Financial interventions and movement restrictions for managing the movement of health workers between public and private organizations in low- and middle-income countries
Researchers in the Cochrane Collaboration conducted a review to evaluate the effect of approaches to encourage health workers to work in particular healthcare facilities. After searching for all relevant studies, they were unable to find any studies that met their requirements for inclusion in this review.
Many countries have a severe lack of health workers. In addition, the health workers that are available are often not distributed in the best possible way. Most health workers work in urban areas, leaving rural areas underserved. Problems also occur in urban areas as health workers here often prefer to work in the private healthcare sector, which is often too expensive for many people. In rural areas, governments may not have built health facilities and the only available health care in these areas may, therefore, be private. However, private facilities in rural areas are not only expensive but may also struggle to attract qualified health workers.
To address these problems, governments need to find ways of ensuring that more health workers work in the areas and facilities where most people seek care. This might, for instance, involve encouraging health workers to work in public healthcare facilities in towns and cities or to work in public or private facilities in rural areas. One approach governments could take is to give extra incentives to health workers serving in particular facilities. These incentives could include higher salaries, special allowances, or higher retirement packages. Another approach is to give health workers bursaries or scholarships during training on the condition that they work in particular facilities for a fixed period of time after they have finished their training.
Although these types of approaches are not uncommon, the review could not find any relevant studies that gave a reliable assessment of their impact. There is still a lot of work to be done to understand how governments can ensure that health workers serve in those health facilities that care for the majority of the population.
Rutebemberwa, E.; Kinengyere, A.A.; Ssengooba, F.; Pariyo, G.W.; Kiwanuka, S.N. Financial interventions and movement restrictions for managing the movement of health workers between public and private organizations in low- and middle-income countries. Cochrane Database of Systematic Reviews (2014) (Issue 2) Art. No.: CD009845. [DOI: 10.1002/14651858.CD009845.pub2]