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Title page
Contents
ACKNOWLEDGEMENTS 6
ABBREVIATIONS 7
EXECUTIVE SUMMARY 9
1. NTRODUCTION 12
Conceptual Framework 13
Structure of the Report 14
2. DRIVERS OF WORKER PERFORMANCE IN HEALTH FACILITIES 15
Staffing 16
Merit-Based Recruitment 20
Performance Management 22
Work Environment: Group Problem Solving 23
Financial Incentives 25
Performance-Based Financing 25
Nonfinancial Incentives 30
Training 31
Health Worker Motivation 33
Mental Health and Resilience 36
3. DRIVERS OF WORKER PERFORMANCE IN THE HEALTH ADMINISTRATION 37
Facility Funding 38
Supportive Supervision 39
Data-Informed Management 41
4. CONCLUSION 45
APPENDIX: DETAILED SURVEY METHODOLOGY 47
REFERENCES 49
Figure 1. Conceptual framework 14
Figure 2. Perceptions on staffing challenges 16
Figure 3. Participation in a recruitment competition (percentage of respondents that said "Yes"), overall and by occupation 21
Figure 4. Salary increases over the past 2 years by performance-based financing participation 28
Figure 5A. Comparison of wages between men and women in top-earning occupations 29
Figure 5B. Comparison of wages between men and women in lower-paid occupations 29
Figure 6. Gender differences in on-the-job training, Mali 33
Figure 7. Facility staff's views on turnover 35
Figure 8. Experiences with receiving facility funding 38
Figure 9. Average interval between supervisory visits 41
Figure 10. Share of respondents agreeing with "Data often captures too many indicators, creating challenges when compiling, interpreting, and effectively utilizing the findings." 42
Figure 11. Percentage of respondents who did not have training on digital skills and data for budgetary decisions 44
Boxes
BOX 1. Guidance to develop rural pathways for health workers in LICs and LMICs 19
BOX 2. Examples of group problem solving interventions 24
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