Lessons Learned and Recommendations
- Putting HRH stakeholders in the driver’s seat by building their capacity to apply evidence-based tools, instead of relying heavily on external assistance, promotes country ownership and increases self-sufficiency of host-country counterparts in making and acting on HRH decisions to address the workforce access and productivity bottlenecks hindering the provision of quality health care. This approach should also enable countries to update their evidence-based recruitment and retention strategies more frequently as economic and other conditions and health worker preferences change over time.
- Geospatially mapping HRH data and health indicator data from demographic and health surveys can aid countries to visualize where the need for addressing workforce access and distribution needs are greatest as well as to monitor the effects of HRH strengthening interventions on health services and outcomes.
- More evaluations of the implementation of health worker recruitment and retention policies are needed to determine their effectiveness and long-term impact on FP, HIV/AIDS, and MNCH service delivery as well as HRH performance, motivation, and productivity. Stakeholders can use any evidence of positive effects on services to encourage national scale-up within all health service areas, as well as advocate for application of the approaches in other sectors such as education and agriculture.
- Where discrete choice experiments have been carried out and resulting incentive packages implemented, longitudinal surveys should also be conducted to follow up on respondents and observe their actual decisions to validate the effectiveness of stated preference methods in predicting labor force decisions. To further validate the ultimate effectiveness of incentive strategies, follow-up studies should be conducted to measure the impact that using incentives to improve health worker recruitment and retention has on accessibility and utilization of services.
- To enable the cross-country and cross-regional comparison of results from different studies, common indices and frameworks should be developed and applied for performance, quality, and productivity.