Working in health: financing and managing the public sector. - health workforce
Gespeichert in:
1. Verfasser: | |
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Format: | Buch |
Sprache: | English |
Veröffentlicht: |
Washington, DC
World Bank
c2009
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Schriftenreihe: | Directions in development
|
Schlagworte: | |
Online-Zugang: | Inhaltsverzeichnis |
Beschreibung: | Includes bibliographical references and index Erscheint: März 2009 |
Beschreibung: | XXVII, 271 p graph. Darst. |
ISBN: | 9780821378021 |
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264 | 1 | |a Washington, DC |b World Bank |c c2009 | |
300 | |a XXVII, 271 p |c graph. Darst. | ||
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490 | 0 | |a Directions in development | |
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500 | |a Erscheint: März 2009 | ||
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650 | 4 | |a Public health personnel |x Salaries, etc |z Developing countries | |
650 | 4 | |a Medical economics |z Developing countries | |
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650 | 4 | |a Developing Countries |z Rwanda | |
650 | 4 | |a Developing Countries |z Zambia | |
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adam_text | Titel: Working in health
Autor: Vujicic, Marko
Jahr: 2009
Contents
Foreword xv
Acknowledgments xix
Executive Summary xxi
Abbreviations xxvii
Chapter 1 Overview 1
The Wage Bill Budgeting Process in the Public Sector 7
The Effect of the Wage Bill Budgeting Process
on the Health Workforce 21
Managing Health Wage Bill Resources in the
Public Sector 24
Policy Options to Address Fiscal Constraints on
the Health Wage Bill and to Improve
Management of the Health Workforce in
the Public Sector 37
Notes 55
References 55
Chapter 2 Background Country Study for Kenya 61
The Health Wage Bill in Kenya 62
Public Sector Employment of Health Workers 74
v
vi Contents
Key Messages 87
Notes 90
References 91
Chapter 3 Background Country Study for Zambia 93
The Health Wage Bill in Zambia 94
Public Sector Employment of Health Workers 108
Key Messages 121
Notes 123
References 125
Chapter 4 Background Country Study for Rwanda 127
The Health Wage Bill in Rwanda 127
Public Sector Employment of Health Workers 139
Donor Funding of Health and Education Workers
Salaries 148
Key Messages 150
Annex 152
Notes 162
References 162
Chapter 5 Background Country Study for the Dominican
Republic 165
The Health Wage Bill in the Dominican Republic 166
Public Sector Employment of Health Workers 182
Key Messages 194
Notes 197
References 197
Appendix A Comparative Analysis of Health Outcomes,
Service Delivery, and Health Workforce Levels in
Kenya, Zambia, Rwanda, and the Dominican
Republic 199
Appendix B Analysis of the Share of Government Health
Expenditure Going to the Health Wage Bill:
Some Stylized Facts 207
Contents vii
Appendix C Decentralization and Human Resources
for Health 215
Appendix D Review of Alternative Compensation Methods
for Health Workers 233
Appendix E Review of GFATM Round 6 and GAVIHSS
Round 1 Policies and Practices for Funding
Health Worker Remuneration 253
Index 265
Boxes
Chapter 1 Overview 1
1.1 Challenges of Civil Service and Administrative Reform 39
1.2 The Kenya Emergency Hiring Program: A Promising
Practice in Using Donor Assistance to
Scale Up the Health Workforce 45
1.3 Summary of Policies and Practices in GFATM and
GAVI HSS for Remuneration of Health Workers 46
1.4 Political Economy of Removing Health Workers from
the Civil Service 53
Chapter 3 Background Country Study for Zambia 93
3.1 Confirming That an Existing Post Has Become Vacant 113
Appendix C Decentralization and Human Resources
for Health 215
C. 1 A Tale of Two Ugandas: Successes and Failures in
Administrative Efficiency under Decentralized
Human Resource Management 222
Appendix D Review of Alternative Compensation Methods
for Health Workers 233
D. 1 Provider Payment Mechanisms and Performance: How
Fee-for-Service, Capitation, and Salaried Systems Affect
Health Worker Performance 238
D.2 Case Study: Performance Contracts with Physicians in
Romania 242
viii Contents
D.3 Case Study: Contracting In and Contracting Out in
Cambodia 243
Appendix E Review of GEATM Round 6 and GAVIHSS
Round 1 Policies and Practices for Funding
Health Worker Remuneration 253
E.I Examples of Countries Using GFATM Grants to Pay
Health Workers 260
Figures
Chapter 1 Overview 1
1.1 Focus of Report 4
1.2 Performance on Selected Health, Service Delivery, and
Staffing Outcomes Relative to Income and Health
Spending in the Dominican Republic, Kenya, Rwanda,
and Zambia, 2005 6
1.3 Public Sector Wage Bill as a Share of GDP, 2000-08 10
1.4 A Comparison of the Health Wage Bill Budgeting Process 12
1.5 Health Wage Bill as a Share of Overall Wage Bill,
2000-07 14
1.6 Change in Public Sector Health Wage Bill versus
Change in Total Public Sector Wage Bill: Sample
Countries over Selected Years 15
1.7 Distribution of Civil Service Employees by Sector,
1996-2000 19
Chapter 2 Background Country Study for Kenya 61
2.1 Public Sector Wage Bill as a Share of GDP, by
Region, 2005 64
2.2 Public Sector Wage Bill as a Share of Government
Expenditure by Region, 2005 65
2.3 Public Sector Wage Bill as a Share of GDP, 2000-06 66
2.4 Public Sector Wage Bill as a Share of Government
Expenditure, 2000-07 67
2.5 Health Expenditure as a Share of Government
Expenditure and Health Wage Bill as a Share of
Health Expenditure, 2000-09 71
2.6 Health Wage Bill as a Share of Public Sector
Wage BUI, 2000-07 72
Contents ix
2.7 Ministry of Health Staff Recruited and Lost, 2001 -06 74
2.8 Flowchart of Process of Filling a Vacant Post 76
Chapter 3 Background Country Study for Zambia 93
3.1 Public Sector Wage Bill as a Share of GDP, 1990-2008 95
3.2 Public Sector Wage Bill as a Share of GDP, by
Country, 2005 97
3.3 Public Sector Wage Bill as a Share of Government
Expenditure, by Country, 2005 98
3.4 Public Sector Wage Bill as a Share of Government
Expenditure, 1990-2008 99
3.5 Health Bill as a Share of Public Sector Wage Bill,
1990-2007 104
3.6 Health Expenditure as a Share of Government
Expenditure and Health Wage Bill as a Share of
Health Expenditure, 1990-2009 105
3.7 Expenditure on Health, 1996-2005 106
3.8 Number of Ministry of Health Staff Appointed,
1999-2007 107
Chapter 4 Background Country Study for Rwanda 127
4.1 Public Sector Wage Bill as a Share of GDP, by
Country, 2005 130
4.2 Public Sector Wage Bill as a Share of Government
Expenditure, by Country, 2005 131
4.3 Distribution of HRH Expenditures as a Share of
Total, 2003-07 134
4.4 Distribution of Education Human Resource
Expenditures as a Share of Total, 2003-06 134
4.5 Public Sector Wage Bill and Recurrent Government
Human Resource Expenditure as a Share of
GDP, 2003-09 136
4.6 Public Sector Wage Bill and Recurrent Government
Human Resource Expenditure as a Share of
Government Expenditure, 2003-09 136
4.7 Health Wage Bill as a Share of Public Sector
Wage Bill, 2003-07 137
4.8 Health Expenditure as a Share of Government
Expenditure and Health Wage Bill as a Share of
Health Expenditure, 2003-06 138
x Contents
4.9 Share of Wages in Sector Recurrent Expenditures,
2003-07 138
4.10 Health Wage Bill Budget Wage Bill Execution Rate,
2003-06 139
4.11 Components of the Health Wage Bill, 2003-06 145
4.12 Components of the Education Wage Bill, 2003-06 146
4.A. 1 PBF Administrative and Oversight Structures for
District Hospitals and Health Centers 159
Chapter 5 Background Country Study for the Dominican
Republic 165
5.1 Public Sector Wage Bill as a Share of GDP, by
Country, 2005 170
5.2 Public Sector Wage Bill as a Share of Government
Expenditure, by Country, 2005 171
5.3 Public Sector Wage Bill as a Share of Government
Expenditure, 2002-07 174
5.4 Government Wage Bill as a Share of GDP, 2002-06 174
5.5 Health Expenditure as a Share of Government
Expenditure and Health Wage Bill as a Share of
Health Expenditure, 2001-07 175
5.6 Education Expenditure as a Share of Government
Expenditure and Education Wage Bill as a Share of
Education Expenditure, 2001-07 177
5.7 Health Wage Bill as a Share of Public Sector Wage
Bill, 2004-07 177
5.8 Education Wage Bill as a Share of Public Sector
Wage Bill, 2004-07 178
5.9 Distribution of Public Sector Wage Bill, by Sector,
2005 and 2007 178
5.10 Hourly Wage Comparison, 2000-06 191
5.11 Salaries and Incentives for Years at Work for
Assistant Doctors 192
Appendix A Comparative Analysis of Health Outcomes, Service
Delivery, and Health Workforce Levels in Kenya,
Zambia, Rwanda, and the Dominican Republic 199
A. 1 Outcomes Relative to Income and Health Spending,
2005 202
Contents xi
A. 2 Service Delivery Relative to Income and Health
Spending, 2005 203
A.3 Health Workforce Levels Relative to Health Spending
and Income, 2005 205
Appendix B Analysis of the Share of Government Health
Expenditure Going to the Health Wage Bill:
Some Stylized Facts 207
B.I Health Wage Bill versus Income: Average, 2000-04 208
B.2 Health Wage Bill versus Health Spending: Average,
2000-04 208
B.3 Health Sector Wage Bill as a Share of Public
Spending on Health, Mean 2000-04 210
B.4 Health Wage Bill versus External Resources for
Health, Average 2000-04 211
B.5 Distribution of Government and Donor Health
Expenditure in Ghana, 1999-2005 212
B.6 Health Wage Bill as a Share of Government Health
Expenditure in Two Regions, 1998-2004 213
Appendix D Review of Alternative Compensation Methods
for Health Workers 233
D. 1 Alternative Contracting Arrangements for Health
Workers in a Performance-Based Contracting System 235
Appendix E Review of GFATM Round 6 and GAVIHSS
Round 1 Policies and Practices for Funding
Health Worker Remuneration 253
E.I Share of GFATM (Round 6) Grants Used for
Remuneration of Health Workers 257
E.2 Share of GAVI HSS (Round 1) Grants Used for
Remuneration of Health Workers 258
E.3 Method of Payments to Managerial and Frontline
Staff Members within GFATM (Round 6) Grants 259
Tables
Chapter 1 Overview 1
1.1 Share of Health Services Provided in the
Public Sector 2
xii Contents
1.2 Analysis of National Human Resources for
Health Strategies 17
1.3 Impact on the Overall Public Sector Wage Bill
of Staffing and Wages Changes in the
Health Sector, Kenya 20
1.4 Impact on the Overall Public Sector Wage Bill
of Staffing and Wages Changes in the Health
Sector, Zambia 21
1.5 Wage Bill Budget Execution Rates, 2004-07 22
1.6 Key Issues in Creation of Funded Posts 27
1.7 Key Issues in Recruitment 28
1.8 Key Issues in Promotions and Transfers 31
1.9 Key Issues in Termination and Sanctioning 32
1.10 Key Issues in Tenure Policies 33
1.11 Key Issues in Remuneration 36
Chapter 2 Background Country Study for Kenya 61
2.1 Main Steps in the Budget Cycle 62
2.2 Comparison of Government of Kenya and
Emergency Hiring Program Recruitment Procedures 70
2.3 Ministry of Health Budget Execution Rates,
2001/02-2004/05 73
2.4 Distribution of Short-Listed Candidates under
Emergency Hiring Program, May 2006 79
2.5 Selected Ministry of Health Cadres and Facility
Distribution by Province, 2004 80
2.6 Distribution of Ministry of Health Staff by Type
of Contract, 2005 82
2.7 Emergency Hiring Program Statistics, 2006 83
2.8 Grades of a Sample of Categories of Health Worker 84
2.9 Monthly Salary and Allowance Type as a Percentage
of Wage Costs in Health Ministry, 2004 85
2.10 Entitled and Actual Housing Allowance Amounts, 2005 86
Chapter 3 Background Country Study for Zambia 93
3.1 Main Stages and Actors in the Budget Planning Cycle 101
3.2 MOH Medium-Term Expenditure Framework
2004-10 107
3.3 MOH Staff Levels against Approved Establishment,
2004 and 2008 115
Contents xiii
3.4 General Salary Scale as of April 1, 2007 118
3.5 Medical Salary Scale as of April 1, 2007 118
3.6 Medical Doctors Salary Scale as of April 1, 2007 119
3.7 Composite Monthly Pay before Tax of Sample of
Health Professionals, 2005 120
3.8 Attendance at Facility of Employment 121
Chapter 4 Background Country Study for Rwanda 127
4.1 Estimated Size of Publicly Funded Health Workforce
in Rwanda, 2003-06 140
4.2 Types of Contracts in the Civil Service 142
4.3 Selected Health Sector Funding Sources, 2004-06 149
4.A.1 Budget Items Used to Compute Government
Recurrent HRH Expenditures 152
4.A.2 Database Used for Calculations, 2003-07 154
4.A.3 Annual Budget Preparation Schedule 160
Chapter 5 Background Country Study for the Dominican
Republic 165
5.1 Process for Determining the Health Wage Bill 168
5.2 Evolution of Public Spending in Health and Education,
2001-07 176
5.3 Budgeted and Executed Wage Bill at SESPAS, 2004-06 179
5.4 Recruitment and Separation of Staff in SESPAS, 2005-08 181
5.5 Skill Mix of Human Resources for Health, 2004-06 184
5.6 Concentration of Health Workers in Provinces, 2003 185
5.7 Main Actors and Their Roles in the Process for
Labor Mobility 187
5.8 Average Monthly Salaries for Health Workers in
SESPAS, 2001-05 190
Appendix A Comparative Analysis of Health Outcomes,
Service Delivery, and Health Workforce Levels in
Kenya, Zambia, Rwanda, and the Dominican
Republic 199
A. 1 Share of Health Services Provided in the Public
Sector 200
A.2 Outcome Indicators, 2005 201
A.3 Input Indicators, 2005 204
xiv Contents
Appendix C Decentralization and Human Resources
for Health 215
C.I Rationales for Decentralization 217
C.2 Decentralization of Human Resource Functions 218
Appendix D Review of Alternative Compensation Methods
for Health Workers 233
D.I Selected Outcomes Measured in Performance-Based
Contracting Interventions 246
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geographic | Entwicklungsländer (DE-588)4014954-7 gnd |
geographic_facet | Entwicklungsländer |
id | DE-604.BV035438210 |
illustrated | Not Illustrated |
indexdate | 2024-07-09T21:35:16Z |
institution | BVB |
isbn | 9780821378021 |
language | English |
lccn | 2008051555 |
oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-017358501 |
oclc_num | 276221927 |
open_access_boolean | |
owner | DE-1049 |
owner_facet | DE-1049 |
physical | XXVII, 271 p graph. Darst. |
publishDate | 2009 |
publishDateSearch | 2009 |
publishDateSort | 2009 |
publisher | World Bank |
record_format | marc |
series2 | Directions in development |
spelling | Vujicic, Marko Verfasser aut Working in health financing and managing the public sector. - health workforce Marko Vujicic, Kelechi Ohiri, and Susan Sparkes ; with Tim Martineau ... [et al.] Washington, DC World Bank c2009 XXVII, 271 p graph. Darst. txt rdacontent n rdamedia nc rdacarrier Directions in development Includes bibliographical references and index Erscheint: März 2009 Entwicklungsländer Public health personnel Salaries, etc Developing countries Medical economics Developing countries Health Manpower economics Dominican Republic Health Manpower economics Kenya Health Manpower economics Rwanda Health Manpower economics Zambia Health Manpower organization & administration Dominican Republic Health Manpower organization & administration Kenya Health Manpower organization & administration Rwanda Health Manpower organization & administration Zambia Developing Countries Dominican Republic Developing Countries Kenya Developing Countries Rwanda Developing Countries Zambia Salaries and Fringe Benefits legislation & jurisprudence Dominican Republic Salaries and Fringe Benefits legislation & jurisprudence Kenya Salaries and Fringe Benefits legislation & jurisprudence Rwanda Salaries and Fringe Benefits legislation & jurisprudence Zambia Lohnpolitik (DE-588)4036241-3 gnd rswk-swf Lohnkosten (DE-588)4036239-5 gnd rswk-swf Beschäftigung (DE-588)4005979-0 gnd rswk-swf Produktivität (DE-588)4047364-8 gnd rswk-swf Gesundheitswesen (DE-588)4020775-4 gnd rswk-swf Effizienz (DE-588)4013585-8 gnd rswk-swf Entwicklungsländer (DE-588)4014954-7 gnd rswk-swf Entwicklungsländer (DE-588)4014954-7 g Gesundheitswesen (DE-588)4020775-4 s Beschäftigung (DE-588)4005979-0 s Lohnpolitik (DE-588)4036241-3 s Lohnkosten (DE-588)4036239-5 s Produktivität (DE-588)4047364-8 s Effizienz (DE-588)4013585-8 s DE-604 Ohiri, Kelechi Sonstige oth Sparkes, Susan Sonstige oth HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017358501&sequence=000004&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
spellingShingle | Vujicic, Marko Working in health financing and managing the public sector. - health workforce Entwicklungsländer Public health personnel Salaries, etc Developing countries Medical economics Developing countries Health Manpower economics Dominican Republic Health Manpower economics Kenya Health Manpower economics Rwanda Health Manpower economics Zambia Health Manpower organization & administration Dominican Republic Health Manpower organization & administration Kenya Health Manpower organization & administration Rwanda Health Manpower organization & administration Zambia Developing Countries Dominican Republic Developing Countries Kenya Developing Countries Rwanda Developing Countries Zambia Salaries and Fringe Benefits legislation & jurisprudence Dominican Republic Salaries and Fringe Benefits legislation & jurisprudence Kenya Salaries and Fringe Benefits legislation & jurisprudence Rwanda Salaries and Fringe Benefits legislation & jurisprudence Zambia Lohnpolitik (DE-588)4036241-3 gnd Lohnkosten (DE-588)4036239-5 gnd Beschäftigung (DE-588)4005979-0 gnd Produktivität (DE-588)4047364-8 gnd Gesundheitswesen (DE-588)4020775-4 gnd Effizienz (DE-588)4013585-8 gnd |
subject_GND | (DE-588)4036241-3 (DE-588)4036239-5 (DE-588)4005979-0 (DE-588)4047364-8 (DE-588)4020775-4 (DE-588)4013585-8 (DE-588)4014954-7 |
title | Working in health financing and managing the public sector. - health workforce |
title_auth | Working in health financing and managing the public sector. - health workforce |
title_exact_search | Working in health financing and managing the public sector. - health workforce |
title_full | Working in health financing and managing the public sector. - health workforce Marko Vujicic, Kelechi Ohiri, and Susan Sparkes ; with Tim Martineau ... [et al.] |
title_fullStr | Working in health financing and managing the public sector. - health workforce Marko Vujicic, Kelechi Ohiri, and Susan Sparkes ; with Tim Martineau ... [et al.] |
title_full_unstemmed | Working in health financing and managing the public sector. - health workforce Marko Vujicic, Kelechi Ohiri, and Susan Sparkes ; with Tim Martineau ... [et al.] |
title_short | Working in health |
title_sort | working in health financing and managing the public sector health workforce |
title_sub | financing and managing the public sector. - health workforce |
topic | Entwicklungsländer Public health personnel Salaries, etc Developing countries Medical economics Developing countries Health Manpower economics Dominican Republic Health Manpower economics Kenya Health Manpower economics Rwanda Health Manpower economics Zambia Health Manpower organization & administration Dominican Republic Health Manpower organization & administration Kenya Health Manpower organization & administration Rwanda Health Manpower organization & administration Zambia Developing Countries Dominican Republic Developing Countries Kenya Developing Countries Rwanda Developing Countries Zambia Salaries and Fringe Benefits legislation & jurisprudence Dominican Republic Salaries and Fringe Benefits legislation & jurisprudence Kenya Salaries and Fringe Benefits legislation & jurisprudence Rwanda Salaries and Fringe Benefits legislation & jurisprudence Zambia Lohnpolitik (DE-588)4036241-3 gnd Lohnkosten (DE-588)4036239-5 gnd Beschäftigung (DE-588)4005979-0 gnd Produktivität (DE-588)4047364-8 gnd Gesundheitswesen (DE-588)4020775-4 gnd Effizienz (DE-588)4013585-8 gnd |
topic_facet | Entwicklungsländer Public health personnel Salaries, etc Developing countries Medical economics Developing countries Health Manpower economics Dominican Republic Health Manpower economics Kenya Health Manpower economics Rwanda Health Manpower economics Zambia Health Manpower organization & administration Dominican Republic Health Manpower organization & administration Kenya Health Manpower organization & administration Rwanda Health Manpower organization & administration Zambia Developing Countries Dominican Republic Developing Countries Kenya Developing Countries Rwanda Developing Countries Zambia Salaries and Fringe Benefits legislation & jurisprudence Dominican Republic Salaries and Fringe Benefits legislation & jurisprudence Kenya Salaries and Fringe Benefits legislation & jurisprudence Rwanda Salaries and Fringe Benefits legislation & jurisprudence Zambia Lohnpolitik Lohnkosten Beschäftigung Produktivität Gesundheitswesen Effizienz |
url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017358501&sequence=000004&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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