A technical framework for costing health workforce retention schemes in remote and rural areas
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METHODOLOGY
Open Access
A technical framework for costing health workforce retention schemes in remote and rural areas Pascal Zurn1*, Marko Vujicic2, Christophe Lemière3, Maud Juquois2, Laura Stormont1, Jim Campbell4, Martine Rutten5 and Jean-Marc Braichet1
Abstract Background: Increasing the availability of health workers in remote and rural areas through improved health workforce recruitment and retention is crucial to population health. However, information about the costs of such policy interventions often appears incomplete, fragmented or missing, despite its importance for the sound selection, planning, implementation and evaluation of these policies. This lack of a systematic approach to costing poses a serious challenge for strong health policy decisions. Methods: This paper proposes a framework for carrying out a costing analysis of interventions to increase the availability of health workers in rural and remote areas with the aim to help policy decision makers. It also underlines the importance of identifying key sources of financing and of assessing financial sustainability. The paper reviews the evidence on costing interventions to improve health workforce recruitment and retention in remote and rural areas, provides guidance to undertake a costing evaluation of such interventions and investigates the role and importance of costing to inform the broader assessment of how to improve health workforce planning and management. Results: We show that while the debate on the effectiveness of policies and strategies to improve health workforce retention is gaining impetus and attention, there is still a significant lack of knowledge and evidence about the associated costs. To address the concerns stemming from this situation, key elements of a framework to undertake a cost analysis are proposed and discussed. Conclusions: These key elements should help policy makers gain insight into the costs of policy interventions, to clearly identify and understand their financing sources and mechanisms, and to ensure their sustainability.
Background Despite human resources for health having been recognized as a cornerstone to achieving better health outcomes [1], there remains a critical shortage of health workers, particularly in remote and rural areas where health outcomes tend to be significantly lower [2] and there is a considerable need for more basic health care. Increasing the availability of health workers in remote and rural areas through improved health workforce attraction and retention is therefore crucial, not only to improve population health, but also to reach the targets * Correspondence: [email protected] 1 World Health Organization, Geneva, Switzerland Full list of author information is available at the end of the article
set out by the health-related Millennium Development Goals [3]. Responses to increasing the availability of health workers in remote and rural areas have included a variety of initiatives at national and international level. This includes the recent launch of a WHO programme on “Increas
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