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Assessment of the Human Resources System in Niger

Crigler L | Djibrina S | Wittcoff A | Boucar M | Saley Z | Lin Y-S
Organization: USAID Health Care Improvement Project/URC

Topics: Employee Engagement, Motivation/incentives, Performance evaluation, Performance management, Retention of health workers/reducing attrition

Region and Country: Niger

Initiatives Inc.

Throughout Africa, a human resources crisis in the public health system has become one of the biggest challenges in the battle against HIV/AIDS, the improvement of maternal and child health and the management of chronic diseases. Health workers face a difficult daily workload in a challenging work environment with inadequate compensation and little recognition for their efforts. Human resource (HR) systems are generally weak and overall capacity in human resource management is low. As a result, health workers are often unprepared and unable to meet the high demands placed on them; they lose motivation, become disengaged, or vacate their posts altogether.

In response to this HR challenge and in an effort to improve the quality of health services, the Government of Niger requested the aid of the USAID-funded Health Care Improvement Project (HCI) in closing these HR gaps and in building the capacity of the MOPH to manage and support health care workers in the Region of Tahoua.  
A rapid assessment of current human resource systems at the national, regional, and district level was conducted, followed by an in-depth baseline assessment at 20 health facilities in three regions— in Tahoua, (15 sites) Maradi (3 sites) and Tillabery (2 sites). The rapid assessment of HR systems looked at the current recruitment, deployment, reward, supervision, evaluation, training and career advancement systems from the central to the district levels. The site-level assessments looked at the impact of those systems on health workers and at their overall engagement. Site-level assessments also included an in-depth look at productivity and client flow analysis.  
Several methods and tools were employed during the assessment: In-depth interviews with managerial staff from regional (34 individuals) and district (44 individuals) health teams and at referral facilities (eight individuals). Interviews were also conducted with 53 health workers. A time utilization tool measured the productivity of 33 health workers and a client flow tool measured how much time 565 patients spent at each stage of a clinical visit. To measure engagement of health workers, a confidential and anonymous instrument of 26 items was completed by 231 health workers, including 147 literate and 84 illiterate workers in 19 different health centers.
The report details the findings from the assessment and includes English versions of the data collection instruments. The findings informed the design of a Human Resource Improvement Collaborative developed by HCI and the Ministry of Public Health of Niger to improve health worker productivity, engagement, and retention.