Ethiopia faces a critical shortage of motivated health workers amid growing demand for services. In 2020, the country needed around 580,150 health workers, a number expected to rise to 751,800 by 2030. In 2023, Ethiopia only had about 326,000 health workers. Attrition, mainly due to issues around motivation, is a key concern; it undermines the national progress toward universal health coverage.
Understanding attrition patterns and providing effective incentives for health workers are crucial in order to tackle these challenges.
Addressing health workers’ needs
In April 2020, the U.S. Agency for International Development launched the Health Workforce Improvement Program (HWIP), which is led by Jhpiego, to address motivation and other human resources for health challenges in 54 hospitals across Ethiopia. Since then, the hospitals have demonstrated progress in implementing locally feasible non-financial incentives that have boosted staff morale and improved performance.
For instance, Tirunesh Beijing General Hospital has established a daycare center, free health services, a lower-priced cafeteria, a savings and credit group, and customer associations for the staff that can help address the costs of city living, which are a source of strain for health workers.
“We have a significant number [671] of health care professionals here, so we had to balance delivering quality health care and employee needs,” says Shambel Seyoum, the human resource director at Tirunesh Beijing General Hospital. “With the escalating cost of residing in the metropolis, non-financial incentives are important for improved productivity and employee engagement.”
Finding effective solutions
The hospital’s free outpatient clinic for employees reduces their wait times and their time away from work. Employees made 3,600 visits to the clinic from July 1, 2023, through May 30, 2024. For women health workers with children, balancing their jobs and family duties is one of the difficulties they face. To help, the hospital provided an on-site daycare facility staffed by nurses, who cared for 23 children from July 2023 through May 2024. This allowed health workers to focus on patient care. “Previously I was concerned about the well-being of my baby while at work. The daycare is a huge relief,” said Aster Erestu, a nursing professional.
As a result of these incentives and other interventions, health workers’ motivation levels improved. The intention of health workers to leave their jobs fell by 31.5 percentage points (49% in 2014 to 17.5% in 2022).
As demonstrated by HWIP’s interventions at Tirunesh Beijing General Hospital and the other 53 hospitals, addressing the needs of health workers through locally feasible non-financial incentives can boost staff morale so that they can concentrate on delivering quality health care.
Anteneh Teshome Habtemichael is the communication and knowledge management specialist with Jhpiego Ethiopia.