East Asia and Pacific
Financial incentives for return of service in underserved areas: a systematic review
Are financial incentives effective in attracting and retaining health workers to underserved areas?
Authors:
T Barnighausen; D. E. Bloom
Publisher:
[publisher information not available], 2009
The shortage of human resources for health can severely impact on the provision of health services; therefore incentive programmes have been used to attract health professionals to work in locations most affected by the lack of staff.
The authors of this paper published in the BMC Health Services Research open access journal conducted a systematic review in order to determine the types of financial incentives provided to health workers and the link between reward systems and the maintenance of staffing levels. These incentive systems are based on health care workers being provided with financial supplements such as scholarships, loans and direct payments in order to encourage them to work in areas that they may otherwise chose not to.
The review is based on 43 articles identified through criteria-based searches of PubMed, Excerpta Medica (EMBASE), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the National Health Services Economic Evaluation Database.
While this review provides information on the use of financial incentives to attract human resources to health, there is a lack of data on the retention of workers once payment is received. The authors note that while the results substantiate the utility of financial incentive, the findings cannot be generalized to a number of settings as the focus of the review is primarily on programmes in the United States. Of the 43 articles included, 34 focused on the United States, five on Japan, two on Canada, and one on New Zealand and South Africa respectively.
The authors conclude that financial incentives are effective strategies for attracting health workers to underserved areas. They note however, that further study is needed on the effectiveness of the reward systems in retaining workers once these commitments have been fulfilled. The paper also reports that workers who receive financial rewards are more likely to work in underserved areas than those who do not receive any type of incentive. Further, the type of incentive offered will require further study as an incentive in one setting may not be applicable in others.
