https://doi.org/10.4081/hls.2022.10376
0
0
0
0
Smart Citations0
0
0
0
Citing PublicationsSupportingMentioningContrasting
See how this article has been cited at scite.ai
scite shows how a scientific paper has been cited by providing the context of the citation, a classification describing whether it supports, mentions, or contrasts the cited claim, and a label indicating in which section the citation was made.
Why measure the retention of health workers within borders? Lessons learned from the ETATMBA program in measuring health workforce retention in Malawi and Tanzania
Health workforce retention is a recognised strategy for alleviating the health workforce scarcity in low- and middleincome countries. However, there is a lack of clarity on what retention is and how it is measured. We followed up with health workers who participated in the ETATMBA program, an in-service training program from selected healthcare facilities in Malawi and Tanzania, once per quarter, for five years, to determine their retention. We measured retention in three aspects: i) duration of stay in target healthcare facilities, ii) retention in clinical roles, and iii) retention in government employment. We tracked 127 participants, 46 in Malawi and 81 in Tanzania. At the end of tracking, the retention in each aspect measured was different. In Malawi, the retention in target facilities was 47.2%, the retention for clinical roles was 69.5%, and retention for government employment was 76.1%. In Tanzania, the rates were 45.7%, 72.8%, and 76.5%, respectively. The extent of workforce retention depends on the parameters chosen to measure it. Standard indicators for workforce retention needs to be outlined to streamline retention measurement, inform health policies and improve human resources for health planning.
Downloads
Citations
0
0
World Health Organisation. The Kampala declaration and agenda for global action. WHO; 2008. Available from: https://apps.who.int/iris/handle/10665/43898
Campbell J, Dussault G, Buchan J, Pozo-Martin F. A universal truth: no health without a workforce. In: Forum Report, Third Global Forum on Human Resources for Health, Recife, Brazil, 2013 Nov 10-13. WHO; 2013. Available from: https://www.euro.who.int/en/media-centre/events/events/2013/11/third-global-forum-on-human-resources-for-health
World Health Organization. Making Health Workers Count. The Global Workforce Alliance 2012 Annual Health Report. WHO, 2012. Available from: https://apps.who.int/iris/bitstream/handle/10665/250330/9789241511407-eng.pdf
World Health Organization. Global strategy on human resources for health: Workforce 2030. WHO Library Cataloguing-in-Publication Data; 2018. Available from: https://apps.who.int/iris/bitstream/handle/10665/250368/9789241511131-eng.pdf
Ministry of Health and Social Welfare, United Republic of Tanzania. Health Sector Strategic Plan, July 2015 – June 2020 (HSSP IV): Reaching all Households with Quality Health Care. Ministry of Health and Social Welfare, United Republic of Tanzania, 2015. Available from: https://www.prb.org/wp-content/uploads/2020/06/Tanzania-Health-Sector-Strategic-Plan-IV-2015-2020-1-4.pdf
Ministry of Health, Malawi. Health Sector Strategic Plan II (2017-2022). Ministry of Health, Malawi; 2017. Available from: https://extranet.who.int/countryplanningcycles/sites/default/files/planning_cycle_repository/malawi/health_sector_strategic_plan_ii_030417_smt_dps.pdf
Wilson N, Couper I, Vries E, et al. A critical review of interventions to redress the inequitable distribution of healthcare professionals to rural and remote areas. Rural Remote Health 2009;9:1060.
Humphreys J, Wakerman J, Kuipers P, et al. Improving workforce retention: developing an integrated logic model to maximise sustainability of small rural & remote health care services. Australian primary Health Care Research Institute; 2009. Available from: https://nceph.anu.edu.au/files/full_report_10797.pdf
Armstrong M, Taylor S. Resourcing practice: retention planning. In: Armstrong’s Handbook of Human Resource Management Practice. 14th ed. Dorset Press; 2017. p.252-3.
Castro Lopes S, Guerra-Arias M, Buchan J, et al. A rapid review of the rate of attrition from the health workforce. Hum Resour Health 2017;15:21.
Kollar E, and Buyx A. Ethics and policy of medical brain drain: A review. Swiss Medical Weekly 2013;143:w13845.
Chen L. Striking the right balance: health workforce retention in remote and rural areas. Bull World Health Org 2010;88:323-4.
Shemdoe A, Mbaruku G, Dillip A, et al. Explaining retention of healthcare workers in Tanzania: moving on, coming to ‘look, see and go’, or stay? Hum Resour Health 2016;14:2.
O’Sullivan BG, Couper I, Kumar P, McGrail MR. Editorial: Effective strategies to develop rural health workforce in Low- and Middle-Income Countries (LMICs). Front Public Health 2021;9:702362.
World Health Organisation. National health workforce accounts: a handbook. Geneva. 2017. https://apps.who.int/iris/bitstream/handle/10665/259360/9789241513111-eng.pdf
World health statistics 2021: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2021. Available from: https://apps.who.int/iris/bitstream/handle/10665/342703/9789240027053-eng.pdf
Russell D, Humphreys J, Wakerman J. How best to measure health workforce turnover and retention: Five key metrics. Aust Health Rev 2012;36:290-5
Gupta J, Patwa MC, Khuu A, Creanga AA. Approaches to motivate physicians and nurses in low- and middle-income countries: a systematic literature review. Hum Resour Health 2021;19:4.
Russell D, Wakerman J, and Humphreys J. What is a reasonable length of employment for health workers in Australian rural and remote primary healthcare services? Aust Health Rev 2013:37;256-61.
Ellard D, Simkiss D, Quenby S, et al. The impact of training non-physician clinicians in Malawi on maternal and perinatal mortality: a cluster randomised controlled evaluation of the enhancing training and appropriate technologies for mothers and babies in Africa (ETATMBA) project. BMC Pregnancy Childbirth 2012:12;1.
Ellard D, Shemdoe A, Mazuguni F, et al. Can training non-physician clinicians/associate clinicians (NPCs/ACs) in emergency obstetric, neonatal care and clinical leadership make a difference to practice and help towards reductions in maternal and neonatal mortality in rural Tanzania? The ETATMBA project. BMJ Open 2016;6:e008999.
Cometto G, Tulenko K, Muula AS, Krech R. Health workforce brain drain: From denouncing the challenge to solving the problem. PLoS Medicine 2013;10:9.
Deressa W, Azazh A. Attitudes of undergraduate medical students of Addis Ababa University towards medical practice and migration, Ethiopia. BMC Medical Education 2012;12:1.
Karan A, DeUgarte D, Barry M. Medical “Brain Drain” and Health Care Worker Shortages: How Should International Training Programs Respond? AMA Journal of Ethics 2016;18:1:665–75.
Labonté R, Sanders D, Mathole T, et al. Health worker migration from South Africa: causes, consequences and policy responses. Hum Resour Health 2015;13:92. https://doi.org/10.1186/s12960-015-0093-4.
Mandeville K, Ulaya G, Lagarde M, et al. Early career retention of Malawian medical graduates: A retrospective cohort study. Trop. Med. Int. Health 2015;20:106-14.
Poppe A, Jirovsky E, Blacklock C, et al. Why sub-Saharan African health workers migrate to European countries that do not actively recruit: A qualitative study post-migration. Glob Health Action 2014;7:24071.
Sirili N, and Simba D. Understanding the Rural–Rural Migration of Health Workers in Two Selected Districts of Tanzania. Adv Public Health 2020;4910791.
Campbell J, Buchan J, Cometto G, et al. Human resources for health and universal health coverage: fostering equity and effective coverage. Bulletin of the World Health Organisation 2013;91:11.
Paina L, Bennett S, Ssengooba F, Peters D. Advancing the application of systems thinking in health : exploring dual practice and its management in Kampala, Uganda. Health Res Policy and Syst 2014;12:41.
How to Cite
Mdegela, M., Mvula, C. J., Vermand, N., Madaj, B., & O’Hare, J. P. (2022). Why measure the retention of health workers within borders? Lessons learned from the ETATMBA program in measuring health workforce retention in Malawi and Tanzania. Healthcare in Low-Resource Settings, 10(1). https://doi.org/10.4081/hls.2022.10376
