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• W2615696689 abstract "Introduction Like most sub-Saharan African countries, Senegal is experiencing a critical health workforce shortage. (1) Health worker shortages, which are more marked in remote and rural areas, weaken health systems and compromises the population's access to health services. (2) Various policy interventions can improve health workforce recruitment and retention in rural and remote areas. (3-6) Over the past few years, the Ministry of Health of Senegal adopted measures to improve the posting process and the recruitment and retention of health workers in rural and remote areas. Among them was the introduction of an innovative special contracting system for recruiting health workers. As illustrated in Table 1, health workers in Senegal are concentrated in certain urban centres, particularly the capital, Dakar. According to the ministry of health, the Dakar region has 0.2 physicians per 1000 population, the regions of Fatick, Kaolack, Kolda and Matam have fewer than 0.04. In other words, Dakar has more than 60% of all physicians in the entire country, even though its dwellers represent only 23% of Senegal's total population. The Kaolack and Kolda regions, which have an acute shortage of medical personnel, are also among Senegal's poorest regions. (7) The density of midwives and nurses also varies widely in Senegal. Approach In recent years, the Ministry of Health has spearheaded various measures to improve the posting process and the recruitment and retention of health workers in underserved areas. In collaboration with the World Health Organization, in July 2008 it reviewed the measures adopted to improve health worker deployment in Senegal, particularly the contracting system, as well as other potential measures. In 2006, the Ministry of Health introduced a special contracting systems in the context of Plan Cobra. This plan was developed to facilitate recruitment to remote and rural areas of Senegal, with a particular focus on the country's border regions. This recruitment process differs from the main, traditional approach whereby the Ministry of Health recruits health workers as civil servants and makes them available for deployment. Under such a scheme, the Ministry of Public Services, in collaboration with the Ministry of Health, establishes a yearly quota of health worker positions for which candidates then apply, but without knowing where they will be deployed if they are selected. While this system is well established for health workers in Senegal, it remains rather inflexible and is often limited in its ability to respond effectively to specific and developing health workforce needs in rural and remote areas. In addition, deployment to such areas is often unpopular among health workers because under this system the length of stay in those regions is uncertain. The temporary employment contracting system that was launched in 2006 in the context of Plan Cobra was designed precisely to be more responsive to changing health workforce needs. Under this system, which is unlike the recruitment system of the Ministry of Public Services, the health worker enters into a contractual arrangement with the Ministry of Health for a specific post in a particular location and for a specific length of time. Like health workers in the civil service, health workers who are contracted are entitled to special benefits when working in remote and rural areas. For instance, housing is provided to contracted nurses who head health outposts. Contracted health workers also benefit from motivation and hardship allowances. While there was clear recognition that such a measure could lead to the reopening of health posts that had been previously left without health workers, it is less clear whether each region, and particularly those with a low health workforce density, benefited to the same degree from this programme. Results In the context of Plan Cobra, 122 health outposts were reopened in Senegal. …" @default.
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• W2615696689 date "2010-05-01" @default.
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• W2615696689 title "How to Recruit and Retain Health Workers in Underserved Areas: The Senegalese experience/Comment Recruter et Retenir Des Agents De Sante Dans Les Zones Mal Desservies : L'experience senegalaise/Como Captar Y Conservar Personal Sanitario En Zonas Subatendidas: La Experiencia del Senegal" @default.
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