Health workforce deployment, attrition and density in East Wollega Zone, Western Ethiopia

Hailemichael, Yohannes; Jira, Challi; Girma, Belayneh; Tushune, Kora

doi:10.4314/ejhs.v20i1.69426

Cited by 15 publications

(15 citation statements)

References 9 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In Ethiopia, 59.4% of all health workers at hospitals and health centers in Jimma Zone intended to leave their jobs in the next year or two compared with actual turnover of 45.9% over 5 years [ 22 ]. A record review in East Wollega Zone found an annual attrition rate of 19.3% for health workers holding diplomas or first degrees [ 23 ]. A 2012 baseline study conducted for the HRH Project found a 4% attrition rate for anesthetists in Ethiopia [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Factors Predicting Ethiopian Anesthetists’ Intention to Leave Their Job

Kols¹,

Kibwana²,

Asemu³

et al. 2017

World j. surg.

View full text Add to dashboard Cite

BackgroundEthiopia has rapidly expanded training programs for associate clinician anesthetists in order to address shortages of anesthesia providers. However, retaining them in the public health sector has proven challenging. This study aimed to determine anesthetists’ intentions to leave their jobs and identify factors that predict turnover intentions.MethodsA nationally representative, cross-sectional survey of 251 anesthetists working in public-sector hospitals in Ethiopia was conducted in 2014. Respondents were asked whether they planned to leave the job in the next year and what factors they considered important when making decisions to quit. Bivariate and multivariable logistic regressions were conducted to investigate 16 potential predictors of turnover intentions, including personal and facility characteristics as well as decision-making factors.ResultsAlmost half (n = 120; 47.8%) of anesthetists planned to leave their jobs in the next year, and turnover intentions peaked among those with 2–5 years of experience. Turnover intentions were not associated with the compulsory service obligation. Anesthetists rated salary and opportunities for professional development as the most important factors in decisions to quit. Five predictors of turnover intentions were significant in the multivariable model: younger age, working at a district rather than regional or referral hospital, the perceived importance of living conditions, opportunities for professional development, and conditions at the workplace.ConclusionsHuman resources strategies focused on improving living conditions for anesthetists and expanding professional development opportunities may increase retention. Special attention should be focused on younger anesthetists and those posted at district hospitals.Electronic supplementary materialThe online version of this article (doi:10.1007/s00268-017-4318-7) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Factors Predicting Ethiopian Anesthetists’ Intention to Leave Their Job

Kols¹,

Kibwana²,

Asemu³

et al. 2017

World j. surg.

View full text Add to dashboard Cite

show abstract

“…22 This showed a clear rise in HEW attrition since the last national assessment of HEP published in 2011, which estimated overall attrition in the cadre for the period between 2005 and 2010 to be 6.5%. 23 HEWs take up a large proportion of the Ethiopian health budget; 21% of the recurrent health expenditure in 2010/2011 was spent on HEW salaries, 21 and so it is critical to make sure that experienced HEWs are retained over time to use this budget efficiently but also to sustain the delivery of quality healthcare. Yet, to date few studies have researched why HEWs leave their posts.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Understanding the importance of non-material factors in retaining community health workers in low-income settings: a qualitative case-study in Ethiopia

et al. 2020

View full text Add to dashboard Cite

ObjectivesThe motivation and retention of community health workers (CHWs) is a challenge and inadequately addressed in research and policy. We sought to identify factors influencing the retention of CHWs in Ethiopia and ways to avert their exit.DesignA qualitative study was undertaken using in-depth interviews with the study participants. Interviews were audio-recorded, and then simultaneously translated into English and transcribed for analysis. Data were analysed in NVivo 12 using an iterative inductive-deductive approach.SettingThe study was conducted in two districts each in the Tigray and Southern Nations, Nationalities and People’s Republic (SNNPR) regions in Ethiopia. Respondents were located in a mix of rural and urban settings.ParticipantsLeavers of health extension worker (HEW) positions (n=20), active HEWs (n=16) and key informants (n=11) in the form of policymakers were interviewed.ResultsWe identified several extrinsic and intrinsic motivational factors affecting the retention and labour market choices of HEWs. While financial incentives in the form of salaries and material incentives in the form of improvements to health facility infrastructure, provision of childcare were reported to be important, non-material factors like HEWs’ self-image, acceptance and validation by the community and their supervisors were found to be critical. A reduction or loss of these non-material factors proved to be the catalyst for many HEWs to leave their jobs.ConclusionOur study contributes new empirical evidence to the global debate on factors influencing the motivation and retention of CHWs, by being the first to include job leavers in the analysis. Our findings suggest that policy interventions that appeal to the social needs of CHWs can prove to be more acceptable and potentially cost-effective in improving their retention in the long run. This is important for government policymakers in resource constrained settings like Ethiopia that rely heavily on lay workers for primary healthcare delivery.

show abstract

“…For example, a longitudinal study in Senegal found that 59% of midwives said they intended to leave their current jobs, but only 37% actively looked for a new job and actual annual turnover was just 9% (Rouleau et al 2012). While evidence is limited, actual attrition in Ethiopia is also likely to be less than 10% (Hailemichael et al 2010). However, even this level of turnover, when it occurs annually, represents a huge cost to the health system.…”

Section: Policy Implicationsmentioning

confidence: 99%