Retention

This report uses a realist review, which is a theory-based method, to address the questions of why and how certain rural retention interventions work better in some contexts and fail in others. The report provides strong support for the assertion that a bundle of retention strategies should be used in order to successfully attract and retain health workers in remote and rural areas and provides insight into why interventions that were effective in one setting may or may not produce similar results in another. [adapted from preface]

The aim of this study was to examine the relationship between quality of work life and turnover intention of primary health care nurses in Saudi Arabia. [from abstract]

The aim of this study was to explore the factors influencing the career plans of medical students and recent graduates with regard to four policy-relevant aspects: emigration outside Malawi; working at district level; private sector employment and postgraduate specialisation. [from abstract]

This brief outlines the concept of performance-based incentives (PBI) in the health sector, facilitating the design of these incentive programs using the case of Senegal as an example, building the evidence for PBI and integrating PBI into strengthening efforts. [adapted from author]

This study examined the factors associated with a physician’s decision to leave a work location. We compared different generations of physicians to assess whether these factors have changed over generations. [from abstract]

This paper investigates whether governments in developing countries can retain skilled health workers by raising public sector wages using sudden, policy-induced wage variation, in which the Government of Ghana restructured the pay scale for government health workers. [adapted from abstract]

This study investigated preferences for job characteristics among final year medical, nursing, pharmacy, and laboratory students at select universities in Uganda to elicit preferences for attributes of potential job postings they were likely to pursue after graduation. [adapted from abstract]

This study aims to identify aspects of recruitment and retention of rural allied health professionals using qualitative methodology to establish the motives and conditions that encourage allied health professionals to practice rurally. [from abstract]

Although a community-based health insurance scheme (CBI) was introduced in Burkina Faso, coverage has remained low and dropout rates high because health workers are dissatisfied with the provider payment mechanism. This research was used to examine CBI provider payment attributes that influence healthcare workers’ stated preferences for payment mechanisms. [adapted from abstract]

This study examined inter-personal, intra-personal and extra-personal factors that influence job satisfaction among rural primary care nurses in a low and middle income country, Papua New Guinea. [from abstract]

The paper describes performance-based incentive contracting schemes that have been implemented to improve results for a range of interventions from time-limited immunizations to chronic conditions that require significant lifestyle changes, such as diabetes. It argues that performance incentives are a viable and potentially more powerful solution than typical inputoriented approaches to dealing with underutilization, poor quality, and low efficiency. [from publisher]

Many countries are facing an ageing of the nursing workforce and increasing workforce shortages. This article reports findings from a qualitative study of 15 participants who explored perceived opportunities for and barriers to implementing flexible strategies to engage older nurses in the workforce after they resign from full-time work. [adapted from abstract}

A better understanding of how public sector midwives in Senegal are experiencing their work and how it is affecting them is needed in order to better address their needs and incite them to remain in their posts. This study aims to explore their job satisfaction and its effects on their burnout, intention to quit and professional mobility. [from abstract]

This paper provides a detailed analysis of the complete responses from an online survey to capture developing country experience with pay for performance - a strategy that is increasingly being introduced with the goal of improving maternal and child health outcomes. [adapted from author]

This study reviews experiences and lessons learned regarding monetary and non-monetary incentives for community workers. It includes indicative costings and recommendations for further policy and development with regard to the effective recruitment, training and deployment of community workers in Zambia. [adapted from summary]

In order to explain the Christian Health Association of Malawi’a (CHAM) approaches to HRH, this paper gives an overview of CHAM especially its operational structure; reviews HRH data from affiliated institutions; looks at elements faced by CHAM with regards to retention; and analyzes what CHAM has done to promote retention of health workers. [adapted from author]

This report contains results from descriptive analysis of a cohort study with final year health students in Ethiopia to build a base line for a cohort survey with future health workers and to provide insights on the supply side aspect of human resources in the health sector. [adapted from summary]

Using qualitative data from Rwanda, this study focuses on four institutional factors that affect health worker performance and career choice: incentives, monitoring arrangements, professional norms and health workers’ intrinsic motivation. It also provides illustrations of three institutional innovations that work, at least in the context of Rwanda: performance pay, the establishment of community health workers and increased attention to the training of health workers. [adapted from introduction]

The government of Rwanda has identified human resources for health as one of its policy priorities. This study aims to contribute to building a better understanding of health worker choice and behaviour, and to improve evidence based polcies. [from summary]

This paper estimates the effectiveness of a range of policy interventions aimed at improving the supply of health workers to rural areas in Ethiopia. Using data from a survey of 861 health workers, it employs stated preference techniques to predict labor market responses of doctors and nurses to changes in rural wages, working conditions, housing bene…ts, and training opportunities. [from abstract]

this prospective study explored the course of job satisfaction in a cohort of Norwegian doctors over a five-year period to determine the overall course of job satisfaction over the period, differences between job positions, and whether changes in job satisfaction was associated with a change in job position. [adapted from author]

This study carries out a microeconomic labor analysis of health worker career choice and of job behavior. It shows how common problems related to distribution or performance of HRH are driven by the behavior of health workers themselves and are determined largely by select monetary and nonmonetary compensation. [from abstract]

This study investigated the career intentions of graduating students attending medical schools in sub-Saharan Africa to identify interventions which may improve retention of African physicians in their country of training or origin. [from abstract]

This research aims to answer concerns about the magnitude, determinants and successful ways of reducing lay health worker attrition in health programs. [adapted from abstract]

This case study explores the process between donors and the government of moving pay for performance (P4P) from concept to design to implementation. It describes key areas of disagreement, and highlights the political tensions inherent in translating high-level interest in P4P into on-the-ground action. [from author]

The objective of this article is to argue that it is important for all stakeholders involved in rural recruitment and/or retention processes to consider their decisions and actions from an ethics perspective. [from abstract]

This document analalyzes the effectiveness of performance incentive schemes in developing countries that comprise maternal health components, including family planning. [adapted from author]

The overall goal of the post-graduation tracer survey was to determine the proportion of graduates still working in Southern Sudan, where they have been deployed, their specific duties, and the perceptions of the graduates on the effectiveness of the training program in preparing them for their duties. [adapted from author]

The focus of this study has been to identify the most common causes for the health worker high attrition rate and poor motivation within the health sector, and look at the various solutions that are possible. It brings together the findings of many relevant studies by other authors and identifies the most common reasons for high attrition rates. [adapted from summary]

The objectives of the research are to come to a better understanding of why health workers adopt behaviours that impact negatively on patients and to look for solutions in policy and practice to improve staff motivation and morale. [from author]