Retention

Pay-for-performance (P4P) is one of the primary tools used to support healthcare delivery reform. This paper summarizes evidence, obtained from studies published between January 1990 and July 2009, concerning P4P effects, as well as evidence on the impact of design choices, and contextual mediators on these effects. [from abstract]

Through in-depth interviews and focus group discussions, this study explores the potential efficacy of non-financial incentives (NFI) proposed by the L10k project, an Ethiopian health extension project. The results of the study outline factors motivating voluntary community health workers, indicate other NFI mechanisms for consideration, and suggest programmatic recommendations. [adapated from publisher]

This research aimed at examining the effects of mentoring functions on the job satisfaction and organizational commitment of new nurses in Taiwan’s hospitals.

This study aimed to identify the determinants of job motivation among physicians, a neglected perspective, especially in developing countries. [from abstract]

After a year-long consultative effort, this document proposes sixteen evidence-based recommendations on how to improve the recruitment and retention of health workers in underserved areas. It also offers a guide for policy makers to choose the most appropriate interventions, and to implement, monitor and evaluate their impact over time. [from publisher]

This case study provides an example of a broad public sector pay for performance approach that incorporates intergovernmental transfers in a decentralized context with rewards for concrete health results at the facility level and the challenges of moving from design to implementation. [from author]

This case study thus describes an example of a private sector pay for performance voucher program targeting reproductive health and offers lessons for countries that are considering implementing similar schemes. [from author]

This case study presents the initial results of the pay-for-performance (P4P) experience of UNIMED-Belo Horizonte, a private, nonprofit organization in Brazil and provides an example of private sector P4P to improve service quality and efficiency. [from author]

The LANE study aims to longitudinally examine a wide variety of individual and work-related variables related to psychological and physical health, as well as rates of employee and occupational turnover, and professional development among nursing students in the process of becoming registered nurses and entering working life. The aim of this paper is to present the LANE study, to estimate representativeness and analyse response rates over time, and also to describe common career pathways and life transitions during the first years of working life. [adapted from abstract]

This study explored sector specific components that contribute to positive work environments and job satisfaction for nurses working outside of the acute care sector. Specifically, this study examined the recruitment and retention initiatives being implemented by nursing employers in the community, public health and long-term care sectors in various geographic areas of Ontario. [from summary]

This article investigated the reasons for the high rates of community health worker attrition in Bangladesh. [adapted from abstract]

The purpose of this study was to measure job satisfaction level of township health centers employees in poor rural China and to identify relevant features in order to provide policy advice on human resource development of health service institutions in poor regions.

Retaining physicians in remote settings can be challenging owing to the heavy workload and harsh environmental conditions and to the lack of opportunities for professional development. This study evaluated corrective measure to address the dearth of physicians in the north of Norway. [adapted from abstract]

This article outlines the introduction of a special contracting system to recruit health workers to improve the posting, recruitment and retention of health workers in rural and remote areas. [adapted from abstract]

This paper builds on earlier work assessing the evidence on effectiveness of interventions to increase access to health workers in rural and remote areas - focusing mainly on studies that evaluated interventions and their impact on the health workforce and health systems performance. [adapted from introduction]

This paper examines the extent to which health workers differ in their willingness to work in rural areas and the reasons for these differences, based on the data collected in Rwanda analysed individually and in combination with data from Ethiopia. [from introduction]

This article outlines a project that deployed short videos on mobile phones designed to motivate health workers and persuade pregnant village women to use health services. The project also asked health workers to record their own videos. The results show evidence that the creation and use of videos helped engage village women in dialogue, showed positive effects toward health worker motivation and learning, and motivated key community influencers to participate in promoting the health workers. [adapted from abstract]

This briefing note provides insight to the factors that obstruct and incentivise health worker responsiveness to clients’ needs. It supports the analysis and design of effective initiatives to health worker responsiveness by taking a holistic approach to health systems strengthening. [from abstract]

Organizational factors are considered to be an important influence on health workers’ uptake of interventions that improve their practices. These are additionally influenced by factors operating at individual and broader health system levels. This article sought to explore contextual influences on worker motivation, a factor that may modify the effect of an intervention aimed at changing clinical practices in Kenyan hospitals. [from abstract]

This review shows how lessons that have been learned from international experiences have been improved further in China by realignment of the incentives for providers towards prevention and primary care, and incorporation of a treatment protocol for hospital services. [from summary]

In Ghana, faith-based organisations play an essential role in providing health care services, especially in rural areas. For a variety of reasons, it can be difficult to retain health care workers, putting essential services under threat. The National Catholic Health Service carried out some vital research to find out how to address the problem. [from author]

A study across three countries to identify policies which would help recruit and retain health workers in rural areas revealed that there is a danger in one size fits all recommendations when it comes to designing human resource policies. Results also show that there is room for both financial and non-financial incentives in human resource interventions in developing countries. [from author]

Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. [from abstract]

While there is considerable research on medical workforce supply trends, there is little research examining the determinants of labour supply decisions for the medical workforce. The MABEL study investigates workforce participation patterns and their determinants using a longitudinal survey of Australian doctors. It aims to generate evidence to support developing effective policy responses to workforce issues such as shortages and maldistribution. This paper describes the study protocol and baseline cohort, including an analysis of response rates and response bias. [from abstract]

This article posits that out-migration of health workers is not a critical contributor to health workforce shortages in Nigeria’s rural and remote areas and that more important factors include: contraction of government health spending as a percentage of GDP despite deteriorating health conditions, public health management systems that operate by default rather than by design, spartan living conditions outside urban areas, inadequate training of appropriate cadres of health staff, limited facilities and medications for effective delivery of clinical services, and burnout of overworked and unde

Financial incentives have been used for many years internationally to improve quality of care in general practice. The aim of this pilot study was to determine if offering general practitioners a small incentive payment per test would increase chlamydia testing in women aged 16 to 24 years, attending general practice. [from abstract]

This toolkit was designed for nurse employers across the province of Ontario to use as a resource in working toward the 70% full-time nurse commitment. It is a practical guide to assist Nurse Managers and Human Resource Staff in identifying staffing needs and creating organization-specific strategies to increase full-time employment for nurses. [from author]

This book explores a new approach to health funding, the transfer of money or goods to patients or providers when they take health-related actions or achieve performance targets. It documents a host of experiences with incentives for maternal and child health care, tuberculosis, child nutrition, HIV/AIDS, chronic conditions and more. [from publisher]

This technical brief focuses on issues around health worker motivation, job satisfaction, incentives, retention and performance. [from author]

The objective of this study was to analyse in what way HRH recruitment, deployment and retention at the district level are influenced by external funding; and to what extent this is in line with national and district policies and strategies. [from abstract]