Using Evidence for Human Resources for Health Decision-Making: An Example from Uganda on Health Workforce Recruitment and Retention

A strong and well-distributed health workforce is necessary for providing access to high-quality health care and achieving national and global health goals. Developing and implementing policies to effectively address health workforce challenges demands relevant data for evidence-based decision-making. This technical brief offers six recommendations to help national stakeholders transform evidence into policy decisions and subsequent action. Using an example from Uganda, the authors illustrate how the development and sharing of evidence can support decision-making for change in health workforce recruitment and retention policies, toward the aim of improving access to high-quality health care for the population.

Recruitment of Community Health Workers

This chapter by CapacityPlus/IntraHealth International authors appears in MCHIP’s publication, Developing and Strengthening Community Health Worker Programs at Scale: A Reference Guide and Case Studies for Program Managers and Policymakers, which provides an in-depth review of issues and questions that should be considered when addressing key issues relevant for large-scale community health worker programs. Chapter 8 considers key questions, recommendations, and challenges for community health worker recruitment planning and implementation, including selection, resource availability, and retention.

Supporting Country-Led Efforts to Recruit and Retain Health Workers and Improve Their Productivity

CapacityPlus, with the USAID ASSIST Project and the World Bank, cohosted a knowledge-sharing and dissemination event at the National Press Club in Washington, DC, on February 18. The three-hour program focused on the latest evidence from country applications of innovations to strengthen health workforce recruitment, retention, and productivity. Through a combination of panel presentations, interactive roundtable groups, and moderated question-and-answer sessions, participants learned about and discussed various approaches and tools that can be used to develop policies to strengthen recruitment, retention, and productivity and improve access to high-quality family planning, reproductive health, HIV/AIDS, and other health services. Read the related news and access videos and presentations: Read more »

Moving Forward with the Health Labor Market Agenda

This presentation guided an interactive roundtable discussion at the CapacityPlus knowledge-sharing and dissemination event, Supporting Country-Led Efforts to Recruit and Retain Health Workers and Improve Their Productivity, held on February 18, 2014, at the National Press Club in Washington, DC.

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.

Why Would I Go There? Motivating Workers to Take and Keep Jobs in Rural Areas

Given the complexity of the social, professional, and economic factors that influence motivation, how do institutions make rural job postings more attractive? While many recognize that salary is an important factor, other characteristics of a job—such as better living or working conditions, supportive supervision, opportunities for continuing professional development, career advancement, networking, and even public recognition—can improve a worker’s sense of purpose and productivity. Identifying and offering the right incentive package to workers can result in a win-win situation, with benefits for both the worker and the community served. To address this issue of job attraction and retention in the health sector, CapacityPlus has helped ministries of health and NGOs answer these questions by using a rapid discrete choice experiment, a rigorous survey method that identifies the trade-offs that workers would be willing to make between specific job characteristics. Garnering statistical evidence of what motivates workers provides policy-makers with the needed information to develop more cost-effective job incentive strategies. This article originally appeared in the December 2012 issue of Monthly Developments Magazine (

Rapid Retention Survey Toolkit: Designing Evidence-Based Incentives for Health Workers

Rapid Retention Survey ToolkitThe Rapid Retention Survey Toolkit is designed to help countries determine what would motivate health workers to accept and remain in rural posts. It builds on the World Health Organization global policy recommendations for rural retention and is based on the discrete choice experiment (DCE), a powerful research method that identifies the trade-offs professionals are willing to make between specific job characteristics and determines their preferences for various incentive packages, including the probability of accepting a post in a rural facility. Employing a simplified version of the DCE methodology, the toolkit guides HR managers through the survey process to quickly assess health students’ and health workers’ motivational preferences to accept a position and continue working in underserved facilities. The results can be used to create evidence-based incentive packages that are appropriate within a country’s health labor market. Read more »


¿Qué motivará a los trabajadores de salud a permanecer en las zonas rurales?

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