Evaluation of Malawi's Emergency Human Resources Programme

Management Sciences for Health
From new and returning staff
� The majority of new and returning staff surveyed from both MOH and CHAM
(57 out of 62) stated that the salary top-ups were a key factor in the decision to
join, or return to health service, although an underlying theme was that the tax on
the top-up was too high; the increase in take home pay ranged from 25% to
41%. 44
� Many respondents cited the three-year contract as a strong incentive for reentering
the health service.
� Respondents overwhelmingly recommended that the government continue to
recruit new and returning staff through recruitment galas.
� Nearly 75% of new and returning staff surveyed (85 out of 117) indicated their
intention to stay in the health sector for 10 years or longer. Most said ‘until
retirement’, or ‘as long as able.’ For many, this was a change from their previous
expectations.
From current staff
� 62 out of 90 of current staff surveyed indicated that, as a result of the top-ups,
they planned to stay in the government or CHAM health services until retirement
or as long as they are able. Nearly half of respondents said that this was a change
from previous expectations.
� Other factors that influenced health workers’ decisions to re-commit themselves
to the health sector included better working conditions, such as improved
promotional opportunities, housing, access to in-service training, workshops, and
improved supplies.
From all staff
� Adequate housing remained a key concern for many staff, especially in the rural
areas.
� Suggestions for improvements in non-financial incentives included more
educational opportunities, improved conditions of service, and improved
management.
� The Locum, a scheme through which medical personnel are paid additional salary
to fill work shifts beyond their own when there is no other coverage, was an
important financial incentive to many people but there are concerns about the
quality of work under this Programme, the cost and how it is being used.
Cost
Expenditure under Element 1 consists of the 52% salary top-ups received by the 11
cadres of staff at MOH and CHAM, 26% top-ups received by the HSAs, and
44 Republic of Malawi, Malawi Health SWAp Donor Group, GTZ/UNDP. Human Resources / Capacity
Development within the Health Sector: Needs Assessment Study. April 2007.
EHRP Evaluation Final Report Page 30