Retention of health workers in Malawi: perspectives of health workers and district management
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BioMed Central
Open Access
Research
Retention of health workers in Malawi: perspectives of health workers and district management Ogenna Manafa*1, Eilish McAuliffe1, Fresier Maseko2, Cameron Bowie2, Malcolm MacLachlan1,3 and Charles Normand1 Address: 1Centre for Global Health, Trinity College, University of Dublin, Dublin, Ireland, 2College of Medicine, University of Malawi, Blantyre, Malawi and 3School of Psychology, Trinity College, University of Dublin, Dublin, Ireland Email: Ogenna Manafa* - [email protected]; Eilish McAuliffe - [email protected]; Fresier Maseko - [email protected]; Cameron Bowie - [email protected]; Malcolm MacLachlan - [email protected]; Charles Normand - [email protected] * Corresponding author
Published: 28 July 2009 Human Resources for Health 2009, 7:65
doi:10.1186/1478-4491-7-65
Received: 13 November 2008 Accepted: 28 July 2009
This article is available from: http://www.human-resources-health.com/content/7/1/65 © 2009 Manafa et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. Methods: A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques. Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were a
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