Policy Options to Attract Nurses to Rural Liberia : Evidence from a Discrete Choice Experiment
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World Bank, Washington, DC
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There is major geographic variation in
nurse staffing levels in Liberia with the largest shortages
in rural areas. A discrete choice experiment (DCE) was used
to test how nurses and certified midwives in Liberia would
respond to alternative policies being considered by the
ministry of health and social welfare (MOHSW). The DCE
methodology provides a quantitative estimate of how
individuals value different aspects of their job. In Liberia
we focused on six key job attributes: location, total pay,
conditions of equipment, availability of transportation,
availability of housing, and workload. Results were used to
predict the share of nurses and certified midwives who would
accept a job in a rural area under different schemes. Based
on the DCE analysis there are four main actionable
recommendations that emerge for improving recruitment and
retention of nurses and certified midwives in rural areas of
Liberia. First, the MOHSW should consider actively
recruiting students from rural areas and exposing them to
rural work conditions during their training. Second, the
MOHSW should strongly consider increasing pay levels in
rural areas as this is likely to be cost effective. Third,
if for some reason financial bonuses are not feasible, the
MOHSW should consider providing transportation to nurses and
certified midwives in rural areas. Fourth, the MOHSW should
reconsider its housing strategy. Providing newly constructed
housing is not a cost effective policy according to the DCE study.
Palabras clave
AGED, BABY, BASIC HEALTH SERVICES, BASIC INFRASTRUCTURE, BULLETIN, BUS, CERTIFIED MIDWIFE, CIVIL WAR, CLINICS, COST EFFECTIVENESS, DENTIST, DEVELOPING COUNTRIES, DOCTORS, DRUGS, EMPLOYMENT, EMPLOYMENT OPPORTUNITIES, FEMALE, FOCUS GROUP DISCUSSIONS, FORCEPS, FREE TRANSPORTATION, FUEL, FUEL COST, FUEL SHORTAGES, GENDER, GOVERNMENT CAPACITY, GPS, HEALTH CARE, HEALTH CARE DELIVERY, HEALTH CARE WORKERS, HEALTH CENTERS, HEALTH ECONOMICS, HEALTH FACILITIES, HEALTH POLICY, HEALTH SECTOR, HEALTH SERVICES, HEALTH SPECIALIST, HEALTH SYSTEM, HEALTH TRAINING, HEALTH WORKERS, HEALTH WORKFORCE, HOSPITAL, HR, HUMAN DEVELOPMENT, HUMAN RESOURCES, IMMUNIZATION, IMMUNIZATIONS, IMPACT ON HEALTH, INCOME, INDEXES, INTERVENTION, IRON, LABOR SUPPLY, LIVING CONDITIONS, MEDICAL EQUIPMENT, MEDICAL SUPPLIES, MIDWIVES, MINISTRY OF EDUCATION, MINISTRY OF HEALTH, MODE OF TRANSPORT, MOVEMENTS OF PEOPLE, NATIONAL DRUG, NATIONAL HEALTH POLICY, NEWBORN, NURSE, NURSES, NURSING, NURSING CARE, NUTRITION, PATIENT, PATIENTS, PEACE, PHARMACIST, PHYSICIAN, PHYSICIANS, POLICY MAKERS, POLICY RESEARCH, POLICY RESEARCH WORKING PAPER, POLICY RESPONSE, PROBABILITY, PROGRESS, PUBLIC TRANSPORT, PUBLIC TRANSPORTATION, QUALITY CONTROL, RESOURCE ALLOCATION, ROAD, ROAD CONDITIONS, ROAD INFRASTRUCTURE, ROADS, RURAL AREAS, SECONDARY EDUCATION, SERVICE DELIVERY, SERVICE PROVISION, SOCIAL SERVICE, SOCIAL WELFARE, SOCIOECONOMIC DEVELOPMENT, SPECIALIST, TRANSPORT, TRANSPORTATION, TRANSPORTATION INFRASTRUCTURE, TRANSPORTATION NETWORKS, TRANSPORTATION PROBLEMS, TRAVEL TIME, TRAVEL TIMES, TRUE, URBAN AREAS, VACCINES, VEHICLE, VEHICLES, VITAL STATISTICS, WORK EXPERIENCE, WORKERS, WORKFORCE, WORKING CONDITIONS, WORLD HEALTH ORGANIZATION