Retention

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, Māori 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 number of health workers employed is an indicator of a country’s ability to meet the health care needs of its people, especially the poorest and most vulnerable. Resource-constrained countries committed to the Millennium Development Goals are facing up to the reality that shortages and uneven distribution of health workers threaten their capacity to tackle the HIV/AIDS pandemic, as well as the resurgence of tuberculosis and malaria. Worker shortages are linked to three factors: 1) decreasing student enrollment in health training institutions, 2) delays or freezes in the hiring of qualified professionals and 3) high turnover among those already employed.

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 paper illustrates that the way human resources for health (HRH) are trained and deployed in Africa does not enhance productivity and that countries are unable to realize the full potential expected from the working life of their health workers.

This study was carried out in order to determine factors that may facilitate the poor retention of registered nurses in the Malawian public health sector.

Functioning health services are key to making the community of New Orleans livable again. Conversely, a livable community is key to attracting a stable healthcare workforce to New Orleans. Hurricane Katrina forced the entire healthcare workforce to evacuate the City of New Orleans and a large majority of these workers have since found jobs elsewhere, such as in neighboring parishes and Texas. This brief summarizes policy options to create and maintain a healthcare workforce, as well as options to bridge the transition from the current situation to the point at which the interventions will show an effect.

This paper presents a case study of an intervention (the lunch allowance scheme) instituted in Uganda to improve retention and motivation of health workers. The study traces the scheme’s evolution, assesses its impact on the brain drain of health professionals (medical doctors and nurses), and identifies difficulties encountered and lessons learned. [abstract]

Recruitment and retention of medical staff are important issues in rural health. The aim of this study was to describe and understand the perceptions of women doctors working in rural hospitals in South Africa about their work. [from abstract]

This paper seeks to provide a compelling evidence base to reveal the factors that lead to high turnover and to promote tested responses to retain health workers. The literature researched is presented to support country-level action. [abstract]

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]

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]

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.

Ghana’s health sector has lost many health care workers, including those migrating to other countries. Strategies aimed at keeping personnel have had varied results. This article briefly reviews these strategies. [adapted from author]

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.