Early Implementation of WHO Recommendations for the Retention of Health Workers in Remote and Rural Areas

The World Health Organization (WHO) issued 16 global recommendations for improving the recruitment and retention of health workers in rural areas—a challenge faced by most countries and a barrier to universal health coverage. This article discusses the challenges and lessons learned from adaptation and adoption of the recommendations in Lao People’s Democratic Republic and South Africa, and explores the influence of the recommendations regionally in Asia and Europe. In Lao PDR, the Ministry of Health partnered with CapacityPlus and the WHO to apply the Rapid Retention Survey Toolkit (developed by CapacityPlus using the WHO recommendations) and iHRIS Retain costing software to assess which of the recommendations would be most effective in the Laotian context and subsequently inform a new national policy for recruiting and retaining health workers.

Net Costs of Health Worker Rural Incentive Packages: An Example from the Lao People’s Democratic Republic

Many developing countries are examining whether to institute incentive packages that increase the share of health workers who opt to locate in rural settings; however, uncertainty exists with respect to the expected net cost (or benefit) from these packages. CapacityPlus utilized findings from discrete choice experiment surveys applied to students training to be health professionals and costing analyses in Lao People’s Democratic Republic to model the anticipated effect of incentive packages on new worker location decisions and direct costs. In this example, incentive packages that do not invest in capital-intensive components generally should produce larger net benefits. Combining discrete choice experiment surveys, costing surveys, and cost-benefit analysis methods may be replicated by other developing countries to calculate whether health worker incentive packages are viable policy options.

Differences in Preferences for Rural Job Postings between Nursing Students and Practicing Nurses: Evidence from a Discrete Choice Experiment in Lao People’s Democratic Republic

A discrete choice experiment was conducted to investigate preferences for job characteristics among nursing students and practicing nurses to understand whether differing policies may be appropriate for each group. Data were collected from 256 nursing students and 249 practicing nurses. For both groups, choice of job posting was strongly influenced by salary and direct promotion to permanent staff. As compared to nursing students, practicing nurses had significantly lower preference for housing allowance and housing provision as well as lower preference for provision of transportation for work and personal use. Findings suggest that it may be important to differentiate between recruitment and retention policies when addressing human resources for health challenges in developing countries, such as Lao PDR.

Designing Evidence-Based Incentive Strategies for Health Worker Retention

Many countries struggle to attract and retain sufficient numbers and types of health workers to provide quality services in rural and remote areas. Ministries of health often rely on external partners to develop the evidence base for formulating retention strategies, use less rigorous methodologies, or forego data altogether when making policy decisions. Presented at the Second Global Symposium on Health Systems Research in Beijing on November 1, 2012, this poster describes two new tools—the Rapid Retention Survey Toolkit and the iHRIS Retain costing tool for retention interventions—and related results from Ministry of Health surveys in Lao People’s Democratic Republic and Uganda.

Toward Development of a Rural Retention Strategy in Lao People’s Democratic Republic: Understanding Health Worker Preferences

This technical report presents the results of a discrete choice experiment (DCE) conducted by the Lao People’s Democratic Republic Ministry of Health, in partnership with the World Health Organization and CapacityPlus, using CapacityPlus’s rural retention survey toolkit. The DCE surveyed health professional students and health workers practicing in rural provinces to investigate their motivational preferences for potential strategies to increase attraction and retention in the country’s rural and remote settings.

Motiver les prestataires de soins pour mieux desservir les populations rurales en République démocratique populaire du Laos

Les docteurs Chanthakhath Papassarang, Phouthone Vangkonevilay et Outavong Phathammavong expliquent comment évaluer les préférences des agents de santé afin de déterminer les mesures d’incitation les plus efficaces pour faciliter la prestation de services en milieu rural.

Motivating Health Workers to Serve in Rural Lao PDR

Dr. Chanthakhath Papassarang, Dr. Phouthone Vangkonevilay, and Dr. Outavong Phathammavong describe an effort to assess health workers’ preferences in order to determine the most effective incentives for rural service. Also available in French.

Syndicate content