Strong financial management at all levels is essential to having the staff to deliver services at health facilities. A primary objective of sound financial management is an approved personnel budget that is in line with the expenditures needed to develop, deploy, and sustain an adequate health workforce. It is also important that those responsible for making decisions about program design and management have financial allocation authority.

Low salaries contribute to migration. Low salaries are one of the major causes of staff migration: talented, motivated staff can become demoralized when they are poorly paid and will seek opportunities elsewhere. Low salaries are tied to poor economic conditions and inappropriate priorities for public expenditure. But good leadership and policy reform can result in more equitable distribution of salaries and allowances. If salaries are not adequate to meet basic living needs, service staff cannot devote themselves full-time to their service roles.

Pre-service and in-service education. With the increasing toll that migration is taking on the health sector, funding for training health workers must be re-assessed. Often scarce funds are being used to train the cadres of health staff that are most exportable at the expense of training cadres who are more likely to stay in-country. Opportunities for staff development not only help staff acquire needed skills, but are also one of the most important factors in an effective retention strategy.

Incentives. Pilot programs in several countries are showing that incentive packages for rural postings can help maintain health service delivery to rural areas. Incentives usually include a salary top-off, housing and education benefits for family members, and guaranteed opportunities for further career development. Funding for scaling-up successful pilot programs needs to be guaranteed. When linked to productivity targets, well-designed incentive programs can lower costs in relation to desired results.

Recruitment, hiring, and deployment. Long delays in recruitment, hiring, and deployment contribute to a loss in the productivity of the health system. Adequate funding must be allowed to support trained human resource managers to carry out these functions in a timely manner.

Related Country Work

MSH is strengthening HRH in part by helping to address financial requirements of human capacity development through large USAID-funded programs in Kenya, Uganda, Mozambique, Haiti, and Namibia.

MSH Resources Related to Addressing Financial Requirements for HRH:

Resources are in PDF format. Click here for information about installing Acrobat Reader.

• Assessing Your Organization’s Capacity to Manage Finances
  » Case Study: The NGO “Health and Life for All” Focuses on Improving Its Financial Management
   

• HRH Framework
• The Financial Management Assessment Tool
• Developing a Salary Policy

• Managers Who Lead
• Tools for Planning and Developing Human Resources for HIV/AIDS and Other Health Services