What Is iHRIS Retain?

iHRIS Retain is a simple, open-source tool to cost retention strategies to be implemented at the district, regional, or national level. The newest product in the CapacityPlus iHRIS Suite of health workforce software, iHRIS Retain is structured around the 2010 WHO Global Policy Recommendations for Rural Retention. The tool guides the user through the costing process step by step to capture all relevant financial, health worker, and target data needed. Based on the inputs entered, iHRIS Retain calculates the total costs and generates reports for each retention intervention and targeted cadre, as well as the aggregated cost of the retention strategy and compares it to available health sector funds. Many different scenarios and combinations can be costed to find the most feasible options. The resulting cost figures can then be shared with relevant stakeholders to discuss and determine the feasibility of the retention interventions within the available fiscal space and to budget for actual implementation.

How Was iHRIS Retain Developed?

The development and dissemination of iHRIS Retain is a joint collaboration between CapacityPlus and the Health Workforce Migration and Retention Unit of the World Health Organization's (WHO) Department of Human Resources for Health.

CapacityPlus

CapacityPlus USAID-funded global project uniquely focused on the health workforce needed to achieve the Millennium Development Goals.

CapacityPlus Partnership

Associate Partners

  • African Population and Health Research Center (APHRC)
  • Asia-Pacific Action Alliance on Human Resources for Health (AAAH)
  • West African Institute of Post-Graduate Management Studies (CESAG)
  • Partners in Population and Development (PPD)

World Health Organization (WHO)

The mission of the WHO Department of Human Resources for Health is "to provide equitable access for all people to an adequately trained, skilled and supported health workforce to contribute towards the attainment of the highest possible level of health." The Health Workforce Migration and Retention analyzes trends in workforce migration in order to develop and evaluate effective mechanisms for the management of international health workforce migration, including the development of an international code of practice. The team also supports and develops policy options that aim to improve workforce recruitment, deployment, retention, return, motivation and performance. In this context, HMR is undertaking a series of country case studies which will inform the development of WHO guidelines for improving health workforce retention in remote and rural areas.

Why the Need for iHRIS Retain?

Skilled and motivated health workers in sufficient numbers in the right place and at the right time are critical to deliver effective health services and improve health outcomes[1]. However, although almost one half of the global population lives in rural[2] areas, they are served by only 38% of the total nursing workforce[3] and by less than a quarter of the total physician workforce. As these statistics illustrate, retention of health workers in remote and rural areas is a serious impediment to achieving access to quality health services. The 2010 WHO GlobalPolicy Guidelines on Rural Retention recommends that to motivate health workers to serve in hard-to-reach areas, health service organizations must implement a “bundle” or combination of well-selected retention interventions. While country stakeholders recognize the need to address health worker retention, health sector budgets in developing countries are limited. The question that needs to be answered is which retention strategies should be pursued—and somewhat more importantly from the feasibility standpoint—how much will they cost. Faced with multiple priorities within the health sector and limited means, policymakers want to know up-front what a recommendation will cost in order to gauge the affordability and sustainability of its implementation.

Who Are the Users of iHRIS Retain?

Instead of depending on external technical assistance, iHRIS Retain is designed with the noneconomist in mind, such as human resources for health (HRH) managers and other health officials. One does not need to be an economist to take advantage of the tool and understand and use the results.

What Are the Benefits of iHRIS Retain?

iHRIS Retain helps remove some of the mysticism of health economics by putting a powerful tool in the hands of HRH managers that yields results close to a traditional costing exercise at a fraction of the cost, without requiring guidance from a senior health economist. The software provides the flexibility of inputting different options for retention interventions and targeted cadres to obtain the most accurate financial scenarios for decision-making. With its focus on self-reliance the retention costing tool promotes country ownership, increases self-sufficiency of host country counterparts in making and acting on HRH decisions, reduces reliance on external technical assistance, and empowers stakeholders to implement economically affordable retention strategies. iHRIS Retain can be combined with another tool CapacityPlus is developing with the World Bank and the WHO, the Rapid Retention Survey Toolkit, to select the most appropriate retention interventions to motivate health worker. When used together, the result is an affordable, cost-effective retention package designed by the country.

References

  1. Increasing access to health workers in remote and rural areas through improved retention: global policy recommendations. Geneva, World Health Organization, 2010
  2. World Urbanization Prospects: The 2007 Revision Population Database. New York, NY, United Nations Department of Economic and Social Affairs, 2008
  3. The World Health Report 2006 – Working Together for Health. Geneva, World Health Organization, 2006.