globally, Iraq (1.03 PMP), and West Bank and Gaza (2.15 PMP) reported the lowest densities of nephrologists in the region, while Oman (30.42 PMP), Lebanon (22.64 PMP), and Saudi Arabia (17.66 PMP) reported the highest (Supplementary Figure S1). In the newly independent states (NIS) and Russia ISN region, countries overall reported a high density (15.68 PMP) of nephrologists (Table 1). Kazakhstan (5.51 PMP) and Armenia (8.18 PMP) reported the lowest densities of nephrologists in the region, while Georgia (23.32 PMP) and Belarus (20.86 PMP) reported the highest (Supplementary Figure S1). In the South Asia ISN region, countries overall reported the lowest density (1.17 PMP) of nephrologists globally (Table 1). Within the region, Bangladesh (0.65 PMP) and Sri Lanka (0.91 PMP) reported the lowest densities of nephrologists, while Pakistan (2.51 PMP) and India (1.04 PMP) reTable 1 | Density of nephrologists and nephrology trainees and shortage in nephrology care providers in 121 countries Region/group ported the highest (Supplementary Figure S1). Total number PMPa Shortage in workforce components (n [%]b ) Nephrologists Nephrology trainees Nephrologists Dietitians Renal pathologists Laboratory technicians Social workers Pharmacists Vascular access coordinators Nurse practitioners Counselors/ psychologists Transplant coordinators Dialysis nurses Dialysis technicians Primary care physicians OveInternational Society of Nephrology; NIS, newly independent states; PMP, per million population. aPMP density of nephrologists and nephrology trainees calculated by taking the median of absolute number of nephrologists and/or nephrology trainees provided by each country respondents, divided by country’s population in millions. bPercentages calculated as the number of responding countries divided by the total number of responding countries, overall and by region. review MA Osman et al.: Health workforce for nephrology care: existing manpower and training capacity 54 Kidney International Sup1 High income Upper middle income Lower middle income Low income c d b Figure 1 | (a) Global distribution of density of nephrologists per million population (PMP) from 121 countries. (b) Countries with the lowest and highest density of nephrologists PMP from 121 countries. (c) Density of nephrologists PMP from 121 countries grouped by International Society of Nephrology region. (d) Density of nephrologists PMP from 121 countries grouped by World Bank income group. Adapted with permission from Bello AK, Levin A, Tonelli M, et al. Assessment of global kidney health care status. JAMA. 2017;317:1864–1881.22 Copyright ª American Medical Association. MA Osman et al.: Health workforce for nephrology care: existing manpower and training capacity review Kidney International Supplements (2018) 8, 52–63 55 Structure of nephrology training by ISN region Availability of nephrology training program by ISN region 0 10 20 30 40 50 60 70 80 90 100 Low income Lower middle income Upper