Why measure the retention of health workers within borders? Lessons learned from the ETATMBA program in measuring health workforce retention in Malawi and Tanzania

Abstract

Health workforce retention is a recognised strategy for alleviating the health workforce scarcity in low- and middleincome countries. However, there is a lack of clarity on what retention is and how it is measured. We followed up with health workers who participated in the ETATMBA program, an in-service training program from selected healthcare facilities in Malawi and Tanzania, once per quarter, for five years, to determine their retention. We measured retention in three aspects: i) duration of stay in target healthcare facilities, ii) retention in clinical roles, and iii) retention in government employment. We tracked 127 participants, 46 in Malawi and 81 in Tanzania. At the end of tracking, the retention in each aspect measured was different. In Malawi, the retention in target facilities was 47.2%, the retention for clinical roles was 69.5%, and retention for government employment was 76.1%. In Tanzania, the rates were 45.7%, 72.8%, and 76.5%, respectively. The extent of workforce retention depends on the parameters chosen to measure it. Standard indicators for workforce retention needs to be outlined to streamline retention measurement, inform health policies and improve human resources for health planning.

Investigating factors influencing implementation of tuberculosis infection prevention and control in rural Papua New Guinea

“…Tuberculosis can be complicated and di cult to manage from micro-level analyses and therefore requires a systems thinking approach to address the complexities. This aligns with the ndings of Mdegela et al 37 who adopted the socio-ecological model as a theoretical framework to appraise health workforce retention in Malawi and Tanzania, who asserted that a broader perspective may be needed to better understand both the risk and the intervention side of the public health programs. Furthermore, Van Cutsem et al 38 explained that minimising TB transmission requires a combination of strategies and a shift of model of care from a patient-centred to a comprehensive approach involving community and the health system.…”

Conceptual Framework of Equity Sensitivity, Training and Promotion on Specialist Doctors Retention in Malaysia: Moderated by Organizational Trust

“…Therefore, retention is a continues process consisting of multiple strategic approaches by the organization to motivate and sustain their employees to prevent loss of quality workers (Das & Baruah, 2013). Specifically, in the context HHR, employee retention is defined as the strategies implemented by healthcare institutions to improve availability and balanced distribution of skilled health workforce in various levels (Mdegela, 2020). Therefore, employee retention is defined as any action adopted by an organization in order to maintain a stable workforce to prevent the loss of competent employees (Kyndt et al, 2009).…”