Laotian Health Workforce Recruitment and Retention Policy Informed by Use of CapacityPlus Tools
In Lao People’s Democratic Republic (PDR), findings from the Ministry of Health’s application of the Rapid Retention Survey Toolkit and iHRIS Retain, with technical support from CapacityPlus and the World Health Organization, have informed the new national recruitment and retention policy for the health workforce. Announced this month, 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 compulsory rural service in order to receive their licenses to practice.
The policy also provides specific incentives, based on the survey and costing results, 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. They will receive a permanent civil service position either immediately upon posting or after two years (based on remoteness of location), transportation, additional salary (also based on remoteness of location), and eligibility for continued education.
The first phase of the policy focuses on new doctors, pharmacists, and dentists, 383 of whom will be assigned to selected health centers and district hospitals serving 105 villages across 51 districts, prioritized on a ranking of poverty, geographical challenges, and other social indicators.
CapacityPlus’s Rapid Retention Survey Toolkit allows health workforce managers to determine health workers’ motivational preferences for accepting posts in rural areas. It is based on the discrete choice experiment, a powerful research method that identifies the trade-offs health professionals are willing to make between specific job characteristics and to determine their preferences for various incentive packages, including the probability of accepting a post in a rural health facility.
iHRIS Retain is an open source tool developed in collaboration with the WHO to cost retention strategies. It guides users through the costing process step by step, collecting necessary data, calculating the costs of interventions, and comparing costs to available funding. The resulting information can then be used to develop retention strategies at the district, regional, or national level.
Building on these retention initiatives, CapacityPlus is also developing a Productivity Diagnostic and Improvement Toolkit, a comprehensive reference guide for use by ministries of health and faith-based organizations to measure and identify health worker productivity challenges, analyze the causes, and implement evidence-based solutions. CapacityPlus’s Wanda Jaskiewicz recently conducted planning sessions with the Lao PDR Ministry of Health and the World Health Organization to prepare for field testing the toolkit in the country. Lessons from the field test will be incorporated before publishing the toolkit in 2013.
Related items:
- New Resource Spotlight: iHRIS Retain, a Tool for Costing Plans to Keep Health Workers in Rural Areas
Photo by Wanda Jaskiewicz. (Health worker at a district hospital in Luang Prabang Province, Lao PDR)
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