Improving the Health Workforce Distribution in Remote and Rural Areas of Ethiopia: An Evidence-Based Policy Brief

Serebe Abay; Amanuel Dibaba; Yosef Gebreyohannes; Desalegn Ararso; Fasil Mengistu; Mamuye Hadis

doi:doi:10.11648/j.jim.20180702.11

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Improving the Health Workforce Distribution in Remote and Rural Areas of Ethiopia: An Evidence-Based Policy Brief

Serebe Abay, Amanuel Dibaba, Yosef Gebreyohannes, Desalegn Ararso, Fasil Mengistu, Mamuye Hadis

Published in Journal of Investment and Management (Volume 7, Issue 2)

Received: 17 January 2018 Accepted: 11 February 2018 Published: 17 April 2018

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Abstract

Human Resources for Health (HRH) constitute the most vital component of health systems. However, the HRH picture of Ethiopia has remained critically low and characterized by geographic mal-distribution. This brief aimed to show the major causes for poor health workforce distribution and to suggest possible policy options. We reviewed relevant evidence describing the problem and feasible options to address the problem, the barriers to implement those options, and implementation strategies to address these barriers. We searched electronic databases of systematic reviews and supplemented with local evidences. In our review, we found different options that help to improve health workforce distribution in the remote and rural areas of the country. Systematic reviews on impact of task shifting, clinical rotations in rural areas during studies and financial incentives have shown favourable results that may lead to increase the number of health workforce working in rural and underserved areas. But none of the studies assessed the costs and cost effectiveness of the suggested options. Therefore, given the limitations of the currently available evidence, there is a need for rigorous evaluative research on the cost effectiveness of each option prior to widespread implementation.

Published in	Journal of Investment and Management (Volume 7, Issue 2)
DOI	10.11648/j.jim.20180702.11
Page(s)	45-52
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Policy Brief, Health Workforce Distribution, Health System, Ethiopia

References

[1]	WHO. Monitoring the building blocks of the health systems: A hand book of indicators and their measurement strategies. Geneva, Switzerland; 2010.
[2]	Araújo E, Maeda A. How to Recruit and Retain Health Workers in Rural and Remote Areas In Developing Countries. A Guidance Note. 2013.
[3]	WHO. World health report 2006: Working together for health. Geneva: WHO Press; 2006.
[4]	Yohannes HJC, Girma B, Tushune K. Health Workforce Deployment, Attrition and Density in East Wollega Zone, Western Ethiopia. Ethiop J Heal Sci. 2010; 20 (1).
[5]	WHO. WHO Estimates of Health Personnel: Physicians, Nurses, Mid-wives, Dentists, Pharmacists. Geneva, Switzerland; 2004.
[6]	Padilha A, Kasonde J, Mukti G, Crisp N, Buch E. Human resources for universal health coverage: leadership needed. Bull World Heal Organ. 2013; 91.
[7]	FMoH. Human Resource for Health Strategic Plan (2009-2025). Federal Democratic Republic of Ethiopia Ministry of Health. Addis Ababa, Ethiopia; 2014.
[8]	FMoH. Health Sector Development Program IV 2010/11 – 2014/15. Addis Ababa, Ethiopia; 2010.
[9]	Serneels P, Montalvo JG, Pettersson G, Lievens T, Butera JD, Kidanu A. Who wants to work in a rural health post? The role of intrinsic motivation, rural background and faith-based institutions in Ethiopia and Rwanda. Bull World Health Organ. 2010; 88:342–9.
[10]	Feysia B, Herbst CH, Lemma W, Soucat A. The health workforce in Ethiopia: Addressing the remaining challenges. Washington DC: The World Bank; 2012.
[11]	FMoH. Health and Health Related Indicators Version 2. Addis Ababa, Ethiopia; 2013.
[12]	FMoH. Health Sector Development Programme IV Annual Performance Report EFY 2006 (2013/14). Addis Ababa, Ethiopia; 2013.
[13]	Gebretekle GB, Fenta TG. Assessment of Pharmacists Workforce in Ethiopia. Ethiop J Heal Dev. 2013; 27 (0).
[14]	Berhan Y. Medical doctors’ profile in Ethiopia: Production, attrition and retention: In the memory of 100-years Ethiopian modern medicine & the new Ethiopian Millennium. Ethiop Med J. 2008; 46 (Sup1).
[15]	CSA. Summary and Statistics Report of the 2007 Population and Housing Census. Addis Ababa, Population Census Commission (Ethiopia). Addis Ababa, Ethiopia; 2008.
[16]	FMoH. and Health related indicators (2007/8). Addis Ababa, Ethiopia; 2008.
[17]	CSA. Ethiopia Demographic and Health Survey 2011 Central Statistical Agency. 2012.
[18]	Geresu T, Shiferaw M, Mitike G, Haile Mariam D. A brief review of the draft human resources for health strategic plan, Ethiopia; 2009-2020. Ethiop J Heal Dev. 2013; 27 (Special Issue 1).
[19]	CSA. Ethiopia Demographic and Health Survey. Addis Ababa, Ethiopia; 2006.
[20]	Gessessew A, Barnabas GA, Prata N, Weidert K. Task shifting and sharing in Tigray, Ethiopia, to achieve comprehensive emergency obstetric care. Int J Gynecol Obstet. 2011; 113:28–31.
[21]	FMoFED. Ethiopia MDGs Report 2012. 2012.
[22]	SURE. Guides for Preparing and Using Evidence-Based Policy Briefs 5. Identifying and addressing barriers to implementing policy options. 2011.
[23]	SURE. Guides for Preparing and Using Evidence-Based Policy Briefs 2. Prioritising topics for policy briefs. 2011.
[24]	Naicker S, Plange-Rhule J, Tutt RC, Eastwood JB. Shortage of Healthcare Workers in Developing Countries—Africa. Ethn Dis. 2009; 19.
[25]	Getie GA, Betre ET, Hareri HA. Assessment of Factors Affecting Turnover Intention Among Nurses Working at Governmental Health Care Institutions in East Gojjam, Amhara Region, Ethiopia, 2013. Am J Nurs Sci. 2013; 4 (3):107–12.
[26]	Ture J A. Assessment of the Magnitude, Patterns and Determinant Factors of Health Worker Migration from the Public Health Sectors: A descriptive case study in East Hararghe zone of Oromiya, Eastern Ethiopia. Addis Ababa University; 2008.
[27]	Abraham Y, Azaje A. The new innovative medical education system in Ethiopia: Background and development. Ethiop J Heal Dev. 2013; 27 (Special Issue 1).
[28]	FMoH. The Federal Democratic Republic of Ethiopia Ministry of Health Health Sector Transformation Plan ( HSTP). Addis Ababa, Ethiopia; 2015.
[29]	WHO. Task Shifting Global Recommendations and Guidelines. Geneva, Switzerland: WHO Document Production Services; 2008.
[30]	Lehmann U, Dieleman M, Martineau T. Staffing remote rural areas in middle-and low-income countries: A literature review of attraction and retention. BMC Health Serv Res. 2008; 8 (19).
[31]	WHO. Task shifting to tackle health worker shortages. Strengthening health services to fight HIV/AIDS. 2007.
[32]	Munga M a, Kilima SP, Mutalemwa PP, Kisoka WJ, Malecela MN. Experiences, opportunities and challenges of implementing task shifting in underserved remote settings: the case of Kongwa district, central Tanzania. BMC Int Health Hum Rights. 2012; 12:27.
[33]	Laurant M, Reeves D, Hermens R, Braspenning J, Grol R, Sibbald B. Substitution of doctors by nurses in primary care (Review) Substitution of doctors by nurses in primary care. 2004.
[34]	Horrocks S, Anderson E, Salisbury C. Systematic review of whether nurse practitioners working in primary care can provide equivalent care to doctors. BMJ. 2002; 324.
[35]	Lewin S, Munabi-Babigumira S, Glenton C, Bosch-Capblanch DK, Van X, Be W, et al. Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases (Review). 2010.
[36]	WHO. Increasing access to health workers in remote and rural areas through improved retention: global policy recommendations. Geneva, Switzerland; 2010.
[37]	Grobler L, Bj M, Mabunda S. Interventions for increasing the proportion of health professionals practising in rural and other underserved areas ( Review ) SUMMARY of Findings for the Main Comparison. 2015; (6).
[38]	Grobler L, Marais BJ, Mabunda S, Marindi P, Reuter H, Volmink J. Interventions for increasing the proportion of health professionals practising in rural and other underserved areas (Review). Cochrane Database Syst Rev Art. 2009; (2).
[39]	Okwundu CI. Which interventions increase the recruitment and retention of health workers practising in under-served and rural areas? A SUPPORT Summary of a systematic review. 2011; 9.
[40]	WHO. The world health report 2000 – health systems: improving performance. Geneva, Switzerland; 2000.
[41]	Nurses IC of, Federation IP, Federation WD, Association WM, Federation IH, Therapy WC for P. Guidelines: Incentives for Health. 2008.
[42]	Bärnighausen T, Bloom DE. Financial incentives for return of service in underserved areas: a systematic review. BMC Health Serv Res. 2009; 9 (86).
[43]	Frehywot S, Mullan F, Ross PWP& H. Compulsory service programmes for recruiting health workers in remote and rural areas: do they work? Bull World Heal Organ. 2010; 88:364–70.
[44]	Peña S, Ramirez J, Becerra C, Carabantes J, Arteaga O. The Chilean Rural Practitioner Programme: a multidimensional strategy to attract and retain doctors in rural areas. Bull World Heal Organ. 2010; 88.
[45]	Gray LG and I. Continuing Professional Development – a Brief Guide. The Psychologist Vol 19 No 9. 2006; 19 (9).
[46]	EU. Recruitment and Retention of the Health Workforce in Europe. 2015.
[47]	Kotzee TJ CI. What interventions do South African qualified doctors think will retain them in rural hospitals of Limpopoprovince of South Africa? Rural Remot Heal. 2006; 6 (3).

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APA Style

Serebe Abay, Amanuel Dibaba, Yosef Gebreyohannes, Desalegn Ararso, Fasil Mengistu, et al. (2018). Improving the Health Workforce Distribution in Remote and Rural Areas of Ethiopia: An Evidence-Based Policy Brief. Journal of Investment and Management, 7(2), 45-52. https://doi.org/10.11648/j.jim.20180702.11

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ACS Style

Serebe Abay; Amanuel Dibaba; Yosef Gebreyohannes; Desalegn Ararso; Fasil Mengistu, et al. Improving the Health Workforce Distribution in Remote and Rural Areas of Ethiopia: An Evidence-Based Policy Brief. J. Invest. Manag. 2018, 7(2), 45-52. doi: 10.11648/j.jim.20180702.11

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AMA Style

Serebe Abay, Amanuel Dibaba, Yosef Gebreyohannes, Desalegn Ararso, Fasil Mengistu, et al. Improving the Health Workforce Distribution in Remote and Rural Areas of Ethiopia: An Evidence-Based Policy Brief. J Invest Manag. 2018;7(2):45-52. doi: 10.11648/j.jim.20180702.11

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@article{10.11648/j.jim.20180702.11,
  author = {Serebe Abay and Amanuel Dibaba and Yosef Gebreyohannes and Desalegn Ararso and Fasil Mengistu and Mamuye Hadis},
  title = {Improving the Health Workforce Distribution in Remote and Rural Areas of Ethiopia: An Evidence-Based Policy Brief},
  journal = {Journal of Investment and Management},
  volume = {7},
  number = {2},
  pages = {45-52},
  doi = {10.11648/j.jim.20180702.11},
  url = {https://doi.org/10.11648/j.jim.20180702.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jim.20180702.11},
  abstract = {Human Resources for Health (HRH) constitute the most vital component of health systems. However, the HRH picture of Ethiopia has remained critically low and characterized by geographic mal-distribution. This brief aimed to show the major causes for poor health workforce distribution and to suggest possible policy options. We reviewed relevant evidence describing the problem and feasible options to address the problem, the barriers to implement those options, and implementation strategies to address these barriers. We searched electronic databases of systematic reviews and supplemented with local evidences. In our review, we found different options that help to improve health workforce distribution in the remote and rural areas of the country. Systematic reviews on impact of task shifting, clinical rotations in rural areas during studies and financial incentives have shown favourable results that may lead to increase the number of health workforce working in rural and underserved areas. But none of the studies assessed the costs and cost effectiveness of the suggested options. Therefore, given the limitations of the currently available evidence, there is a need for rigorous evaluative research on the cost effectiveness of each option prior to widespread implementation.},
 year = {2018}
}

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TY  - JOUR
T1  - Improving the Health Workforce Distribution in Remote and Rural Areas of Ethiopia: An Evidence-Based Policy Brief
AU  - Serebe Abay
AU  - Amanuel Dibaba
AU  - Yosef Gebreyohannes
AU  - Desalegn Ararso
AU  - Fasil Mengistu
AU  - Mamuye Hadis
Y1  - 2018/04/17
PY  - 2018
N1  - https://doi.org/10.11648/j.jim.20180702.11
DO  - 10.11648/j.jim.20180702.11
T2  - Journal of Investment and Management
JF  - Journal of Investment and Management
JO  - Journal of Investment and Management
SP  - 45
EP  - 52
PB  - Science Publishing Group
SN  - 2328-7721
UR  - https://doi.org/10.11648/j.jim.20180702.11
AB  - Human Resources for Health (HRH) constitute the most vital component of health systems. However, the HRH picture of Ethiopia has remained critically low and characterized by geographic mal-distribution. This brief aimed to show the major causes for poor health workforce distribution and to suggest possible policy options. We reviewed relevant evidence describing the problem and feasible options to address the problem, the barriers to implement those options, and implementation strategies to address these barriers. We searched electronic databases of systematic reviews and supplemented with local evidences. In our review, we found different options that help to improve health workforce distribution in the remote and rural areas of the country. Systematic reviews on impact of task shifting, clinical rotations in rural areas during studies and financial incentives have shown favourable results that may lead to increase the number of health workforce working in rural and underserved areas. But none of the studies assessed the costs and cost effectiveness of the suggested options. Therefore, given the limitations of the currently available evidence, there is a need for rigorous evaluative research on the cost effectiveness of each option prior to widespread implementation.
VL  - 7
IS  - 2
ER  -

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Author Information

Serebe Abay

Technology Transfer and Research Translation Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Amanuel Dibaba

Technology Transfer and Research Translation Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Yosef Gebreyohannes

Technology Transfer and Research Translation Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Desalegn Ararso

Technology Transfer and Research Translation Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Fasil Mengistu

Technology Transfer and Research Translation Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Mamuye Hadis

Technology Transfer and Research Translation Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

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APA Style

Serebe Abay, Amanuel Dibaba, Yosef Gebreyohannes, Desalegn Ararso, Fasil Mengistu, et al. (2018). Improving the Health Workforce Distribution in Remote and Rural Areas of Ethiopia: An Evidence-Based Policy Brief. Journal of Investment and Management, 7(2), 45-52. https://doi.org/10.11648/j.jim.20180702.11

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ACS Style

Serebe Abay; Amanuel Dibaba; Yosef Gebreyohannes; Desalegn Ararso; Fasil Mengistu, et al. Improving the Health Workforce Distribution in Remote and Rural Areas of Ethiopia: An Evidence-Based Policy Brief. J. Invest. Manag. 2018, 7(2), 45-52. doi: 10.11648/j.jim.20180702.11

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AMA Style

Serebe Abay, Amanuel Dibaba, Yosef Gebreyohannes, Desalegn Ararso, Fasil Mengistu, et al. Improving the Health Workforce Distribution in Remote and Rural Areas of Ethiopia: An Evidence-Based Policy Brief. J Invest Manag. 2018;7(2):45-52. doi: 10.11648/j.jim.20180702.11

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@article{10.11648/j.jim.20180702.11,
  author = {Serebe Abay and Amanuel Dibaba and Yosef Gebreyohannes and Desalegn Ararso and Fasil Mengistu and Mamuye Hadis},
  title = {Improving the Health Workforce Distribution in Remote and Rural Areas of Ethiopia: An Evidence-Based Policy Brief},
  journal = {Journal of Investment and Management},
  volume = {7},
  number = {2},
  pages = {45-52},
  doi = {10.11648/j.jim.20180702.11},
  url = {https://doi.org/10.11648/j.jim.20180702.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jim.20180702.11},
  abstract = {Human Resources for Health (HRH) constitute the most vital component of health systems. However, the HRH picture of Ethiopia has remained critically low and characterized by geographic mal-distribution. This brief aimed to show the major causes for poor health workforce distribution and to suggest possible policy options. We reviewed relevant evidence describing the problem and feasible options to address the problem, the barriers to implement those options, and implementation strategies to address these barriers. We searched electronic databases of systematic reviews and supplemented with local evidences. In our review, we found different options that help to improve health workforce distribution in the remote and rural areas of the country. Systematic reviews on impact of task shifting, clinical rotations in rural areas during studies and financial incentives have shown favourable results that may lead to increase the number of health workforce working in rural and underserved areas. But none of the studies assessed the costs and cost effectiveness of the suggested options. Therefore, given the limitations of the currently available evidence, there is a need for rigorous evaluative research on the cost effectiveness of each option prior to widespread implementation.},
 year = {2018}
}

Copy | Download

TY  - JOUR
T1  - Improving the Health Workforce Distribution in Remote and Rural Areas of Ethiopia: An Evidence-Based Policy Brief
AU  - Serebe Abay
AU  - Amanuel Dibaba
AU  - Yosef Gebreyohannes
AU  - Desalegn Ararso
AU  - Fasil Mengistu
AU  - Mamuye Hadis
Y1  - 2018/04/17
PY  - 2018
N1  - https://doi.org/10.11648/j.jim.20180702.11
DO  - 10.11648/j.jim.20180702.11
T2  - Journal of Investment and Management
JF  - Journal of Investment and Management
JO  - Journal of Investment and Management
SP  - 45
EP  - 52
PB  - Science Publishing Group
SN  - 2328-7721
UR  - https://doi.org/10.11648/j.jim.20180702.11
AB  - Human Resources for Health (HRH) constitute the most vital component of health systems. However, the HRH picture of Ethiopia has remained critically low and characterized by geographic mal-distribution. This brief aimed to show the major causes for poor health workforce distribution and to suggest possible policy options. We reviewed relevant evidence describing the problem and feasible options to address the problem, the barriers to implement those options, and implementation strategies to address these barriers. We searched electronic databases of systematic reviews and supplemented with local evidences. In our review, we found different options that help to improve health workforce distribution in the remote and rural areas of the country. Systematic reviews on impact of task shifting, clinical rotations in rural areas during studies and financial incentives have shown favourable results that may lead to increase the number of health workforce working in rural and underserved areas. But none of the studies assessed the costs and cost effectiveness of the suggested options. Therefore, given the limitations of the currently available evidence, there is a need for rigorous evaluative research on the cost effectiveness of each option prior to widespread implementation.
VL  - 7
IS  - 2
ER  -

Copy | Download