Retention

This presentation outlines the work on retention, incentives and positive practice environments as it relates to the Kampala Declaration.

This presentation outlines the strengths and weaknesses of the DCE, an increasingly popular methodology for eliciting health worker preferences regarding rural jobs. [adapted from author]

This presentation reviews the current state of health worker retention in rural areas, discusses interventions aimed at addressing the problem and describes the challenges and directions for solving it.

This presentation outlines the World Health Organization’s (WHO) efforts to scale up health care delivery in rural areas through health care worker retention programs.

This article describes the issues facing Uganda’s health system and presents arguments for and against instituting a performance-based pay system.

Health human resource (HHR) strategies for Canadian rehabilitation professionals are lagging behind other professional groups such as physicians and nurses. The objectives of this study were: 1) to identify recruitment and retention strategies of rehabilitation professionals including occupational therapists, physical therapists and speech language pathologists from the literature; and 2) to investigate both the importance and feasibility of the identified strategies using expert panels amongst HHR and education experts. [from abstract]

The motivation for this study was to investigate how role stress among nurses could affect their job satisfaction and organizational commitment, and whether the job rotation system might encourage nurses to understand, relate to and share the vision of the organization, consequently increasing their job satisfaction and stimulating them to willingly remain in their jobs and commit themselves to the organization. [from abstract]

Since the early 1990s Indonesia has attempted to increase the level of skilled attendance at birth by placing rural midwives in every village in an effort to reduce persistently high levels of maternal mortality. Yet evidence suggests that there remains insufficient incentive to ensure an equal distribution across areas while the poor in all areas continue to access skilled attendance much less than those in richer groups.

This presentation details the issues of migration and retention in Swaziland.

This country study in Swaziland thus sought to map and assess incentives for retaining heath workers, particularly non-financial incentives. Specifically it sought to identify existing policies and measures for incentives for retention of health workers, their relevance to current factors driving exit and retention, and propose inputs for guidelines for introducing and managing incentives for health worker retention to maximize their positive impact. [from summary]

The current global tuberculosis (TB) epidemic has pressured health care managers, particularly in developing countries, to seek for alternative, innovative ways of delivering effective treatment to the large number of TB patients diagnosed annually. One strategy employed is direct observation of treatment for all patients. In high-burden settings innovation with this strategy has resulted into the use of lay community members to supervise TB patients during the duration of anti-TB treatment.

While the recruitement of rural doctors is steadily rising, there is concern about their long-term retention. In response, an orientation course for recently established rural doctors was set up in 2003, based on a training needs assessment. This paper draws lessons from this experience, focusing on processes and mechanisms operating in the relation between training and retention in rural practice. [adapted from author]

This presentation on health worker retention in rural area was offered during a dialogue hosted by the WHO and OECD.

This document discusses the in-country ownership of health initiatives from the Health Sector Strategic Plan focusing on critical areas such as retention, recruitment and occupational safety.

The United States has the largest professional nurse workforce in the world but does not produce enough nurses to meet its growing demand. The U.S. is now the world’s major importer of nurses, but the shortage is too large to be solved by recruitment abroad without depleting world nursing resources. The national shortage could be largely addressed by investments in expanding nursing school capacity. [adapted from summary]

Health worker retention is critical for health system performance and a key problem is how best to motivate and retain health workers. The authors undertook a systematic review to consolidate existing evidence on the impact of financial and non-financial incentives on motivation and retention. [from abstract]

This paper investigates the impact of the framework and strategies to retain critical health professionals (CHPs) that the Zimbabwean government has put in place, particularly regarding non-financial incentives, in the face of continuing high out-migration. [from summary]

Health professionals face the duality of the professional and the organizational systems, each of which has its own distinct values, principles and expectations. This study presents organizational and professional commitment concepts and their relations in the context of the health sector. [adapted from introduction]

The theory of planned behaviour states that attitudinal variables such as job satisfaction only have an indirect effect on retention whereas intentions have a direct effect. This study tests for the direct and indirect effects of job satisfaction of nurses during the 3 years after qualification. [adapted from abstract]

All long-term care agencies struggle to find and keep sufficient, reliable, and skilled staff capable of meeting client needs and providing great quality care. This workbook offers 12 concrete steps to guide agencies in developing excellent recruitment, selection and retention practices

The objectives of this paper are to highlight the situation of health workers in Pacific and Asian countries to gain a better understanding of the contributing factors to health worker motivation, dissatisfaction and migration; examine the regional and global evidence on initiatives to retain a competent and motivated health workforce, especially in rural and remote areas; and suggest ways to address the shortages of health workers in Pacific and Asian countries by using incentives. [from abstract]

In this study, the overall job satisfaction of medical laboratory scientist graduates of one Kuwaiti University was examined in relation to the environment and organizational features of their places of employment. [from abstract]

Incentives such as P4P can be very powerful in their effects. Caution in their design and deployment is essential. However, ignoring their potential would be unwise, as they offer the possibility of improving value for money for taxpayers and patients. The first section of the paper will review evidence of common provider problems in all health care systems and their implications for introducing a P4P system. This will be followed by a review of P4P reforms in the United Kingdom and United States in particular. [from author]

The Tanzanian health system is currently undergoing major reforms. As part of this, a study was commissioned into the delivery of services and care at the Muhimbili National Hospital. One of the main components of this comprehensive study was to measure the extent to which workers in the hospital were satisfied with the tasks they performed and to identify factors associated with low motivation in the workplace. [from abstract]

This paper looks at the HRH crisis as experienced by the Uganda Catholic Medical Bureau network giving the trend, examining the reasons, the destinations of attritional cases and what the network is trying to do to improve human resource stability. [from abstract]

Health human resources are now a high priority on the political agenda. It is within this context that policy makers, planners and managers have turned their attention to identifying and implementing incentive systems which will be effective in improving the recruitment and retention of health care personnel. [from abstract]

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]

The so-called brain drain is a complex phenomenon with a web of push-pull factors determining final outcomes. There are no quick fixes. Yet, those on the front lines addressing the critical personnel shortages in South Africa’s public health system - especially in rural areas - have pointed to approaches that could slow the exodus and eventually turn the situation around. [from author]

This paper was commissioned by the health professions with the support of the Global Health Workforce Alliance to provide an overview of the use of incentives for health care professionals. It describes some of the different approaches taken and presents characteristics shared by effective incentive schemes. The paper also suggests some approaches to their development and implementation. [from introduction]

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.