Developing effective policy strategies to retain health workers in rural Bangladesh: a policy analysis

Rawal, Lal; Joarder, Taufique; Islam, Sheikh Mohammed Shariful; Uddin, Aftab; Ahmed, Syed Masud

doi:10.1186/s12960-015-0030-6

Cited by 45 publications

(53 citation statements)

References 27 publications

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“…Thus, we found that the majority of the students (60%) came from a rural background, and in general their intention towards taking up jobs in rural areas was quite positive. Evidence from other countries also suggests that training students with rural backgrounds increases the likelihood of taking rural jobs after the graduation (Laven and Wilkinson, 2003;Woloschuk and Tarrant, 2004;Wilson et al, 2009;Walker et al, 2012;Rawal et al, 2015). In the case of medical doctors, a systematic review showed that doctors with a rural background are twice as likely to work as rural doctors compared with those with an urban background (Laven and Wilkinson, 2003).…”

Section: Discussionmentioning

confidence: 99%

Training mid-level health cadres to improve health service delivery in rural Bangladesh

Rawal

Mahmud

Islam

et al. 2016

Prim Health Care Res Dev

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This study provides a current picture of MATS students' characteristics, educational services, competencies and perception towards working in rural areas. The MA students in both private and public sectors showed a greater level of willingness to serve in rural health facilities. The results are promising to improve health service delivery, particularly in rural and hard-to-reach areas of Bangladesh.

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Section: Discussionmentioning

confidence: 99%

Training mid-level health cadres to improve health service delivery in rural Bangladesh

Rawal

Mahmud

Islam

et al. 2016

Prim Health Care Res Dev

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“…Considering most healthcare workers' motivation to work in rural areas lasts only a limited number of years, setting up a clear duration of the assignment in rural areas and introducing a rotation system could be one policy option to improve the transparency. Many countries already implement a rotation system, but effectiveness seems to vary [22][23][24] . Thus, a rotation system with non-adherence to a transparent policy would further demotivate healthcare workers in rural areas 19 …”

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confidence: 99%

Retention of qualified healthcare workers in rural Senegal: lessons learned from a qualitative study

Nagai¹,

Fujita²,

Diouf³

et al. 2017

Rural Remote Health

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A B S T R A C TIntroduction: Deployment and retention of a sufficient number of skilled and motivated human resources for health (HRH) at the right place and at the right time are critical to ensure people's right to access a universal quality of health care. Vision Tokyo 2010 Network, an international network of HRH managers at the ministry of health (MoH) level in nine Francophone African countries, identified maldistribution of a limited number of healthcare personnel and their retention in rural areas as overarching problems in the member countries. The network conducted this study in Senegal to identify the determining factors for the retention of qualified HRH in rural areas, and to explore an effective and feasible policy that the MoH could implement in the member countries. Methods: Doctors, nurses, midwives and superior technicians in anesthesiology who were currently working (1) in a rural area and had been for more than 2 years, (2) in Dakar with experience of working in a rural area or (3) in Dakar without any prior experience working in a rural area were interviewed about their willingness and reasons for accepting work or continuing to work in a rural area and their suggested policies for deployment and retention of healthcare workers in rural areas. In-depth interviews were conducted with policy makers in MoH, asking for their perceptions on human resource management in health and about their suggested policies for deployment and retention.Results: A total of 176 healthcare workers and eight policy makers were interviewed. The willingness to face challenges in a new place was one of the main reasons for accepting work in rural areas. The identified factors to motivate or demotivate healthcare workers in rural areas were related to pre-service and in-service education, regulatory systems, financial and non-financial incentive schemes and environmental support. Factors not included in WHO's global recommendation but highly valued in this study were (1) the fairness, transparency and predictability of human resource management by the MoH and (2) employment status, © M Nagai, N Fujita, IS Diouf, M Salla 2017. A Licence to publish this material has been given to James Cook University, http://www.jcu.edu.au 2 ie permanent government staff versus contract staff. Financial incentive schemes were less commonly suggested. Family bonding and religious-related non-financial incentive schemes were found to be specific factors in Senegal, but would also be applicable in countries where family and religion play important roles in the values of healthcare workers. Conclusions: Improved HRH management, eg the transparency of human resource management by the MoH, was identified as a pre-condition of any policy implementation related to HRH. This factor can be considered in other countries struggling to retain healthcare workers in rural areas. The Vision Tokyo 2010 Network or HRH managers' network in Francophone Africa, Senegal MoH and the research team plan to conduct a quantitative survey to confirm the generaliz...

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“…Low motivation has been identified by some studies as the second most important health workforce problem after staff shortages [63]. Corruption in the recruitment and promotion of health workers may affect their motivation and retention [64,65]. However, while there are several studies on health worker motivation, few explicitly mention corruption in HRH as a factor.…”

Section: Impact On Motivation Of Health Workersmentioning

confidence: 99%

Promoting anti-corruption, transparency and accountability in the recruitment and promotion of health workers to safeguard health outcomes

Kirya

2020

Global Health Action

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Background: Human Resources for Health are a core building block of a health system, playing a crucial role in improving health outcomes. While the existing literature has examined various forms of corruption that affect the health sector, few articles have examined the role and impact of corruption in the recruitment and promotion of health-workers.Objectives: This study reviews the role of corrupt practices such as nepotism, bribery and sextortion in health-worker recruitment and promotion and their implications for health systems.Methods: The study is based on an interdisciplinary non-systematic review of peer-reviewed journal articles in the public health/medicine and political science literature, complemented with the 'grey' literature such as technical reports and working papers. Results: Political and personal ties, rather than merit are often factors in the recruitment and promotion of health-workers in many countries. This results in the employment or promotion of poorly qualified or unsuitable workers, with negative implications for health outcomes. Conclusion: Corrupt practices in health-worker recruitment and promotion 'set the tone' for other forms of corruption such as absenteeism, embezzlement, theft and bid-rigging to flourish, as those recruited corruptly can collude for nefarious purposes. On the other hand, merit-based recruitment is important for curbing corruption. Corrupt recruitment practices have deleterious effects on health-worker motivation and retention, quality and competency, citizens' trust in health services and health outcomes. Whereas international law and policy such as the United Nations Convention Against Corruption and the WHO Handbook on Monitoring and Evaluation of Human Resources for Health state that recruitment of public officers and health workers respectively should be done in a transparent and accountable manner, more research is needed to inform policies on merit-based recruitment. ARTICLE HISTORY

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Developing effective policy strategies to retain health workers in rural Bangladesh: a policy analysis

Cited by 45 publications

References 27 publications

Training mid-level health cadres to improve health service delivery in rural Bangladesh

Training mid-level health cadres to improve health service delivery in rural Bangladesh

Retention of qualified healthcare workers in rural Senegal: lessons learned from a qualitative study

Promoting anti-corruption, transparency and accountability in the recruitment and promotion of health workers to safeguard health outcomes

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