Theme area
Human resources for health
Malema NR, Muthelo L
Title of publication EQUINET Discussion paper 115: Literature review: Strategies for recruitment and retention of skilled healthcare workers in remote rural areas
Date of publication
2018 September
Publication type
Publication details
EQUINET discussion paper 115, EQUINET (Harare) and University of Limpopo (South Africa), 2018
Publication status
health workers; rural; retention; east and southern Africa; desk review
This literature review, implemented within an EQUINET programme of theme work on health workers at the University of Limpopo, presents published evidence on the recruitment and retention of skilled healthcare workers in rural areas of east and southern Africa. It reviewed published documents in English with a focus on east and southern Africa from 2000-2017. From the literature reviewed the following strategies emerged as key for health worker retention: Education and training of healthcare workers; review of regulations and policies regarding provision of healthcare services in rural areas; provision of financial incentives; and personnel and professional support of healthcare workers. The report identified strategies relating to: Reviewing admission policies and criteria for health worker education; including rural practice issues and skills in health worker training and exposing students to rural areas during training; improving access to continuing professional development (CPD) in rural areas; ensuring that compulsory measures are accompanied by relevant support and incentives; ensuring that mitigatory strategies such as task shifting are not ‘task dumping’, do not replace more substantive solutions and that they are accompanied by suitable regulatory systems, training and management support; using financial and non-financial incentives to address issues prioritised by health workers, in a way that does not motivate some while demotivating others, and not as a substitute for a more substantive review of working conditions of healthcare workers and strategies to reduce the disparities in salaries between different health professionals; and improving health worker management and support, and the skills of HRH managers.
East and southern Africa region
Equinet Publication Type
Discussion paper