Prepared by: Dr. Musa Ajlouni January, 2010 - World Health ...

There are two types of staff turnover in the health care sector, occurring internally aswell as externally. Internally, health care professionals move from the public sector(MOH, RMS, University hospitals) to the private sector and from one hospital toanother within the private sector based on better job opportunities and salaries.Some health workers (physicians, dentists, pharmacists, nurses, and labtechnicians) in the public sector also work illegally for the private sector. Retiredpersonnel, from the public sector, are also moving into the private sector wherewages and benefits are much better, especially among physicians.High staff turnover, intention to move to urban centers and low motivation amongmedical staff has been found among professionals in rural areas. High turnover is aparticular problem among female physicians and nurses in MCH centers, not only inrural areas, but also in cities of three hours’ distance from the capital. The poor stateof the equipment and buildings, a closed social system (specifically for female healthprofessionals) and lack of incentives are major problems of the rural areas.Externally, movement is seen from Jordan to the Gulf area and to other developedcountries as UK, in particular among nurses and physicians where wages andbenefits are more attractive than in Jordan. It is estimated that 18-21 per cent ofnursing workforce has left Jordan. The percentage of physicians moving outside thecountry is not reported but still high. Further, physicians who are sponsored abroadto complete specialties often do not return to Jordan upon completion of theirstudies. 30It is estimated that about 2-3 thousand Jordanian physicians are working outsideJordan. Many of them work in advanced medical centers in the United States ofAmerica, United Kingdom and other Western countries. The advancement,expansion and increasing reputation of the private health sector cause manyJordanian physicians, mainly specialists, to return to the country during the last tenyears. 29Finally, MOH and other health sectors need to actively seek ways to reduce attritionthrough:- Improving human resources management processes and practices.- Decentralization of authority to hospital and directorate managers and ensuringaccountability.- Seeking ways to improve salaries and benefits to reward increased productivity.- Institutionalizing continuing education programs and professional grading system.- Improving working conditions and work environment.63