New Resource Spotlight: Discrete Choice Experiment User Guide

How can policy-makers formulate appropriate responses to address shortages of health workers in remote and rural areas? A new publication produced through close collaboration among the World Health Organization (WHO), the World Bank, and CapacityPlus proposes an innovative methodology—the discrete choice experiment (DCE)—for measuring the strength of health workers’ preferences related to different job characteristics that can influence their decision to accept and remain in rural posts.

User Guide with Case Studies: How to Conduct a Discrete Choice Experiment for Health Workforce Recruitment and Retention in Remote and Rural Areas offers step-by-step advice on the application of the DCE to identify policy interventions appropriate to a particular country to tackle health workforce shortages in underserved areas. The guide includes case studies from Tanzania and Uganda that demonstrate the application of the DCE in real-life contexts.

The Uganda case study documents a DCE conducted by the Uganda Ministry of Health, with assistance from CapacityPlus, which analyzed data from both students in health worker training programs (to inform policies related to attraction to rural posts) and in-service health workers (to inform policies related to retention).

Related tools
Intended to be used as part of training programs for researchers involved in the design and implementation of a DCE, the user guide complements three related tools developed by CapacityPlus:

  • The Rapid Retention Survey Toolkit, which offers a simplified approach intended for use by human resources managers from ministries of health and faith-based organizations to follow a rapid DCE survey process to create evidence-based incentive packages for attraction and retention that are appropriate within a country’s health labor market
  • An eLearning course to train users on applying the Rapid Retention Survey Toolkit
  • iHRIS Retain, an open source software program developed by CapacityPlus and the WHO to cost retention interventions.

A resource for creating experts
“The user guide provides a valuable resource for creating a global force of researchers, academics, economists, and others with the capacity to provide expert technical assistance to organizations in the public and private health sectors to design DCEs that can produce the evidence-based information needed to implement effective incentive strategies to attract and retain more health workers in rural areas,” notes CapacityPlus's Wanda Jaskiewicz, who managed the project’s contributions to the guide.

Both the user guide and the Rapid Retention Survey Toolkit build on the WHO Guidelines on Increasing Access to Health Workers in Remote and Rural Areas through Improved Retention.

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