For Public Service or Money - Understanding Geographical Imbalances in the Health Workforce

Pieter Serneels, Centre for the Study of African Economies, University of Oxford1
Magnus Lindelöw, The World Bank
Jose Garcia-Montalvo?, University of Pompeu Fabra, Barcelona
Abigail Barr, Centre for the Study of African Economies, University of Oxford

World Bank Policy Research Working Paper 3686, August 2005


"......Geographical imbalances in the health workforce have been a consistent feature of nearly all health systems, and especially in developing countries. In this paper we investigate the willingness to work in a rural area among final year nursing and medical students in Ethiopia. Analyzing data obtained from contingent valuation questions, we find that household consumption and the student's motivation to help the poor, which is our proxy for intrinsic motivation, are the main determinants of willingness to work in a rural area....."

".....While human resource challenges take many dimensions shortages, geographic imbalances, international migration, low skills and inappropriate skills mix, poor performance and low motivation, etc.this paper focuses on the specific issue of geographical imbalances. Geographic imbalances in the health workforce have been a persistent feature of nearly all health systems. Given the obvious relationship between the number of health workers and the capacity to deliver services--both in terms of volume and quality, the distribution of health professionals has implications for equity in access to health services. But the distribution of health professionals is also an efficiency issue: the under-provision of cost-effective interventions in some areas implies that overall health outcomes could be improved through a reallocation of resources....."

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Fonte: Informativo PAHO 09/05/2006
http://listserv.paho.org/scripts/wa.exe?A2=ind0605&L=equidad&T=0&F=&S=&P=2402 (external link)