An exploratory analysis of the regionalization policy for the recruitment of health workers in Burkina Faso

Abstract

BackgroundHealth personnel retention in remote areas is a key health systems issue wordwide. To deal with this issue, since 2002 the government of Burkina Faso has implemented a staff retention policy, the regionalized health personnel recruitment policy, aimed at front-line workers such as nurses, midwives, and birth attendants. This study aimed to describe the policy’s development, formulation, and implementation process for the regionalization of health worker recruitment in Burkina Faso.MethodsWe conducted a qualitative study. The unit of analysis is a single case study with several levels of analysis. This study was conducted in three remote areas in Burkina Faso for the implementation portion, and at the central level for the development portion. Indepth interviews were conducted with Ministry of Health officials in charge of human resources, regional directors, regional human resource managers, district chief medical officers, and health workers at primary health centres. In total, 46 indepth interviews were conducted (February 3 - March 16, 2011).ResultsDevelopmentThe idea for this policy emerged after finding a highly uneven distribution of health personnel across urban and rural areas, the availability of a large number of health officers in the labour market, and the opportunity given to the Ministry of Health by the government to recruit personnel through a specific budget allocation.FormulationThe formulation consisted of a call for job applications from the Ministry of Health, which indicates the number of available posts by region.The respondents interviewed unanimously acknowledged the lack of documents governing the status of this new personnel category.ImplementationDuring the initial years of implementation (2002-2003), this policy was limited to recruiting health workers for the regions with no possibility of transfer. The possibility of job-for-job exchange was then approved for a certain time, then cancelled. Starting in 2005, a departure condition was added. Now, regionalized health workers can leave the regions after undergoing a competitive selection process.ConclusionThe policy was characterized by the absence of written directives and by targeting only one category of personnel. Moreover, there was no associated incentive—financial or otherwise—which poses the question of long-term viability.

A cross‐sectional mixed study of the opportunity to improve maternal postpartum care in reproductive, maternal, newborn, and child health services in the Kaya health district of Burkina Faso

“…Other studies in MOMI project sites showed certain human resources barriers, for instance understaffing, high staff turnover, poor motivation, and lack of knowledge and skills by staff in postpartum care [13]. In Burkina Faso, rural facilities in particular are suffering from many obstacles in terms of recruiting and retaining FHWs [29,42,43]. The success of the integration relies on the overall support of the health system [44].…”

Street-level workers’ inadequate knowledge and application of exemption policies in Burkina Faso jeopardize the achievement of universal health coverage: evidence from a cross-sectional survey

“…First, descriptive statistics suggested the presence of district-level effects rather than of facility-level effects. Conceptually, this might be due to the influence of the district health management team as well as to the mobility between facilities within a given district, a phenomenon that is well-known in Burkina Faso [ 34 , 35 ] and that provides a conceptual grounding for our empirical analytical choice. Second, the number of health workers interviewed in each facility was very small (fewer than three health workers in two-thirds of all facilities), which did not allow for meaningful clustering at the facility level.…”

Motivations des agents obstétricaux qui décident d’exercer en milieu rural au Niger

“…Toutefois, l'étude avance également que la réalisation d'un stage en milieu rural pendant la formation peut encourager une préférence pour une carrière dans ce milieu(RC :1,53; IC 95 %:1,19-1,98) [29]. L' origine rurale et l'expositionen milieur ural pendant la formation semblent êtred es éléments favorisant l'acceptation de l'exercice de la profession médicale en milieu rural [30]. Dans une autre étuderéaliséesur le comportement desagents de santé en milieu rural dans une autrerégionsanitaireduNiger que celledenotre recherche, les auteurs ont montré que seuls lesmédecinsayant une origine rurale ont exercé dans des espaces rurauxpendant plus de trois ans.…”