Discovering the Real World

Danila Serra

Description

This paper presents unique evidence on health workers' career choices in Ethiopia. It shows that challenges like health workers' limited willingness to work in rural areas, as well as their likelihood to migrate abroad vary substantially and are correlated with background, motivation, and job satisfaction. Governments in Africa have identified human resources for health as a priority to improve health outcomes. This study is a valuable resource to better understand health worker choices and help toward the design of more effective human resource policies.
This working paper was produced as part of the World Bank's Africa Region Health Systems for Outcomes (HSO) Program. The Program, funded by the World Bank, the Government of Norway, the Government of the United Kingdom and the Global Alliance for Vaccines and Immunization (GAVI), focuses on strengthening health systems in Africa to reach the poor and achieve tangible results related to Health, Nutrition and Population. The main pillars and focus of the program center on knowledge and capacity building related to Human Resources for Health, Health Financing, Pharmaceuticals, Governance and Service Delivery, and Infrastructure and ICT.

Sujets

• Health

Informations

• Publié par: world-bank-publications
• Publié le: 24 juin 2010
• Nombre de lectures: 43
• EAN13: 9780821383575
• Langue: English

Extrait

WORLD BANK WORKING PAPER NO. 191
AFRICA HUMAN DEVELOPMENT SERIES
Discovering the Real World
Health Workers’ Career Choices and
Early Work Experience in Ethiopia
Danila Serra
Pieter Serneels
Magnus Lindelow
Jose Garcia Montalvo
THE WORLD BANKWORLD BANK WORKING PAPER NO. 191
Discovering the Real World:
Health Workers’ Career Choices and
Early Work Experience in Ethiopia
Danila Serra
Pieter Serneels
Magnus Lindelow
Jose G. Montalvo
Africa Region Human Development Department
DiscoveringRealWorld_txt.indb iDiscoveringRealWorld_txt.indb i 5/6/10 3:29:28 PM5/6/10 3:29:28 PMCopyright © 2010
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World Bank Working Papers are published to communicate the results of the Bank’s work to the
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has not been prepared in accordance with the procedures appropriate to formally-edited texts.
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ISBN-13: 978-0-8213-8356-8
eISBN: 978-0-8213-8357-5
ISSN: 1726-5878DOI: 10.1596/978-0-8213-8356-8
Library of Congress Cataloging-in-Publication Data
Discovering the real world : health workers’ early work experience and career choices.
p. ; cm.
ISBN 978-0-8213-8356-8
1.Medical personnel—Ethiopia.2.Medical personnel—Ethiopia—
Statistics.3.Ethiopia—Statistics, Medical.I.World Bank.
[DNLM:1.Health Manpower—statistics & numerical data—Ethiopia.2.Career
Choice—Ethiopia—Statistics.3.Cohort Studies—Ethiopia—Statistics.4.Emigration and
Immigration—statistics & numerical data—Ethiopia.5.Rural Health Services—manpower—
Ethiopia.6.Urban Health Services—manpower—Ethiopia.W 16 D611 2010]
RA410.9.E7D57 2010
362.1’042570963—dc22 2010010858
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33333332233233242332333333323323323322Contents
Contents .......................................................................................................................................... iii
Acknowledgments ..........................................................................................................................v
Foreword .........................................................................................................................................vi
Executive Summary vii
1. Introduction ................................................................................................................................. 1
2. Background and Method ........................................................................................................... 2
The Health Sector and Human Resources for Health in Ethiopia..................................... 2
Satisfaction and Motivation ....................................................................................................3
Geographical Imbalances ........................................................................................................3
Migration Abroad of Health Workers .................................................................................. 4
The Ethiopia Health Worker Cohort Study .......................................................................... 5
First Wave of the Study: Final-Year Health Students in 2004 ............................................. 5
Second Wave of the Study: Starting Health Workers in 2007 ............................................ 5
3. Health Workers’ Activities and Distribution ....................................................................... 8
Summary .................................................................................................................................... 8
Overview .................................................................................................................................. 8
Who Is Working? ...................................................................................................................... 9
Working in a Rural or Urban Area, in the Public or Private Sector,
and in Which Region? .............................................................................................................. 9
Working in Which Type of Facility and Which Occupation? .......................................... 11
Secondary Job in the Health Sector ...................................................................................... 11
The Release to Work in the Private Sector .......................................................................... 12
4. Job Characteristics, Job Preferences, and Satisfaction ....................................................... 15........... 15
Overview ................................................................................................................................. 16
Current Salaries and Nonpecuniary Benefi ts ..................................................................... 16
Other Important Job A ributes ........................................................................................... 18
Job Satisfaction ....................................................................................................................... 20
Satisfaction with Di erent Spheres of Life ......................................................................... 23
A itudes toward Working on the Side ............................................................................... 24
5. The Choice between Rural and Urban Posting ................................................................... 27
Summary .................................................................................................................................. 27
Overview ................................................................................................................................. 28
The Profi les of Health Workers in Rural and Urban Areas .............................................. 28
iii
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44iv World Bank Working Paper
The Preference for a Rural or Urban Posting in 2004 versus 2007 .................................. 30
Reasons for Qui ing First Job ............................................................................................... 32
Reservation Wages to Work in a Rural Area....................................................................... 35
6. Likelihood of Migration Abroad ........................................................................................... 40
Summary .................................................................................................................................. 40
Overview ................................................................................................................................ 40
Likelihood of Migrate Abroad in the Coming Two Years ................................................ 40
For What Wages Would Health Workers Stay in Ethiopia? ............................................. 42
7. Conclusion ................................................................................................................................. 46
Appendix A. Survey Methodology ............................................................................................ 47
Follow-up E orts in 2005, 2006, and 2007 .......................................................................... 47
Appendix B. Job Search ........................................