Malawi

1
Malawis innovative scheme for improving
attraction and retention of health workers
2
Background

• Recognition and documentation of the extent of
  the HRH situation
• Quantification of the scale of the problem and
  implications for service delivery
• Studies identify inadequate remuneration as one
  factor in health worker attrition from the public
  service
• Options and cost of increased salaries explored
  to improve recruitment and retention
• Proposed increases aligned with pay reforms
  proposed selective accelerated salary enhancement
  (SASE) scheme

3
Background contd.

• MoH pay enhancement used to pilot SASE scheme
• Supported harmonization of public and private
  sector (e.g. CHAM) salaries
• Donor (DFID GF) and GoM commitment to support
  salary increases (GoM health sector contributions
  have doubled from 2003/04)
• Global Fund commitment to strengthening the human
  resource base in Malawi
• Core and essential health workers targeted 11
  priority cadres 3750 health workers (18.75)
• Malawi one of 2 countries that has received
  funding from the Global Fund for HRH funding
  available to recruit and retain an additional
  8200 HSAs over 5 years
• Plans to pilot additional retention schemes
  targeting underserved areas, facilities, and
  essential cadres (both posts and individuals)

4
Issues for consideration

• Is there evidence for prioritising and targeting
  specific cadres/health workers?
• Is there reliable and accurate information for
  decision making on retention strategies e.g.
  service delivery goals, attrition data , etc.?
• Will increased compensation alone attract and
  retain health workers?
• What other factors/interventions should be
  considered?

5
Issues contd.

• What monitoring and evaluation systems will be
  required to track impact?
• How to deal with those who will benefit and those
  who will not?
• What communication strategy is needed?
• How to ensure that this investment results in
  improved performance?