Retention

All eyes were on newly appointed Minister of State for Health Dr. Muhammad Ali Pate as he presented his vision of health for Nigeria: 1,000,000 lives saved and quality of care measurably improved. He expertly laid out four pillars to achieve this goal: expanding basic services; disease prevention (particularly through scaling-up Hib and pneumococcal vaccination); increasing quality of care via improved clinical governance; and unlocking the health sector’s market potential via increased public and private investment.

One of the special reasons for the excitement in the room at the “Innovative Approaches to Expanding Health Care Services in Nigeria” meeting on September 21 at Africare in Washington, DC, was the fact that many of the attendees, myself included, knew and had worked with Dr. Pate personally.
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Five years ago the World Health Organization told us that 57 countries had a critical shortage of health workers—fewer than 2.3 service providers for every thousand people. Today, all 57 countries are still below this threshold. What’s holding us back from faster progress?

First, the good news: many of these countries have national health workforce plans in place. Forty-four of the 57 crisis countries have a plan, according to the Global Health Workforce Alliance’s recent progress report.

Now, the bad news: not all of these countries are implementing their plans. Among the 57 crisis countries, only 24 have evidence-based and costed plans and are in the process of implementing them. Countries may be daunted by perceived barriers to implementation.

That’s why it makes me hopeful to see how many countries are trying creative approaches and moving from planning to action. Read more »

This is an excerpt from an original post on the IntraHealth International blog.

In the northern arid lands and other remote parts of Kenya, the Capacity Kenya project has been working with the Ministry of Health to design simple packages to attract health workers and encourage them to stay. Starting with a selected list of diverse pilot sites, the project set out to design intervention packages, implement them, and systematically evaluate their impact on health worker retention over time.

A couple of weeks ago I attended the Second Global Forum on Human Resources for Health in Bangkok, which gave me a unique opportunity to learn about the struggles, successes, and constraints of other countries. As I listened to the experiences of others and what they see as best practices, I kept thinking about what new interventions might work best in the Kenyan context. Read more »

I work on health systems strengthening, mostly for low-income countries. One major challenge is attracting and retaining health workers in rural and remote areas where health services are mostly scanty. Let me quote the recent WHO global policy recommendations for retention:

Approximately one half of the global population lives in rural areas, but these areas are served by only 38% of the total nursing workforce and by less than a quarter of the total physician workforce.

Which retention strategies should be pursued, and how much will they cost? Faced with multiple priorities and limited means, policy-makers want to know up-front what a recommendation will cost, to gauge the affordability of its implementation. Uganda, for instance, developed its Motivation and Retention Strategy back in 2008, but could not implement it because it didn’t know what the incremental costs would be.

In collaboration with WHO, CapacityPlus is designing a simple and user-friendly costing tool. Instead of depending on external technical assistance, HR managers or other health officials will be able to cost a retention strategy at the district, regional, or national level.

Historically, this kind of costing has been undertaken by health economists, which can be expensive. In contrast, our new tool is designed with the layperson in mind. You don’t need to be an economist to use it and understand the results. Read more »