Transforming Global Health Security to Prevent, Detect and Respond: A Systematic Review of Workforce Development Restricted; Files Only

Owusu Agyare, Bernard (Spring 2022)

Permanent URL:


Introduction: The COVID-19 pandemic has exposed deep cracks in the global health security architecture. Although the health workforce has a responsibility to prevent, detect and respond to health threats, workforce is usually insufficiently prepared and uncoordinated. This systematic review aims to examine the state of the global health security workforce, identify gaps in workforce development, and offers recommendations to transform global health security to effectively prevent, detect and respond to health threats.


Methods: The study searched PubMed™; Web of Science™; and ERIC™ databases for English-language literature on global health workforce development published between January 2000 and December 2021. Electronic searches for selected articles were supplemented by manual reference screening. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.


Results: Out of 1,437 citations retrieved from the electronic searches, 37 articles were included in the review. There is increased interest in health workforce development activities immediately after a global health event. National governments, the World Health Organization (WHO), and the United States Centers for Disease Control and Prevention (CDC) were identified as the major stakeholders in workforce development whereas Physicians, nurses, and epidemiologists were identified as key professionals responsible for maintaining global health security. There was no specific tool or framework for the enumeration of workforce to identify demand and supply projections. Blended learning (combining online and in-person instruction) was identified as the preferred training modality for workforce development.


Conclusion: Findings suggested that there was no clear definition for global health security and which professions should constitute the global health workforce among stakeholders. There was also little recognition from stakeholders in animal and environmental health which undermined the principles of One Health. The study also identified that most workforce development frameworks were vague on indicators and competencies expected of the different cadre of health workforce. There was a need for sustained investment in the global health workforce and enhanced collaboration between human, animal, and environmental health.

Table of Contents


Introduction 1

Background 2

Problem statement 5

Purpose statement 7

Research questions 8

Significance 8


Literature review 10

Pandemic and health threats prevention 10

Pandemic and health threats detection 11

Pandemic and health threats response 12

Existing global health security workforce development frameworks 13

IHR framework 14

WHO framework on Workforce Development 16

Global Health Security Agenda Framework 16

International organizations and national governments' commitment to workforce development 18

Contemporary issues and workforce development 19

Climate change 19

Biotechnology-synthetic biology 19

One Health 20

Negative influence of neocolonialism 20

Re-examine the health security workforce cadre 21

Strengthening global coordination and capabilities 21

Summary 21


Methods 23

Literature search strategy 23

Inclusion and Exclusion Criteria 24

Inclusion 24

Exclusion 25

Data collection and management 25

Data extraction 25

Data synthesis 26

Institutional Review Board (IRB) 26


Findings 27

Publications on Global Health Workforce Development 28

Existing frameworks for global health security workforce development 31

Key stakeholders identified for Global Health Workforce Development 35

Composition of global health security workforce 36

Key global health workforce 36

Monitoring global health workforce to anticipate demand 37

Global health workforce training modalities 40


Discussion 41

Publication trends on global health workforce development 41

Geo-distribution of source literature 41

Key stakeholders and existing frameworks 42

Composition of global health security workforce 44

Monitoring the global health workforce to anticipate demand 45

Global health workforce training modalities 45

Conclusion 46

Strengths and Limitations 47

Recommendations 48



PRISMA 2020 Checklist 60


About this Master's Thesis

Rights statement
  • Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.
  • English
Research Field
Committee Chair / Thesis Advisor
Last modified Preview image embargoed

Primary PDF

Supplemental Files