Three new tools are now available as part of a growing suite of resources to help countries strengthen their health workforces. The tools focus on improving retention of health workers in rural areas, increasing productivity, and addressing gender inequality. The tools were published by the CapacityPlus project—USAID’s flagship global health workforce strengthening project led by IntraHealth International. 

Many countries are striving to prepare their workforces to help meet demand for family planning, end preventable child and maternal deaths, and achieve an AIDS-free generation, among other health goals. CapacityPlus worked with national health leaders in Lao People’s Democratic Republic, Malawi, Namibia, and Nigeria to pilot, apply, and refine the tools.

The suite also includes more than 20 peer-reviewed journal articles, 16 technical briefs, and eight eLearning courses, as well as other specialized tools like the free and open source iHRIS software for managing health worker data.   

The newest additions include the following three resources.   

Rapid Retention Survey Toolkit, Revised Edition 

While over half the world’s population lives in rural areas, only 38% of the world’s nurses and a quarter of doctors work there. To help countries determine what motivates health workers to accept and remain in rural posts, CapacityPlus developed the Rapid Retention Survey Toolkit: Designing Evidence-Based Incentives for Health Workers. 

This revised edition contains new insights from Namibia’s experience last year applying the tool among pharmacists and pharmacist assistants. 

Lao People’s Democratic Republic also applied the toolkit along with iHRIS Retain, a software tool that costs retention interventions. The data informed a new national recruitment and retention policy that requires new graduates in medicine, nursing, midwifery, pharmacy, and dentistry, as well as postgraduates in family medicine, to complete three years of rural service in order to receive their licenses to practice. The policy also provides specific incentives—such as housing and eligibility for continued education—to motivate health workers to excel at their jobs during their rural service, as well as encourage them to remain in rural posts. In the first two years, the country posted 1,551 health workers to rural district hospitals and health centers.  

Health Workforce Productivity Analysis and Improvement Toolkit 

Increasing the number of health workers is essential, but it is also important to improve the productivity of the existing workforce and make health service delivery more efficient.

The Health Workforce Productivity Analysis and Improvement Toolkit describes a step-wise process to measure the productivity of facility-based health workers, understand any underlying causes of productivity problems, and identify potential interventions to address them. 

The Ministry of Health in Lao PDR used the toolkit in 12 health facilities. Results revealed seven of the facilities were less than half as productive as the benchmark facility, primarily due to inefficiencies and low patient demand. Qualitative data showed the underlying causes of low productivity included access barriers (economic, geographic, and cultural); deficiencies in medicines, supplies, infrastructure, and health worker staffing and skill mix; and insufficient health worker skills and capacity. The Ministry is working to fund and implement a number of interventions to address the challenges and plans to use the toolkit in additional facilities.

The Christian Health Association of Malawi (CHAM) also applied the toolkit in nine health centers. CapacityPlus trained facility managers, district health officers, and health workers to lead the process. CHAM is now assisting the facilities to address identified productivity challenges.

Promoting Gender Equality in the Health Workfoce: An Advocacy Tool 

Many countries are taking action to increase numbers of health workers and improve their distribution and productivity, but may not be aware of the ways in which gender discrimination is impeding their efforts. 

When all health workers, whether male or female, have equal access to education, the health worker pipeline is strengthened. When they have an equal chance of being hired, fairly paid, and having equal opportunities to advance their careers, and when female health workers are supported through life events such as childbearing, this can lead to greater productivity and retention—and increased availability of essential health services in communities.

Promoting Gender Equality in the Health Workforce: An Advocacy Tool is a new online resource that walks users through how to effectively influence policies and actions that can affect gender equality. It helps users understand how common forms of gender discrimination can negatively affect the health workforce; assess whether workers may be experiencing one or more forms of discrimination; and successfully advocate and take action through policy-making and improved management to promote gender equality and strengthen the workforce.

The advocacy tool was field-tested in Cross River State, Nigeria, where stakeholders drafted a strategic advocacy plan for gender equality in the health workforce and formed a Gender Working Group to follow up on these activities.

Learn more:

• Selected Health Workforce Tools from CapacityPlus