Retention

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]

Anecdotal evidence suggests that there is severe competition for personnel and staff time between various health programmes and between public and private providers. Such competition is reinforced by the vertical nature of various funding mechanisms supported by bilateral donors, international NGOs and global initiatives. The objective of this study was to analyse in what way HRH recruitment, deployment and retention at the district level are influenced by externally funded programmes. [from summary]

This study’s purpose is to compare how physicians, working for both public and privatized hospitals, rate their respective psychosocial working conditions and job satisfaction. [from abstract]

Pay for performance (P4P) is an innovative approach that explicitly links financial investment in health to health results. However, the mechanics of its implementation need to be planned very carefully to elicit the desired behavior change in a given country. This guide offers the reader a systematic framework to document and structure a P4P initiative. [adapted from foreword]

This study sought to gain understanding of the motivations of community service (CS) officers to continue working at the same district hospital for a subsequent year after their obligatory year was over. The objectives were to determine the number of CS officers who actually remained at the same district hospital after completing their CS in 2002, the major factors that influenced them to remain and factors that would encourage the 2003 cohort of CS officers to remain at the same district hospital for an additional year. [from abstract]

Because of the demographic changes, appropriate measures are needed to prevent early exit from work and to encourage workers to prolong their working life. The aims of this study were to examine the reasons for voluntary early retirement, the reasons for continuing working life after the official retirement age and the predictive value of the reasons mentioned. [adapted from abstract]

Most of the district health services in Malawi are provided by nurses and clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. This study explores how these cadres are managed and motivated and the impact this has on their performance. [adapted from abstract]

This study analyzed data from a human resources health facility survey conducted in Kenya. The study looked into the status of attrition rates and the proportion of attrition due to retirement, resignation or death among doctors, clinical officers, nurses and laboratory and pharmacy specialists in surveyed facilities. [adapted from abstract]

This paper presents data on the remittances sent by migrant nurses to their families back home. It gives voice to the experiences of migrant nurses and illustrates the financial obligations they maintain while working overseas. [from abstract]

We carried out a literature review of studies using discrete choice experiments to investigate human resources issues related to health workers, both in developed and developing countries. Ten studies were found that used discrete choice experiments to investigate the job preferences of health care providers. The use of discrete choice experiments techniques enabled researchers to determine the relative importance of different factors influencing health workers’ choices. [from abstract]

This article assesses the potential impact of financial incentives in alleviating health worker shortages in underserved areas through contracting future health workers to work for a number of years in an underserved area in exchange for a financial pay-off. [adapted from author]

Health worker shortages are one of the main constraints in achieving worldwide population health goals. Financial-incentive programs for return of service can alleviate local and regional health worker shortages through a number of mechanisms. This article draws on studies of financial-incentive programs and other initiatives with similar objectives to discuss management functions that are essential for the long-term success of financial-incentive programmes. [adapted from abstract]

There is growing evidence that informal payments for health care are fairly common in many low- and middle-income countries. Informal payments are reported to have a negative consequence on equity and quality of care; it has been suggested, however, that they may contribute to health worker motivation and retention. This study suggests that the practice of informal payments contributes to the general demotivation of health workers and negatively affects access to health care services and quality of the health system. [adapted from abstract]

Nepal’s Safe Delivery Incentive Programme (SDIP) was introduced nationwide in 2005 with the intention of increasing utilisation of professional care at childbirth. It provided cash to women giving birth in a health facility and an incentive to the health provider for each delivery attended, either at home or in the facility. We explored early implementation of the programme at the district-level to understand the factors that have contributed to its low uptake. [from abstract]

A number of low- and middle-income countries have a severe shortage of health workers. This paper studies how health workers’ choices of labour supply and work effort impact on the quality of health services when health workers are in short supply. [from abstract]

This video, produced by the Center for Global Development, outlines the case for a new metthod of disbursing donor contributions for global health called Performance-Based Incentives (PBI). PBI aims to boost global health by basing donor contributions on performance and permitting developing countries health systems to determine how to disburse these incentives. [from publisher]

Rwanda is one of the pioneers of performance-based financing. Building on lessons from three donor-financed pilots, the government has assumed leadership for this approach and is scaling up a standardized model nationwide. [from author]

We wanted to try to account for worker motivation as a key factor that might affect the success of an intervention to improve implementation of health worker practices in eight district hospitals in Kenya. In the absence of available tools, we therefore aimed to develop a tool that could enable a rapid measurement of motivation at baseline and at subsequent points during the 18-month intervention study. [from abstract]

The study used a literature review and field research to obtain data on strategies for the retention of health workers in various institutions in Kenya.

This article reports on research that assessed international and national best practice in the selection of students for graduate entry medical courses in order to investigate correlations between medical student selection procedures and exposure to rural medical practice during medical training with choice of careers in rural medicine. Central to the study was the issue of the medical workforce shortage in Australia’s rural communities. [from introduction]

Retention continues to be a serious challenge in the human resources for health crisis. There is increasingly widespread commitment to initiatives to attract and retain skilled workers, especially in rural areas. The purpose of this brief is to update and document some contributions made from 2005 to 2008 in the area of worker retention. [from author]

This study undertook an in-depth exploration of the unintended consequences of pay-for-performance programs In England and California. The authors interviewed primary care physicians in California and England and compared unintended consequences in each setting. [adapted from abstract]

Mid-level cadres of health workers provide the bulk of emergency obstetric and neonatal care in Malawi. This study set out to explore the perceptions of mid-level providers regarding the factors affecting their performance and retention within the Malawian health system. [adapted from author]

Population size is often correlated with the number of physicians in a community, and is conventionally considered to represent the power of communities to attract physicians. However, associations between other demographic/economic variables and the number of physicians in a community have not been fully evaluated. This study seeks other parameters that correlate with the physician population and show which characteristics of a community determine its attractiveness to physicians. [adapted from abstract]

This paper serves as background documentation for the first expert meeting for developing the evidence-based recommendations for increasing access to health workers in remote and rural areas through improved retention, to be held in Geneva on 2-4 February 2009. It is intended to provide an overview of the issues, challenges and potential solutions to the problem of inequitable access to health workers in remote and rural areas. [from introduction}

Work satisfaction of nurses is important, as there is sufficient empirical evidence to show that it tends to affect individual, organizational and greater health and social outcomes. This paper presents a national study that compares and contrasts satisfaction levels of nurses in both public and private sectors. [from abstract]