Review of Health Workers' Incentives for Improving Retention: A Case of Ethiopia

Background:

Ethiopia’s widely publicized health policy and indeed its expressed wish to put it into practical application is its political commitment towards achieving MDGs through universal health coverage to be implemented under the decentralized federal governance. Ethiopia has recently completed a comprehensive HRH strategic document that addresses both the supply and demand of HRH including health workforce motivation schemes as part of rationalization of the HRM covering periods 2009-2020. The FMOH uses three interrelated HRH strategies for overcoming the long standing shortages and equitable distribution of HRH in Ethiopia. Pre-deployment training to new graduates especially Doctors, accelerated training for mid-level health professionals (Non-clinician health officers, midwives) and frontline Health Extension Workers and enforcement and rural service obligation.

Methodology

We examined what incentive mechanisms and service enforcement schemes exist within the public health sector of Ethiopia both at the national and across the different regions of the country. 

Result

This review found out that among the financial incentives, an increase in the base salary between 28-80% that was introduced two years has been implemented uniformly in all health public facilities and regions including the centre. There are also almost similar financial and non-financial incentive mechanisms introduced by different Regional states aimed at attracting and retaining selective health workforce. But, the payment rates, for example, in terms of night duty/off duty allowance/ and other allowances including rural allowances considerably differ from one regional state to the other including between regions and the center.

Conclusion

In terms of policy direction, the widely varied incentive packages practiced by regional states may need to be standardized in order to avoid unnecessary competition in the recruitment of rare skilled health professionals thus undermining equity in the delivery of health care services in all regions of Ethiopia.