Malawi

Malawi’s innovative scheme forimproving attraction and retentionof health workers

Background

•Recognition and documentation of the extent of the HRHsituation

•Quantification of the scale of the problem andimplications for service delivery

•Studies identify inadequate remuneration as one factorin health worker attrition from the public service

•Options and cost of increased salaries explored toimprove recruitment and retention

•Proposed increases aligned with pay reforms &proposed selective accelerated salary enhancement(SASE) scheme

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 salaryincreases (GoM health sector contributions have doubled from2003/04)

•Global Fund commitment to strengthening the human resource basein 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 GlobalFund for HRH – funding available to recruit and retain an additional8200 HSAs over 5 years

•Plans to pilot additional retention schemes targeting underservedareas, facilities, and essential cadres (both posts and individuals)

Issues for consideration

•Is there evidence for prioritising andtargeting specific cadres/health workers?

•Is there reliable and accurate information fordecision making on retention strategies e.g.service delivery goals, attrition data , etc.?

•Will increased compensation alone attractand retain health workers?

•What other factors/interventions should beconsidered?

Issues contd.

•What monitoring and evaluation systems willbe required to track impact?

•How to deal with those who will benefit andthose who will not?

•What communication strategy is needed?

•How to ensure that this investment results inimproved performance?