Flexibility of deployment: challenges and policy options for retaining health workers during crisis in Zimbabwe
Background
Zimbabwe experienced a socio-economic crisis from 1997 to 2008 which heavily impacted all sectors. In this context, human resource managers were confronted with the challenge of health worker shortage in rural areas and, at the same time, had to operate under a highly centralised, government-centred system which defined health worker deployment policies. This study examines the implementation of deployment policies in Zimbabwe before, during and after the crisis in order to analyse how the official policy environment evolved over time, presenting the actual practices used by managers to cope with the crisis and draw lessons. ‘Deployment’ here was considered to include all the human resource management functions for getting staff into posts and managing subsequent movements: recruitment, bonding, transfer and secondment. The study contributes to address the existing paucity of evidence on flexibility on implementation of policies in crisis/conflict settings.
Results
Before the crisis, health workers were allowed to look for jobs on their own, while during the crisis, they were given three choices and after the crisis the preference choice was withdrawn. The government froze recruitment in all sectors during the crisis which severely affected health workers’ deployment. In practice, the implementation of the deployment policies was relatively flexible. In some cases, health workers were transferred to retain them, the recruitment freeze was temporarily lifted to fill priority vacancies, the length of the bonding period was reduced including relaxation of withholding certificates, and managers used secondment to relocate workers to priority areas.
Conclusion
Flexibility in the implementation of deployment policies during crises may increase the resilience of the system and contribute to the retention of health workers. This, in turn, may assist in ensuring coverage of health services in hard-to-reach areas.
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Mashange, W, Martineau, T, Chandiwana, P, Chirwa, Y, Pepukai, VM, Munyati, S, Alonso-Garbayo A. Flexibility of deployment: challenges and policy options for retaining health workers during crisis in Zimbabwe. Human Resources for Health 2019 17:39 https://doi.org/10.1186/s12960-019-0369-1
Image: Nurse Checking Baby Vitals in Zimbabwe 2012, RBF Health, Peter Von Elling, Flickr