Absenteeism amongst Health Workers: Developing a Typology to Support Empiric Work in Low-Income Countries and Characterizing Reported Associations

The authors aimed to review the literature on absenteeism from a health system manager’s perspective to inform needed work on this topic and to develop a typology of definitions that might be useful to classify different forms of absenteeism and identify factors associated with absenteeism. [adapted from abstract]

Where Have They Gone? A Study on the Absenteeism of Doctors and Support Staff in Primary Health Care Centres

This study focused on the causes of absenteeism among doctors and paramedical staff in primary health care centres in Karnataka and loss of resources due to absenteeism and related issues, with a view to suggest ways and means of reducing absenteeism and maximising impact on the utilisation of public resources. [from summary]

Improving Service Delivery through Measuring Rate of Absenteeism in 30 Health Centres in Tonk District of Rajasthan, India

The objective of the study defined in this report was to evolve a community-based model of monitoring absenteeism in public health centres that can induce demand accountability of service providers, along with measuring the rate of their absenteeism and the satisfaction of the beneficiaries, and to do evidence-based advocacy for adopting the model and improving the service delivery. [from abstract]

Where Have They Gone? Using ICT to Address Health Worker Absenteeism in India

This 8 minute video highlights one solution to the problem of doctor absenteeism being deployed in the Karnataka region in southern India. When patients arrive at a primary health clinic and the doctor is absent, they can use their phones to text a central location which will record this data to allow the government to track and citizens to see which clinics are chronically understaffed. [from publisher]

Holding Health Workers Accountable: Governance Approaches to Reducing Absenteeism

This technical brief looks at the cost of absenteeism, examines governance issues, describes the various stakeholders, and offers a number of recommendations for strengthening governance to reduce absenteeism. [from publisher]

Struggling and Coping to Serve: The Zambian Health Workforce as Depicted in the Public Expenditure Tracking and Quality of Service Delivery Survey

This paper reports the findings of the Zambian study pertaining to human resources for health, including issues with high staff vacancies, high rates of absenteeism and tardiness, impact on patients and the coping mechanisms health workers are employing to augment their incomes. [adapted from summary]

Is There a Doctor in the House? Medical Worker Absence in India

The authors present data from a nationally representative all-India survey which enumerators physically verify the attendance of providers during unannounced visits, and found that nearly 40% of doctors and medical service providers are absent from work on a typical day. [from abstract]

Missing in Action: Teacher and Health Worker Absence in Developing Countries

This paper reports results from surveys in which enumerators made unannounced visits to primary schools and health clinics in Bangladesh, Ecuador, India, Indonesia, Peru, and Uganda and recorded whether they found teachers and health workers in the facilities. Averaging across the countries, about 35 percent of health workers were absent. [from author]

Absenteeism of Health Care Providers in Machakos District, Kenya

This policy brief highlights results from unannounced visits made to a sample of public health facilities in Machakos District with the intention of documenting the proportion of critical health care workers who were absent from their stations of operation. It also presents policy options to address the problem of absenteeism of critical health providers in the health sector. [from author]

Reincentivizing: a New Theory on Work and Work Absence

Work capacity correlates weakly to disease concepts, which in turn are insufficient to explain sick leave behavior. With data mainly from Sweden, a welfare state with high sickness absence rates, our aim was to develop an explanatory theory of how to understand and deal with work absence and sick leave. In this paper we present a theory of work incentives and how to deal with work absence. [from abstract]

How to Monitor and Address Absenteeism in District Hospitals

Many health service managers are familiar with the problem of absenteeism in district hospitals. It affects the running of the hospital and can seriously compromise the quality of care which patients receive. For the purpose of this Kwik-Skwiz absenteeism is defined as staff taking time off that has not been scheduled or staff taking more leave than is necessary or reasonable. Clearly there are many legitimate reasons for taking sick or other types of leave. It is often debatable how much leave is reasonable. It often depends on the pattern and circumstances, rather than the actual total amount of leave that an individual takes. Managers have a responsibility to balance the rights and needs of individual staff members, with the needs of the hospital. High levels of absenteeism, both on the part of individuals or in the whole hospital, are often symptomatic of underlying problems. Addressing these issues can result in lower absenteeism levels that benefits staff, managers and patients. [author’s description]

Ghost Doctors: Absenteeism in Bangladeshi Health Facilities

The authors report on a study in which unannounced visits were made to health clinics in Bangladesh with the intention of discovering what fraction of medical professionals were present at their assigned post. This survey represents the first attempt to quantify the extent of the problem on a nationally representative scale. [from abstract]