Retention

This paper examines the employment preferences of public sector registered nurses working in Malawi and identifies the range and relative importance of the factors that affect their motivation. The research was designed in the light of the Malawi government’s programme to address the shortage of health workers, which is based on salary top-ups as a means of increasing employee motivation and reducing high rates of attrition. This policy has been adopted despite relatively little quantitative exploration into the employment preferences of health workers in developing countries. This study aims to provide a clearer picture of the preferences of registered nurses about different aspects of their employment, and the factors that might persuade them to continue in the profession within their home country.

This paper focuses on the scheme by the Malawi Ministry of Health (MOH) to retain nurse tutors in collaboration with the Christian Health Association of Malawi (CHAM). It chronicles the scheme's successful elements for purposes of eventual replication, suggests how to address some of the challenges and identifies effective incentives, including salary supplements. [from executive summary]

The NSW Department of Health is responsible for managing nurse supply. It needs to identify the extent and nature of shortages and develop ways to attract, retain and best manage nurses working in public hospitals. This audit looks at how nurses are managed in four of our public hospitals and examines how the Department has responded to expected nurse shortages. It also highlights actions that have helped reduce the number of nurses leaving hospitals. [from foreword]

This paper examines the experience with using various incentives to motivate and retain community health workers (CHWs) serving primarily as volunteers in child health and nutrition programs in developing countries.

This presentation was part of the ECSA Workforce Observatory Meeting in Arusha. It describes an incentive scheme to help retain certain critical staff in the rural areas and to attract health workers to areas with inadequate staff.
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This paper addresses the problem of wastage of the qualified labor force, which takes place both during the education process and when trained personnel try to find jobs in the local market. Reducing wastage at both the educational and labor levels should improve the capacity of social investment, thereby increasing the capacity of the health system as a whole to provide services, particularly to those populations who are most in need. [from abstract]

Beginning in 1992, JHPIEGO worked in close collaboration with the Bolivia Ministry of Health (MOH) to develop an integrated family planning/reproductive health (FP/RH) training network throughout the country. The focus of the assistance was the establishment of nine national training centers (NTCs) for inservice training conducted by physician-nurse teams and located at departmental maternity hospitals in departmental capitals. By 2000, the government of Bolivia and other stakeholders had shifted the training emphasis to preservice education efforts. JHPIEGO preservice assistance focused on improving FP/RH education in three medical and nine nursing schools, and the role of the training teams at the NTCs moved toward supporting the preservice education efforts.

The availability of medical human resource supply is a growing concern for rural and remote communities in many countries. In the last decade, various telehealth experiences in Canada have highlighted the potential impact of this technology on professional practice. The purpose of this study was to explore physicians' and managers' perceptions regarding the potential of telehealth to support recruitment and retention of physicians in remote and rural regions. [abstract]

The hypothesis of this study is that workers in the health service with low level or no qualifications are more easily retained in jobs in remote rural areas, and that many are already providing health services above the level detailed in job descriptions or other work guidelines. The aim of the study is therefore to identify the most suitable group(s) of health workers for the provision of community health services in remote rural areas using case studies in remote locations of Malawi and South Africa. [from abstract]

This report is the result of a two-year project. The aim of the project was to examine the crucial issue of nursing shortages and identify priority areas for intervention. Five priority areas of intervention for ICN and nursing were identified: Macroeconomic and health sector funding policies; Workforce policy and planning, including regulation; Positive practice environments and organisational performance; Recruitment and retention, addressing in-country maldistribution, and out-migration; and Nursing leadership.

Against the backdrop of growing concern about shortages of health personnel, the report focuses on one of the most critical components of the workforce – nurses. Nurses are the "front line" staff in most health systems, and their contribution is recognised as essential to meeting these development goals and delivering safe and effective care. In presenting a global overview, the paper reports on key trends, main challenges and potential solutions. The emphasis is on breadth of coverage, but specific nursing workforce issues in different countries are highlighted to illustrate the main challenges facing those responsible for developing and implementing policies on the nursing workforce. The report presents a snapshot of a dynamic and challenging situation worldwide. [from executive summary]

This document reports on the findings of three projects in Canada that link population health needs to health human resource planning, to illustrate the value and challenges in using health human resource data to inform policy decisions on nursing productivity and to generate evidence based retention policies to guide nursing workforce sustainability. [adapted from summary]

This report is the result of a regional meeting held March 17-19 in Arusha, Tanzania and presents the regional context for work on migration and retention; an overview of the current situation, integrating evidence from background papers and country experiences; and summarizes the discussions held on follow-up work on migration and retention. [adapted from introduction]

This report is aimed at policy makers both in developing country governments and in international agencies. It was a key input to the second meeting of the High Level Forum on the Health Millennium Development Goals held in Abuja in December 2004. It was written to raise awareness of a looming crisis in human resources for health confronting most countries in sub-Saharan Africa, and to help serve as a catalyst for action to avert this crisis. It is hoped that it goes beyond illustrating the potential gravity of the impending crisis in human resources for health, to demonstrating that concrete actions can and in many cases are being taken to address the problem.

There have been reported shortages in both the regulated and unregulated workforce in New Zealand, in particular of medical practitioners, nurses in primary care, mental health professionals, allied and primary health professionals, M?ori and Pacific practitioners, and support workers. There is also an ongoing issue of a maldistribution of workers between rural and urban locations. In the future, the constraints on labour supply in New Zealand will necessitate a much greater focus on growing the health workforce and improving the performance and productivity of the available workforce. The area in which there has been the most consistent investment in workforce development since the 1990s is mental health.

While publications like the World Health Report have described general approaches that can be taken to improve the human resources for health (HRH) situation at the country level, there is a relative paucity of more detailed documentation that describes promising practices that would be useful to HRH leaders and practitioners. As a result, USAID's Africa Bureau commissioned a study to identify and document promising practices in a way that takes into account the context of the practice, describes lessons learned and puts forth potential implications for replication in other countries. The intent of the promising practices study is to "serve as a practical and much needed resource for governments, partners and donors in promulgating policies and approaches that have successfully mitigated the negative effects of the health workforce crisis." After consultation within USAID, it was decided that the study would focus on promising practices in four African countries: task shifting in Ghana and Uganda, improving retention in Malawi, and increasing recruitment and rapid deployment in Namibia.

This report focuses on the impact of human resource shortages witnessed by MSF teams in four southern African countries - Lesotho, Malawi, Mozambique, and South Africa. While the focus is largely on nurses in rural areas, it should be acknowledged that health staff is lacking across the spectrum - from doctors to laboratory technicians to pharmacists - at all levels of care. In all these cases the need for access to ART, as well as other health needs, is outstripping human resource capacity. [from introduction]

This presentation was given as part of the Christian Health Association's Conference: CHAs at a Crossroad Towards Achieving Health Millennium Development Goals. It outlines FBO health services in Kenya and sources of and financial support for them. It also discusses the exodus of health workers from church health facilities, the reasons behind this migration and how this problem is being addressed.

This paper discusses human capital outflow from Africa from a developmental perspective. The focus is on the high skill content of African emigration to industrial countries, its impact on development in the region, and the challenges faced by institutions of higher learning to help the region deal with this problem. This paper further takes up the issue of African brain drain in the context of relevant changes taking place globally: globalization, movement towards a knowledge-based economy, and global demographic trends. [adapted from author]

This presentation was given as part of the Christian Health Association's Conference: CHAs at a Crossroad Towards Achieving Health Millennium Development Goals. It discusses church health institutions and the HR crisis, including staffing levels and attrition; the national response, and details the many efforts of the CHAZ response such as the CHAZ Health Workers' Retention Scheme.

This paper, aimed primarily at DFID advisers and health sector analysts, will attempt to map out selected issues relating to the planning and management of human resources by combining an international perspective with issues and trends emerging from individual countries. HR issues and challenges have been grouped into four broad objectives that poor countries, donors and advisers will need to address simultaneously over the next decade and beyond. The objectives are: Increasing coverage and staff retention to ensure adequate and equitable delivery of priority health services; Ensuring availability of key competencies and skills in the health workforce; Increasing staff performance against objectives; Strengthening capacity for planning and managing HR in the health sector.

This presentation was given at the First Forum on Human Resources for Health in Kampala. It discusses the Zambia Health Workers Retention Scheme, an incentive program targeting key health worker cadres primarily in rural district to decrease attrition rates of critical service providers. [adapted from author]

Staff shortages could harm the provision and quality of health care in Uganda and therefore staff retention and motivation are crucial. Understanding the impact of HIV/AIDS on staff contributes to designing appropriate retention and motivation strategies. This research aimed to identify the influence of HIV/AIDS on staff working in general hospitals at district level in rural areas and to explore support required and offered to deal with HIV/AIDS in the workplace. Results from interviews and surveys show that HIV/AIDS is an important contextual factor that impacts working conditions in various ways.

Both financial and nonfinancial factors influenced the tenure and job satisfaction of nurses at public maternity services in South Africa. Surveys suggest that strong management and fully equipped facilities could help redress staff turnover. [author's description]

In response to the under-representation of female peer educators in the Geração BIZ Program (GBP), an adolescent sexual and reproductive health program in Mozambique, an operational research study was used to test new strategies for improving recruitment, participation, and retention of female peer educators. The study tested an intervention model to increase the involvement and performance of girls in the GBP. The study started with the hypothesis that a protocol addressing young women’s needs for comfort and security, skills acquisition, support, and mentoring would improve their recruitment, retention, and effective performance in the program.

This report was commissioned to describe experiences and to provide lessons learnt with respect to interventions to retain staff and improve their productivity, competence and responsiveness. [from summary]

This article describes the experience of the Family Life Education Programme, a reproductive health program that provides community-based health services through 40 clinics in five districts of Uganda, in improving retention and performance by using the Human Resource Management Rapid Assessment Tool. [adapted from abstract]

This presentation was part of the International Conference on Global Health session, "Answering the Call: Innovations in Human Resources by African Faith-Based Organizations." It introduces the Christian Health Association of Malawi and talks about the organizations effort in HR, recruitement strategies - including the impact and challenges of their strategy.

African public health care systems suffer from significant brain drain of its health care professionals and knowledge as health workers migrate to wealthier countries. In this paper, the brain drain is defined as both a loss of health workers (hard brain drain) and unavailability of research results to users in Africa (soft brain drain).

This report examines key issues in the recruitment and retention of nurses in the UK. The research was conducted because there are currently significant recruitment and retention problems across a number of professions within the NHS, but particularly in nursing and the professions allied to medicine. [from executive summary]