Working In Health: Financing And Managing The Public Sector Health Workforce (directions In Development)

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Working in Health focuses on two key human resources for health policy questions: What is the impact of government fiscal policy on health worker staffing levels, and how effectively do governments manage health wage bill resources in the public sector? Through in-depth country case studies in Kenya, Zambia, Rwanda, and the Dominican Republic this book demonstrates how an analysis of wage bill budget trends, budget execution rates, and other factors helps determine whether wage bill ceilings are an important constraint to hiring health workers in the public sector. This book also reviews policies and practices related to recruiting, deploying, promoting, sanctioning, and paying health workers in the public sector in the four countries. In both of these policy areas, the options for reform are discussed. The health workforce challenges in developing countries are significant, but the evidence base for policy makers is weak. This book is an important contribution in the areas of fiscal policy and public sector management.

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DIREC TIONS IN DE VELOPMENT Human Development Working in Health Financing and Managing the Public Sector Health Workforce Marko Vujicic, Kelechi Ohiri, Susan Sparkes Authors Working in Health Working in Health Financing and Managing the Public Sector Health Workforce Marko Vujicic Kelechi Ohiri Susan Sparkes With contributions from Aly Sy Tim Martineau Christoph Kurowski Claudia Rozas Andrew Mitchell Kyla Hayford and Sherry Madan © 2009 The International Bank for Reconstruction and Development / The World Bank 1818 H Street NW Washington DC 20433 Telephone: 202-473-1000 Internet: www.worldbank.org E-mail: [email protected] All rights reserved 1 2 3 4 11 10 09 This volume is a product of the staff of the International Bank for Reconstruction and Development / The World Bank. The findings, interpretations, and conclusions expressed in this volume do not necessarily reflect the views of the Executive Directors of The World Bank or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgement on the part of The World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries. Rights and Permissions The material in this publication is copyrighted. Copying and/or transmitting portions or all of this work without permission may be a violation of applicable law. The International Bank for Reconstruction and Development / The World Bank encourages dissemination of its work and will normally grant permission to reproduce portions of the work promptly. For permission to photocopy or reprint any part of this work, please send a request with complete information to the Copyright Clearance Center Inc., 222 Rosewood Drive, Danvers, MA 01923, USA; telephone: 978-750-8400; fax: 978-750-4470; Internet: www.copyright.com. All other queries on rights and licenses, including subsidiary rights, should be addressed to the Office of the Publisher, The World Bank, 1818 H Street NW, Washington, DC 20433, USA; fax: 202-522-2422; e-mail: [email protected] ISBN-13: 978-0-8213-7802-1 eISBN: 978-0-8213-7803-8 DOI: 10.1596/978-0-8213-7802-1 Library of Congress Cataloging-in-Publication Data Vujicic, Marko. Working in health : financing and managing the public sector health workforce / Marko Vujicic, Kelechi Ohiri, and Susan Sparkes ; with Tim Martineau ... [et al.]. p. ; cm. — (Directions in development) Includes biblio