1. Retention of HCW to overcome skills shortage Dimakatso Shirinda Health Risk Management Strategist ©082 909 1104

2. Agenda Introduction HIV Impact on your business Healthcare worker statistics Motivational factors for HCW’s Recommendations Strategic considerations Conclusion

3. Let’s just imagine… Competitor sets up a similar business across your premises, essentially destroying your business and its sustainability… Market share Customer base Profitably Trained and competent employees WHAT DO YOU DO? YOU CHOOSE TO BE INNOVATIVE… Create better products,reseach new technologies, improve processes and systems to ensure adequate ROI, Recruit new staff,Upskill existing staff, Incentivise them, Reposition your brand

4. WHY IS THAT NOT ALWAYS THE CASE WITH HCW’s? The HIV epidemic is still one of the major challenges to the country's socio-economic development. Health worker retention is critical for health system performance and a key problem is how best to motivate and retain health workers.

5. Corporate HIV/AIDS impact: forces summary Insurance coverRetirement fundsHealth and safetyMedical assistanceTesting/CounselingFuneral costs Staff turnover Increased absenteeism Loss of skills Knowledg e attrition Declining morale Corporate costs: summary Increased costs Clearly there is a need for effective Healthcare Worker Retention Strategies …

6. HCW Statistics… Africa has 2.3 Health Workers p/1000 population VS. America has 24.8 Health Workers p/1000

7. Several major themes regarding motivational factors were identified Financial (in terms of salary or allowances) Career development (in regards to the possibility to specialise or be promoted) Continuing education (having the opportunity to take classes and attend seminars) Hospital infrastructure (the physical condition of the health facility, in papers often described as 'work environment') BMC Health Services Research 2008

8. Motivational factors were identified continues … Resource availability (refers to equipment and medical supplies that are necessary for health workers to perform their job) Hospital Management ( Poor management practices may contribute to high attrition, while management practices that value health workers may reduce attrition ) Personal recognition or appreciation (either from managers, colleagues of the community) Other themes included fringe benefits (e.g. housing and transport allowances), job security, personal safety, staff shortages and social factors, such as effect on family life BMC Health Services Research 2008

9. Implementation challenges often experienced “ Silo” approach Lack of leadership endorsement and participation Lack of union buy-in and participation Reactive vs proactive Lack of financial resources Perceived to be an HR issue vs a business imperative Separate scheme from employer initiatives

10. Recommendations Reviewing the curriculums of all these professions to be in line with the latest developments e.g. include component of managed heath care Increasing safety measures at public hospitals Restructuring remuneration packages “Claw back” on health professionals who want to leave the country Increasing the number of tertiary institutions producing health professionals Actively “promoting” these professions at schools

11. Strategic considerations Retired Health Care Workers are in a good position to drive Home Based Care Programmes (experience, loyalty) Training of lab staff, definite roles for community caregivers and Lay-counsellours Repositioning of the profession through innovative campaigns to attract new entrants Specific HCW retention strategie s, including financial and non- financial incentives, to be addressed Health worker HIV/AIDS treatment & prevention programmes, incl. post-exposure prophylaxis (PEP) to always be in place. Deployment policies, skills mix, task shifting and their relationship to the rest of the health system needs to be clearly defined Continued support from regulatory bodies

12. Conclusion Whilst we expect HCW’s to show us kindness,we,too need to show them kindness…

13. THANK YOU…