Abstract
BackgroundIncreasing the availability of health workers in remote and rural areas through improved health workforce recruitment and retention is crucial to population health. However, information about the costs of such policy interventions often appears incomplete, fragmented or missing, despite its importance for the sound selection, planning, implementation and evaluation of these policies. This lack of a systematic approach to costing poses a serious challenge for strong health policy decisions.MethodsThis paper proposes a framework for carrying out a costing analysis of interventions to increase the availability of health workers in rural and remote areas with the aim to help policy decision makers. It also underlines the importance of identifying key sources of financing and of assessing financial sustainability.The paper reviews the evidence on costing interventions to improve health workforce recruitment and retention in remote and rural areas, provides guidance to undertake a costing evaluation of such interventions and investigates the role and importance of costing to inform the broader assessment of how to improve health workforce planning and management.ResultsWe show that while the debate on the effectiveness of policies and strategies to improve health workforce retention is gaining impetus and attention, there is still a significant lack of knowledge and evidence about the associated costs. To address the concerns stemming from this situation, key elements of a framework to undertake a cost analysis are proposed and discussed.ConclusionsThese key elements should help policy makers gain insight into the costs of policy interventions, to clearly identify and understand their financing sources and mechanisms, and to ensure their sustainability.
Highlights
Increasing the availability of health workers in remote and rural areas through improved health workforce recruitment and retention is crucial to population health
Despite human resources for health having been recognized as a cornerstone to achieving better health outcomes [1], there remains a critical shortage of health workers, in remote and rural areas where health outcomes tend to be significantly lower [2] and there is a considerable need for more basic health care
Information about the costing of policy interventions focusing on recruitment and retention in remote and rural areas contributes to making better policy decisions
Summary
Increasing the availability of health workers in remote and rural areas through improved health workforce recruitment and retention is crucial to population health. Information about the costs of such policy interventions often appears incomplete, fragmented or missing, despite its importance for the sound selection, planning, implementation and evaluation of these policies This lack of a systematic approach to costing poses a serious challenge for strong health policy decisions. While there is a growing recognition of the importance of improving access to health workers in remote and rural areas, most countries have only very limited financial resources to address this issue This is especially true for the 57 countries identified as having a critical health workforce shortage [5]. In this context, information about the costing of policy interventions focusing on recruitment and retention in remote and rural areas contributes to making better policy decisions
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