Recruiting and motivating health workers in Zambia

  • Incentives in the selection of public service delivery workers are essential to improving their motivation

  • Researchers used field experiments with community health assistants in Zambia to evaluate different recruitment strategies

  • Compared to social incentives, career incentives attract more productive applicants

  • The findings from this project led to a significant policy change

Governments are the primary provider of services for the poor in developing countries. Yet, low productivity among government employees is a significant problem. The Government of Zambia approached the IGC about assisting them with the evaluation of their new National Community Health Assistant (CHA) programme.

This project addressed the growth policy challenges faced by Zambia and other developing countries by providing direct guidance to the Government of Zambia as it aims to recruit, train, motivate, and retain 5,000 new Community Health Assistants by 2017. The study will provide policy guidance on how, in the face of severe human resource constraints, governments can best manage their human resources and deliver basic services by adjusting two key human resource levers: recruitment and incentives.

The projects findings allay the concern that career benefits may lead to adverse selection by attracting those who are not intrinsically motivated. More importantly, it was observed that the large and robust selection effects on job performance. After 18 months of deployment, CHAs recruited with career incentives conduct 29% more household visits (their primary job task), organize twice as many community meetings, and see an equal number of patients at the health facility, with no differences in retention.

This project has influenced government recruitment and compensation policies and a scale-up project is in progress.

This project has been followed up by the IGC project: Recruiting and motivating community health workers.

Outputs

Authors

Project information

Status

Completed

Start date / End date

1 January 2011 - 1 March 2012

Country

Zambia

Research Theme

Public Sector and Tax, State