Retention and Productivity:
Tools and Resources

  Tools and Resources

Ensuring a Positive Practice Environment: Occupational Safety and Health for Health Worker Productivity

CapacityPlus Technical Brief #4 (PDF)

CapacityPlus Technical Brief #4 (Interactive Version)

Providing high-quality health care should not be hazardous to the health worker. Health workers are adversely affected by numerous occupational safety and health (OSH) hazards they face on the job. Effective OSH measures contribute to national workforce health and productivity, but only 5%-10% of workers in developing countries have adequate OSH services. This technical brief outlines ways to make health workers’ safety a higher-level policy issue and shows how to create working environments that prioritize occupational health.

Health Workforce Productivity Analysis and Improvement Toolkit

Health Workforce Productivity Analysis and Improvement Toolkit

The health workforce is critical for ensuring access to high-quality family planning/reproductive health, maternal and child health, HIV/AIDS, and other services in order to improve health outcomes. While increasing the number of health workers where there are shortages is essential, it is equally important to improve the productivity of the existing workforce and make service delivery more efficient. The Health Workforce Productivity Analysis and Improvement Toolkit describes a step-wise process to measure the productivity of facility-based health workers, understand the underlying causes of productivity problems, and identify potential interventions to address them. Users can enter and save facility-level data on service delivery outputs and human resources costs in order to calculate total health workforce productivity and compare these rates across facilities. This process differentiates higher-productivity facilities from lower-productivity ones, which through a qualitative assessment can help managers and supervisors to consider which factors are affecting health workforce productivity in the facilities.

Holding Health Workers Accountable: Governance Approaches to Reducing Absenteeism

CapacityPlus Technical Brief #3 (PDF)

CapacityPlus Technical Brief #3 (Interactive Version)

Health workforce absenteeism is a serious problem and can greatly diminish the effectiveness of health service delivery. Reducing absenteeism requires a decentralized approach involving broad stakeholder groups to address underlying governance issues and reinforce complementary accountability mechanisms. This technical brief looks at the cost of absenteeism, examines governance issues, describes the various stakeholders, and offers a number of recommendations for strengthening governance to reduce absenteeism.

iHRIS Retain

iHRIS Retain

iHRIS Retain is an open source tool to cost health worker retention interventions. People living in rural and remote areas need more skilled health workers to care for their communities. However, attracting and retaining health workers to serve in these areas is a challenge. Developed by CapacityPlus in collaboration with the World Health Organization (WHO), iHRIS Retain is based on the WHO’s 2010 global policy recommendations on retention, which offer guidance on the different interventions in the areas of education, regulation, financial incentives, and professional development that can increase access to health workers in remote and rural areas through improved retention. iHRIS Retain guides users through the costing process step by step, collecting necessary data, calculating the costs of interventions, and comparing costs to available funding. The resulting information can then be used to develop retention strategies at the district, regional, or national level.

Optimizing Performance and Quality: Stages, Steps, and Tools

Optimizing Performance and Quality

Optimizing Performance and Quality (OPQ) is a stakeholder-driven, cyclical process for analyzing human and organizational performance and setting up interventions to improve performance and quality or build on strengths and successes. It has been used by country leaders in over 15 countries to strengthen health-sector governance through greater accountability and transparency, broadened partnerships, and measurable results in improved service quality. The OPQ process builds capacity within an organization to recognize and address problems or performance gaps on an ongoing basis. Each of the seven stages provides evidence-based guidance and steps to follow, with a suite of tools to help users through the process.

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

Rapid Retention Survey Toolkit (English and French)

The 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 »

TAGS: DCE, Discrete Choice Experiment, Health Workers, Motivation, Recruitment, Retention, Rural

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

CapacityPlus Legacy Series #4

CapacityPlus built the capacity of national human resources for health (HRH) leaders and managers in Uganda, Laos, and Malawi to use the project’s retention and productivity tools to generate evidence and inform decisions to influence policy-making and improve the availability of services through increased staffing and distribution.

User Guide with Case Studies: How to Conduct a Discrete Choice Experiment for Health Workforce Recruitment and Retention in Remote and Rural Areas

Discrete Choice Experiment User Guide

Understanding why health workers want or don’t want to take posts and remain in remote and rural areas is a prerequisite to formulating appropriate policy responses to the shortage of health workers in these areas. Building on the World Health Organization (WHO) Guidelines on Increasing Access to Health Workers in Remote and Rural Areas through Improved Retention, this user guide proposes an innovative methodology, the discrete choice experiment (DCE), to measure the strength of health workers’ preferences and trade-offs related to different job characteristics that can influence their decision to take up rural postings. The user guide offers step-by-step advice on the application of DCE to identify policy interventions appropriate to a particular country context. The guide is the product of close collaboration among three agencies—the World Bank, the WHO, and USAID/CapacityPlus—and represents their shared commitment to supporting policy-relevant research on critical topics related to human resources for health.

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

CapacityPlus Technical Brief #15 (PDF)

CapacityPlus Technical Brief #15 (Interactive Version)

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.


For additional resources and publications see the Workforce Effectiveness section of the CapacityPlus Knowledge Library.