An evaluation of the effectiveness of the Zambian Health Worker Retention Scheme (ZHWRS) for rural areas

Background: Zambian Health Workers Retention Scheme (ZHWRS) commenced in 2003. The schemes' original aim was to retain and recruit Zambian doctors in rural and remote districts. The aim of the ZHWRS subsequently expanded to also include other health workers, in either rural or urban areas. The scheme was formulated to address, in part, the drastic shortage of health workers. Objectives: To evaluate the effectiveness of the ZHWRS in achieving its aim. Methods: The data on the number of health workers recruited by the ZHWRS and the spatial distribution of them was reviewed. A survey of health workers was undertaken to elicit their views of their working conditions, their job satisfaction and the effectiveness of retention schemes in retaining or increasing the numbers of and overall satisfaction of health workers. Results: The ZHWRS has not been successful in recruiting sufficient numbers of health workers to reverse the shortage problem or even to meet the modest targets of the scheme itself. However, these improvements do not decrease the likelihood of Department of Health (DoH) workers leaving their rural based positions. Conclusions: The ZHWRS has not fully met either its original or revised aims. The drastic shortage of health workers in Zambia continues.