HEALTH WORKFORCE DEPLOYMENT, ATTRITION AND DENSITY IN EAST WOLLEGA ZONE, WESTERN ETHIOPIA

Abstract

Background: In East Wollega Zone, despite the success in creating considerable number of health facilities, short-age of health personnel, geographical imbalance and increasing attrition is found to be a persistent barrier to theeffectiveness of the health system. However, available data is not rich enough to provide reliable information as towhat extent these problems exist in the Zone. Hence, this study was conducted to assess health workforce density,deployment and attrition in East Wollega Zone.Methods: A six years retrospective record review from 2000-2005 was conducted between February 1, and March30, 2006 in eleven randomly selected districts of East Wollega Zone. Data obtained from records and interviewsmade with selected resource persons were organized by triangulating quantitatively and qualitatively. Quantitativedata was analyzed using SPSS 12.01 for windows and thematic frame work analysis was used for qualitative data.Results: Health workforce deployment rate for the years 2000-2005 ranged from 8.2% to 15.4 %. In contrast, at-trition rate for the same period ranged from 2.9 % to 8.5 %. Attrition rate for the time after decentralization (2003–2005) was nearly two times greater than before decentralization (OR, 2.04, CI, 1.51, 2.85, P=0.00). Moreover,attrition rate was nearly three times greater for a high level professional when compared to the lower level(OR,3.15,CI ,2.63, 4.37, P=0.00). Attrition rate for males was two times higher as compared to females (OR, 2.07,CI, 1.67, 3.74, P=0.00). About (26.3%) of all health workers and (36.7%) of nurses and midwives were deployedto the capital town of the zone. Factors identified as most likely cause for the lower deployment and higher attri-tions were budget related constraints, lack of continuing education opportunity and poor career development.Conclusions: The number of health personnel in East Wollega was low both by international standards and rela-tive to the national density. Moreover, attrition was higher for the time after decentralization process. Hence,measures that seek to increase the size of the health workforce through increased recruitment, higher retention ofexisting staff and better geographical balance have to be urgently explored.