric workforce. However, there have been few syntheses of empirical evidence examining workforce trends across career stages, and none have focused specifically on paediatric staff. We aimed to systematically synthesise evidence on the global trends of the availability, distribution, career progression, and differences across career stages among the paediatric workforce.
We searched CENTRAL, Embase, MEDLINE, and Scopus between 1 and 20 November 2025 for primary studies reporting on the above-mentioned trends within the paediatric workforce. We extracted and narratively synthesised the related data, and assessed the risk of bias of included studies using Joanna Briggs Institute tools.
We included 35 studies from high-income and upper-middle-income countries, with no low- or lower-middle-income countries being eligible. Workforce supply increased steadily over time in high-income countries, driven largely by subspecialty growth. However, geographic imbalances persisted, with low representation of paediatric staff in rural areas. In terms of career stage, early-career paediatricians reported higher workload burden, dissatisfaction, and career uncertainty compared with their senior counterparts. Women progressively came to account for most of the workforce, although men continued to predominate in leadership positions. Evidence from upper-middle-income countries focused primarily on training preparedness and early-career experiences.
Despite growth in the size of the paediatric workforce in high-income countries, challenges related to distribution, retention, and equity persist, particularly during early career stages. Importantly, the evidence base on this topic heavily underrepresents low- and lower-income countries. Future research should prioritise career-stage specific data to support equitable global workforce planning.
PROSPERO: CRD420261283831.

PMID:
42495734
Bibliographic data and abstract were imported from PubMed on 24 Jul 2026.

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