New Publication Spotlight: Interview with Peter Rockers on Determining Priority Retention Packages to Attract and Retain Health Workers in Rural and Remote Areas in Uganda

Currently, positions staffed by the Uganda Ministry of Health (MOH) in many of the country’s rural and remote areas remain 50% vacant. This situation is not unique to Uganda, and health system planners in both developing and developed countries struggle to staff positions in rural areas. “The MOH is in the process of identifying which strategies for attracting and retaining health workers will be most successful, given resource constraints in underserved areas in the country,” says Peter Rockers, coauthor of a new CapacityPlus publication.

Peter RockersThe report, “Determining priority retention packages to attract and retain health workers in rural and remote areas in Uganda” by Peter Rockers, Wanda Jaskiewicz, Laura Wurts, and George Mgomella, presents the results of a project—led by the MOH and CapacityPlus—to assess Ugandan health workers’ preferences for various attraction and retention strategies among four cadres of health workers—medical officers, nursing officers, lab technicians, and pharmacists.

Although the primary audience for the report is the MOH, Rockers notes that “the report is aimed at all of the government ministries—such as finance, education, etc. With this report, the MOH will have evidence that it can use to negotiate with the Ministry of Finance and other stakeholders, and strengthen [the MOH’s] ability to advocate for the resources it needs.”

What makes this report unique is that it is based on a study that used the discrete choice experiment (DCE) method to determine health workers’ relative preferences or trade-offs. According to Rockers, “The DCE provides information that other methods cannot. Previous research has asked health workers about what’s important to them in terms of what jobs they pick, but DCE will allow the MOH to understand trade-offs.”

DCE ReportIn examining trade-offs, health workers must choose, for example, whether they would prefer a salary or housing allowance increase. “This information can then be quantified to show how important a certain option would be to health workers,” says Rockers. “Then, the MOH can identify the top two or three strategies to develop potential retention packages.”

Not only is this report important to the MOH, the research findings are important to health workers themselves. Rockers explains, “We interviewed several medical students—in their final year of school—many of whom were thinking of going to Rwanda after they graduate. The medical students were very interested in this study because they were concerned about what their futures may hold.” While in medical school, the students have limited exposure to what the job postings would really be like, and they expressed concern that rural posts would not allow them to adequately provide for their families.

“The MOH doesn’t have the resources to pursue all possible strategies, and using the DCE allows them to identify the most important strategies with the most potential to be effective,” says Rockers.

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Photo courtesy of Peter Rockers