Salary

Assessing the Post-Training Family Planning Service Delivery Skills of Clinical Providers in Kenya

This assessment establishes the link between service quality and initial training by examining the skill retention of 2 cohorts of service providers who participated in a family planning (FP) training program in Kenya during 1994–1995. The following two questions were considered: 1) Do providers use the skills in which they were trained? 2) Is the length of time after the course concludes related to whether trained providers retain their new skills? [publisher’s description]

Community-Based Distribution in Tanzania: Costs and Impacts of Alternative Strategies to Improve Worker Performance

Donor funds may be inadequate to support the growing demand for services provided by community-based distribution (CBD) programs. One solution may be to reduce the remuneration of CBD agents, but this approach may lower their productivity. Programs also need to consider reducing other costs, including those for supervision and training. The cost per agent visit—including costs associated with payments to agents and to supervisors and the costs of training—was calculated for three CBD programs in Tanzania. The output measure was visits in which contraceptives were provided or referrals made for family planning services.

Developing a Salary Policy

Establishing a salary policy is a critical function of human resource administration which serves to support the organization’s most valuable asset, its human resources. A salary policy should be equitable, structured and clearly understood. By following these components of a salary policy and answering the questions posed, an organization can reflect on its past and present salary policy and establish a salary policy that is sound. [author’s description]

Dual Practice by Public Health Providers in Shandong and Sichuan Provinces, China

There are four types of health providers at present in China. These are defined in terms of differences in ownership. Private practice in the health sector was reintroduced from 1980, when China began its economic reform from a planned economy to a market economy. Dual practice (DP) is quite common and a major concern from the point of view of health policy-making as little is known about it. The aim of this study was to describe policies and regulations of DP, the current situation, its impact on access to services and physician behaviour, and to provide evidence for future policy decisions. This study was conducted in two provinces, Shandong and Sichuan.

Health Worker Benefits in a Period of Broad Civil Service Reform: The Philippine Experience

Developing countries that have to cope with pressures to reform their bureaucracies have to contend with increasing health worker benefits and salaries that are often intended to retain these health workers in government service. In the Philippines, national and local efforts in health have been forced to focus on guaranteeing some of these benefits, and local governments are feeling the financial limitations of their local funds. [from abstract]

How Health Workers Earn a Living in China

During the period of the command economy government health workers were paid the same salary throughout China. Over the past twenty years the government has managed a gradual liberalization of the labour market, as part of the transition to a ‘socialist market economy’. This paper explores this process in the health sector. Government has found it impossible to maintain uniform pay levels, particularly in the face of a radical devolution of its own financial management. Health workers have increasingly resorted to informal methods of earning an income. Doctors quite commonly accept cash gifts from patients.

How Should Doctors Be Paid? Lessons from Theory and Practice

For long now, doctors in Uganda have been complaining that their terms of service, particularly remuneration, are not commensurate with the years that they spend training and the amount of work that they do. This issue has persistently been raised at several fora over the years but with no definite resolution. But how should doctors be paid? This paper attempts to answer this question. In the developed world, policy makers attempt to answer the question of cost containment. In Uganda, due to limited financial resources, the overriding question is where will the extra resources to adequately pay doctors be found? [from introduction]

How to Pay: Understanding and Using Incentives

Many countries have experimented with alternative ways of paying providers of health care services. This paper illustrates different methods, suggests some of the theoretic advantages and limitations of each, and provides a general theoretical framework for evaluating alternatives. Over the last two decades, new and more sophisticated payment systems have evolved, with a broadening of units of payment and setting of payments prospectively. The authors discuss the international experience of a number of payment systems, both traditional and more recently developed, including line-item budgeting, salary, fee-for-service, per diem, case-mix adjusted per episode, global budgets and capitation.

HRM Resource Kit

This toolkit includes a collection of HRM resources and links assembled for the Global Health 2005 conference. Most of the resources are in Microsoft Word format and provide guidance on how to develop a variety of HRM documents or processes. Topics covered include supervision, hiring and recruitment, HR policies, and HIV Workplace Programs and training. [publisher’s description]

Medical Leave: the Exodus of Health Professionals from Zimbabwe

The study aimed to establish the magnitude of migration of health professionals, its causes and to document the associated impacts on service delivery. [author’s description]

Medicines without Doctors: Why the Global Fund Must Fund Salaries of Health Workers to Expand AIDS Treatment

Recent comments from the Global Fund suggest an intention to focus more on the three diseases, and to leave the strengthening of health systems and support for the health workforce to others. This could create a “Medicines without Doctors” situation in which the medicines to fight AIDS, tuberculosis, and malaria are available, but not the doctors or the nurses to prescribe those medicines adequately. [author’s description]

Nurse Wages and Their Context: Database Summary (Asia)

This summary report provides information on nurse wages and the comparitive buying power of these wages in Hong Kong, Japan, Korea, Macau, Malaysia, Philippines, Singapore, Taiwan and Thailand. The data are results from a survey of 11 National Nurses’ Associations. [from introduction]

Nurse Wages and Their Context: Database Summary (North America, Western Europe and Japan)

This summary report provides information on nurse wages and the comparitive buying power of these wages in select countries in North America, Western Europe and Japan. The data are results from a survey of 10 National Nurses’ Associations. [from introduction]

Paying Health Personnel in the Government Sector by Fee-For-Service: A Challenge to Productivity and Quality, and a Moral Hazard

The Ministry of Public Health has implemented increasingly complex payment schemes to cope with the internal brain drain situation among certain categories of health personnel. Non-private-practice allowances have been given to medical doctors, dentists and pharmacists since 1993 and a fee-for-service scheme for extra office hour practices started since 1994. This research is to evaluate the impact of the fee-for-service payment on productivity and quality of care and to consider any resultant moral hazards amongs health providers. [from abstract]

Role of Wages in the Migration of Health Care Professionals from Developing Countries.

Several countries are increasingly relying on immigration as a means of coping with domestic shortages of health care professionals. This trend has led to concerns that in many of the source countries—especially within Africa—the outflow of health care professionals is adversely affecting the health care system. This paper examines the role of wages in the migration decision and discusses the likely effect of wage increases in source countries in slowing migration flows. [from abstract]

Salaries and Incomes of Health Workers in Sub-Saharan Africa

This article investigates pay structures for health workers in the public sector in sub-Saharan Africa; the adequacy of incomes for health workers; the management of public- and private-sector pay; and the fiscal and macroeconomic factors that impinge on pay policy for the public sector. The study finds that pay and income of health workers varies widely, whether between countries, by comparison with cost of living, or between the public and private sectors. To optimize the distribution and mix of health workers, policy interventions are needed. Fiscal constraints to increased salaries might need to be overcome in many countries, and non-financial incentives improved. [adapted from summary]

Uganda: the Motivation of Health Personnel

This video clip is 8 minutes and 45 seconds and discusses Uganda’s pay reforms and other incentive for health personnel to address the brain drain issue. It also has information on other incentives and programs such as government sponsored grants to health institutions to promote research and the retention of health educators.


You must have access to a media player to see the video. Download instructions are available from the WHO Best Practices in Human Resources for Health Development website.

Working Practices and Incomes of Health Workers: Evidence from an Evaluation of a Delivery Fee Exemption Scheme in Ghana

This article describes a survey of health workers and traditional birth attendants (TBAs) which was carried out in 2005 in two regions of Ghana. The objective of the survey was to ascertain the impact of the introduction of a delivery fee exemption scheme on both health workers and those providers who were excluded from the scheme (TBAs).