Incentives and Dynamics in the Ethiopian Health Worker Labor Market
94 pages
English

Incentives and Dynamics in the Ethiopian Health Worker Labor Market

-

YouScribe est heureux de vous offrir cette publication
94 pages
English
YouScribe est heureux de vous offrir cette publication

Description

By international standards, health workers in Ethiopia are in short supply. In addition, those who do enter the health fields and remain in the country disproportionately live and work in the capital, Addis Ababa. This paper uses detailed data gathered from nearly 1,000 health workers to examine the incentives and constraints that health workers face when choosing where to work, the likely responses of workers to alternative incentive packages, and the longer term performance of the health worker labor market.
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

Informations

Publié par
Publié le 07 juillet 2010
Nombre de lectures 30
EAN13 9780821383643
Langue English
Poids de l'ouvrage 1 Mo

Exrait

WORLD BANK WORKING PAPER NO. 192
AFRICA HUMAN DEVELOPMENT SERIES
Incentives and Dynamics
in the Ethiopian Health
Worker Labor Market
William Jack
Joose de Laat
Kara Hanson
Agnes Soucat
THE WORLD BANKWORLD BANK WORKING PAPER NO. 192
Incentives and Dynamics in
the Ethiopian Health Worker
Labor Market
William Jack
Joose de Laat
Kara Hanson
Agnes Soucat
Africa Region Human Development Department
WP192_EthiopiaHealth_Text.indb iWP192_EthiopiaHealth_Text.indb i 6/9/10 1:24:56 PM6/9/10 1:24:56 PMCopyright © 2010
The International Bank for Reconstruction and Development / The World Bank
1818 H Street, N.W.
Washington, D.C. 20433, U.S.A.
All rights reserved
Manufactured in the United States of America
First Printing: June 2010
printed on recycled paper
1 2 3 4 13 12 11 10
World Bank Working Papers are published to communicate the results of the Bank’s work to the
development community with the least possible delay. The manuscript of this paper therefore
has not been prepared in accordance with the procedures appropriate to formally-edited texts.
Some sources cited in this paper may be informal documents that are not readily available.
The fi ndings, interpretations, and conclusions expressed herein are those of the author(s)
and do not necessarily refl ect the views of the International Bank for Reconstruction and
Development/The World Bank and its a liated organizations, or those of the Executive Directors
of The World Bank or the governments they represent.
The World Bank does not guarantee the accuracy of the data included in this work. The
boundaries, colors, denominations, and other information shown on any map in this work do
not imply any judgment on the part of The World Bank of the legal status of any territory or the
endorsement or acceptance of such boundaries.
The material in this publication is copyrighted. Copying and/or transmi ing portions or all
of this work without permission may be a violation of applicable law. The International Bank
for Reconstruction and Development/The World Bank encourages dissemination of its work and
will normally grant permission promptly to reproduce portions of the work.
For permission to photocopy or reprint any part of this work, please send a request with
complete information to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers,
MA 01923, USA, Tel: 978-750-8400, Fax: 978-750-4470, www.copyright.com.
All other queries on rights and licenses, including subsidiary rights, should be addressed
to the O ce of the Publisher, The World Bank, 1818 H Street NW, Washington, DC 20433, USA,
Fax: 202-522-2422, email: pubrights@worldbank.org.
ISBN: 978-0-8213-8358-2
eISBN: 978-0-8213-8364-3
ISSN: 1726-5878 DOI: 10.1596/978-0-8213-8358-2
Library of Congress Cataloging-in-Publication Data has been requested.
WP192_EthiopiaHealth_Text.indbWP192_EthiopiaHealth_Text.indb ii ii 6/9/10 1:25:00 PM6/9/10 1:25:00 PM
43333333333Contents
Foreword ...........................................................................................................................................v
Acknowledgments ....................................................................................................................... vii
Abstract ............................................................................................................................................ix
Acronyms and Abbreviations ......................................................................................................xi
1. Studying the Health Labor Market in Ethiopia: An Overview .......................................... 1
Introduction ............................................................................................................................... 1
Human Resources for Health in Ethiopia ............................................................................. 2
Empirical Methodology ........................................................................................................... 5
Descriptive Results: Facilities, People, and Jobs .................................................................. 8
Analytic Results: The Performance of the Physician Labor Market................................ 15
Predictive Results: Rural Health Care—How Much Does It Cost? ................................. 22
Bibliography ............................................................................................................................ 29
2. Long-Term Career Dynamics .................................................................................................. 30........... 30
Ethiopia’s Market for Physician Labor ................................................................................ 31
A Model of the Physician Labor Market ............................................................................. 32
Empirical Setup: Sampling, Data, and Model Validity ..................................................... 37
Short-Run Impacts of the Lo ery System on the Physician Labor Market .................... 44
Longer-Term Dynamics in the Physician Labor Market ................................................... 48
Conclusion ............................................................................................................................... 52
References ................................................................................................................................ 54
3. Designing Incentives for Rural Health Workers ................................................................ 55
Introduction ............................................................................................................................. 55
Data and DCE Methodology ................................................................................................ 57
Specifi cation and Estimation................................................................................................. 60
Interpretation of Estimated Coe cients ............................................................................. 61
A ribute Interactions ............................................................................................................. 62
Wage Equivalents ................................................................................................................... 63
Results ...................................................................................................................................... 65
Direct E ects Model ............................................................................................................... 68
Full Model with Characteristic and A ribute Interactions .............................................. 69
Policy Experiments ................................................................................................................. 72
Wage Equivalents ..... 73
Conclusions ............................................................................................................................. 75
References ....................................................................................................................................... 78
iii
WP192_EthiopiaHealth_Text.indbWP192_EthiopiaHealth_Text.indb iii iii 6/9/10 1:25:00 PM6/9/10 1:25:00 PM
444WP192_EthiopiaHealth_Text.indb ivWP192_EthiopiaHealth_Text.indb iv 6/9/10 1:25:00 PM6/9/10 1:25:00 PMForeword
y international standards, the supply of health workers in Ethiopia is low. In addition, Bthose who do enter the profession and remain in the country disproportionately live
and work in the capital city, Addis Ababa. This story is repeated across the developing
world, and in particular in Sub-Saharan Africa, where shortages of health workers are
deemed chronic. Increasing the supply of health workers, and improving their geographic
distribution, requires an understanding of their responsiveness to changes in the incentives
and constraints they face, and the e cacy with which labor markets can be expected to
allocate scarce human resources for health (HRH).
This book presents evidence on these and other HRH issues from a new survey of
Ethiopian health workers. Detailed data was collected from nearly 1,000 health workers
which is used to answer some fundamental questions: (i) how do compensation levels vary
with location, training, experience, etc.?; (ii) what kinds of incentive packages are potentially
most e ective in a racting workers to under-served rural areas?; and (iii) what can we learn
about the health worker labor market from one of its unique institutional features, that is,
that new graduates are assigned to their fi rst jobs via a lo ery?
The rigorous study methodology and policy relevant fi ndings may be of interest to all
those working to improve the allocation of human resources for health in the developing
world. Ethiopia for one, has shown strong government commitment to the development
of its health workforce, and is determined to futher refi ne and strengthen policies to serve
the poor. Evidence on what motivates doctors and nurses to practice in remote rural areas
will support the government design and refi ne targeted interventions on HRH that will
accellerate progress towards the MDGs even further.
Yaw Ansu,
Sector Director, Human Development
Africa Region
World Bank
v
WP192_EthiopiaHealth_Text.indb vWP192_EthiopiaHealth_Text.indb v 6/9/10 1:25:00 PM6/9/10 1:25:00 PM
44WP192_EthiopiaHealth_Text.indb viWP192_EthiopiaHealth_Text.indb vi 6/9/10 1:25:00 PM6/9/10 1:25:00 PMAcknowledgements
his work was produced by the HRH Team of the Africa Region Health Systems Tfor Outcomes (HSO) Program of the World Bank and was made possible by the
contributions of a large number of individuals and organizations. Financial support
from the Bill and Melinda Gates Foundation and NORAD is gratefully recognized. We
thank Dr Tedros, Dr Kebede, and Dr Nejmudinthe of the Ministry of Health, and the
Government of Ethiopia. Other contributors include Dr. Aklilu Kidanu and colleagues
from the Miz-Hasab Research Center in Addis Ababa, as well as Christopher H. Herbst,
Magnus Lindlow, Gebreselassie Okubagzhi, Pieter Serneels, and Kate Tulenko from the
World Bank.
vii
WP192_EthiopiaHealth_Text.indb viiWP192_EthiopiaHealth_Text.indb vii 6/9/10 1:25:00 PM6/9/10 1:25:00 PMWP192_EthiopiaHealth_Text.indb viiiWP192_EthiopiaHealth_Text.indb viii 6/9/10 1:25:01 PM6/9/10 1:25:01 PMAbstract
y international standards, the supply of health workers in Ethiopia is tiny. In addition, Bthose who do enter the profession and remain in the country disproportionately live
and work in the capital, Addis Ababa. This book examines the incentives and constraints
faced by health workers when choosing where to work, the likely responses of workers to
alternative incentive packages, and the longer-term performance of the health worker labor
market.
WP192_EthiopiaHealth_Text.indb ixWP192_EthiopiaHealth_Text.indb ix 6/9/10 1:25:01 PM6/9/10 1:25:01 PM

  • Accueil Accueil
  • Univers Univers
  • Ebooks Ebooks
  • Livres audio Livres audio
  • Presse Presse
  • BD BD
  • Documents Documents