Working in Health addresses two key questions related to
health workforce policy in developing countries:
- What is the impact of government wage bill policies on the size of
the health wage bill and on health workforce staffing levels in the
- Do current human resources management policies and practices lead
to effective use of wage bill resources in the public sector?
Health workers play a key role in increasing access to health
services for poor people in developing countries. Global and country
level estimates show that staffing levels in many developing
countries—particularly in sub-Saharan Africa—are far below
what is needed to deliver essential health services to the
One factor that potentially limits scaling up the health workforce
in developing countries is the government overall wage bill policy
which sometimes creates restrictions. Through a review of literature,
analysis of data, and country case studies in Kenya, Zambia, Rwanda,
and the Dominican Republic, this book examines the process that
determines the health wage bill budget in the public sector, how this
is linked to overall wage bill policies, how this affects staffing
levels in the health sector, and the relevant policy options.
But staff numbers are not everything and more money for the health
wage bill alone will not solve the health workforce problems of
developing countries. Working in Health looks at how effectively
governments use the available wage bill resources in the health sector
and policy options. Policies and practices in recruitment, deployment,
promotion, transfer, sanctioning, and remuneration for health workers
are reviewed to identify their influence on budget execution rates,
geographic distribution, and productivity of health workers.
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