New Resource Spotlight: Rapid Retention Survey Toolkit, Revised Edition

Many countries are working to increase access to health care by recruiting more health workers to serve in rural areas. While nearly half the world’s population lives in rural areas, only 38% of the world’s nurses and a quarter of doctors work there. To help countries determine what would motivate health workers to accept and remain in rural posts, CapacityPlus developed the Rapid Retention Survey Toolkit: Designing Evidence-Based Incentives for Health Workers. Now, a revised edition contains improvements based on additional application in Namibia among pharmacists and pharmacy assistants, as part of the People that Deliver initiative and in collaboration with the Ministry of Health and Social Services and the University of Namibia.

About the toolkit

Rapid Retention Survey ToolkitThe Rapid Retention Survey Toolkit is based on the discrete choice experiment (DCE). This is 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. The toolkit employs a simplified approach, the “rapid DCE,” which was created for use by human resources managers for the health workforce. This approach enables them to quickly assess health professional students’ and/or health workers’ motivational preferences to take up posts and remain in underserved facilities. The results can be used to create evidence-based incentive packages that are appropriate within a country’s health labor market.

The toolkit includes step-by-step instructions, sample formats, and examples that can easily be adapted to a specific country context, including survey planning, design, instrument development, and administration as well as data analysis and presentation of results to stakeholders. The appendices can be downloaded as Microsoft Word and Excel files.

Companion tools

The Rapid Retention Survey Toolkit can be combined with iHRIS Retain, a software tool developed by CapacityPlus and the World Health Organization to cost retention interventions. The result is the development of an affordable, cost-effective retention package designed by country stakeholders to meet health worker needs within their specific context, and ultimately contribute to more health workers serving rural communities to increase their access to family planning/reproductive health, HIV/AIDS, maternal and child health, and other essential health services.

Case study from Lao People’s Democratic Republic

Health workers in Lao PDRCapacityPlus field-tested these tools in Lao People’s Democratic Republic with the Ministry of Health and in partnership with the WHO. The results informed a new national recruitment and retention policy for the health workforce. The policy stipulates that all new graduates in medicine, nursing, midwifery, pharmacy, and dentistry, as well as postgraduates in family medicine, must complete three years of rural service in order to receive their licenses to practice.

Based on the survey and costing results, the policy also provides specific incentives—such as housing and eligibility for continued education—to motivate health workers to provide high-quality services while carrying out their rural service, as well as encourage them to stay after the compulsory service has ended. In the first two years, 1,551 newly recruited doctors, nurses, midwives, pharmacists, and dentists have been posted to rural district hospitals and health centers. Learn more:

To get started, check out this overview and browse the PDF. At any time, please let us know if you have any questions. We’re glad to help. And if you do apply these tools, please tell us about it.

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Photo by Wanda Jaskiewicz (health workers in Lao People’s Democratic Republic)