Reducing Geographical Imbalances ofHealth Workers in Sub-Saharan Africa : A Labor MarketPerspective on What Works, What Does Not, and Why

Lemiere, Christophe ; Herbst, Christopher H. ; Jahanshahi, Negda ; Smith, Ellen ; Soucat, Agnes

World Bank

关键词: ACCESS TO HEALTH SERVICES;    AUXILIARY NURSES;    BIRTH ATTENDANTS;    BIRTH RATES;    BRAIN DRAIN;   

DOI  :  10.1596/978-0-8213-8599-9
RP-ID  :  58843

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

This report discusses and analyzes labormarket dynamics and outcomes (including unemployment, workershortages, and urban-rural imbalances of categories ofhealth workers) from a labor economics perspective. It thenuses insights from this perspective as a basis forelaborating policy options that incorporate the underlyinglabor market forces. The goal of the study is to addressundesirable outcomes (including urban-rural HRH imbalances)more effectively. The study draws on an extensive inventoryof policy options relevant to urban-rural labor forceimbalance in Sub-Saharan Africa and the experiences withthese imbalances to date. Given the limited documentationavailable on this topic through formal channels, the reviewrelies heavily on 'gray literature' frompolicymakers in Sub-Saharan Africa and their developmentpartners, especially the World Bank and the World HealthOrganization (WHO). The report is divided into five mainsections. The first section focuses on economic policiesrelated to Human Resources for Health (HRH) objectives. Itargues that policymaking has ignored health labor marketdynamics. The second section provides data showing theextent of urban-rural imbalances and describes how theseimbalances affect health system outcomes. The third sectionuses a health labor market framework to explain theseimbalances. The fourth section outlines policy optionsrelevant to Sub-Saharan Africa for addressing marketdistortions and affecting labor market outcomes. It alsoreviews evidence on the policies, strategies, and programsdesigned to address geographic imbalances in Sub-SaharanAfrica, highlighting what has been done, what has worked,and what has not. The last section provides a roadmap for policymakers.