There is increasingly widespread commitment to initiatives to attract and retain skilled workers, especially in rural areas. Retention continues to be a serious challenge in the human resources for health (HRH) crisis. This brief from the Capacity Project updates and documents a previously published resource paper and technical brief which focus on the area of worker retention. The author highlights key findings from three country assessments in Uganda, Tanzania and Liberia. The brief shows how a number of developing countries are employing various strategies to energise the workforce and stem flows. Many practices show promise for wider application across countries, but evidence of successful programmes is seldom documented or shared. Various schemes to improve worker retention are described in countries including Kenya and Zambia.

Key reflections about retention initiatives are offered. It is found that since 2005 activity in the retention scheme area has increased. Before countries embark on schemes to stop workers from leaving their posts, they need more accurate data to establish the real magnitude of turnover. The author argues that based on local conditions, countries should consider an appropriate mix of incentives that will be sustainable in the long term. It is also highlighted that worker shortages and imbalances should not always be attributed to high turnover. Finally, it is concluded that building a strong team and systems at all levels of health care delivery to lead HRH planning and management is one untapped practice that may yield good returns for addressing shortages and imbalances.

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