Improving availability of Eye Health Workers in Rural and Remote Areas of West Africa

1. Improving availability of Eye Health Workers in Rural and Remote Areas of West Africa - Role of Retention Strategies <|> Prof. Kayode ODUSOTE Health Systems Development, 9th General Assembly, International Agency for the Prevention of Blindness, Hyderabad, India, 17 – 20 Sept. 2012.

3. HREH in WA - Role of Retention Intervention Strategies

4. HREH in WA - Role of Retention Intervention Strategies

5. HREH in WA - Role of Retention Intervention Strategies

6. HREH in WA - Role of Retention Intervention Strategies

7. HREH in WA - Role of Retention Intervention Strategies

11. PERSONNEL IN EYE CARE by 2020 • Ophthalmologists 1: 250,000 • Cataract Surgeons (1:250,000) • Ophthalmic Assistants/ON 1:100,000 • Optometrists/Refractionists 1:50,000 • Community/PEC Workers 1:5,000 • Ophthalmic Equip. Technicians ?? • Managers & Administrative Personnel 100% of 3o and 50% of 2o HREH in WA - Role of Retention Intervention Strategies

12. Progress in Numbers of EHWs HREH in WA - Role of Retention Intervention Strategies

13. Characteristics of HRH Crisis in West Africa • Inadequate number of all categories of health professionals. • Mal-distribution of available staff. • Inappropriate mix of health workers. • Poor performance associated with poor motivation. HREH in WA - Role of Retention Intervention Strategies

14. In-equitable distribution HREH in WA - Role of Retention Intervention Strategies

15. HREH in WA - Role of Retention Intervention Strategies

16. HREH in WA - Role of Retention Intervention Strategies

17. HREH in WA - Role of Retention Intervention Strategies

18. HREH in WA - Role of Retention Intervention Strategies

19. HREH in WA - Role of Retention Intervention Strategies

20. Attraction and Retention HREH in WA - Role of Retention Intervention Strategies

21. Major factors against Retention HREH in WA - Role of Retention Intervention Strategies • Living conditions • Housing • Infrastructure – roads, water, electricity, telephone • School for children, work for spouse • Opportunities for Career Progression • Work Environment • In Eye Health – lack of facilities for specialized care. • Professional Development and isolation • Opportunity Cost.

22. Interventions that have worked in general HRH in West Africa HREH in WA - Role of Retention Intervention Strategies • Financial incentives – rural allowance, etc • main issue is sustainability • Enhanced career progression – • reduced length of service for promotion to next grade • Hire Purchase facilities for car purchase • less effective with high cost of new vehicles and lower cost of imported used cars.

23. Interventions that have worked in general HRH in West Africa - 2 HREH in WA - Role of Retention Intervention Strategies • Compulsory rural service • effect is only short-term and does not make for sustained retention • Bonding for sponsored training • Difficult to police sometimes, effect is short-term and requires other packages for long-term retention. • Priority for further training or overseas trips • dependent on volume of available sponsorships. • Decentralized recruitment • works in a situation of adequate supply and no vacancies in the major cities/

24. WHO recommended interventions – potential for effectives in HREH/WA Key:Def – Definite Pos – Possible Prb – Probable NL – Not likely HREH in WA - Role of Retention Intervention Strategies

25. WHO recommended interventions – potential for effectives in HREH/WA 2 Key:Def – Definite Pos – Possible Prb – Probable NL – Not likely HREH in WA - Role of Retention Intervention Strategies

26. WHO recommended interventions – potential for effectives in HREH/WA 3 Key:Def – Definite Pos – Possible Prb – Probable NL – Not likely HREH in WA - Role of Retention Intervention Strategies

27. WHO recommended interventions – potential for effectives in HREH/WA 4 Key: Def – Definite Pos – Possible Prb – Probable NL – Not likely HREH in WA - Role of Retention Intervention Strategies

28. Proposed new HRD Goal HREH in WA - Role of Retention Intervention Strategies By 2020 – Every person, everywhere, should have access to a well-trained and well-motivated specialized eye health worker within 50 km and a well-trained and well-motivated primary eye care worker within 5 km of where he/she lives.

29. Conclusion HREH in WA - Role of Retention Intervention Strategies • We need retention strategies to achieve the new goal, but • No single intervention works for all situations and for all categories. • Package of financial and non-financial incentives have better chances of success. • Eye Health remains low in priority of governments in WA and so is Human Resources for Eye Health. • We appreciate the support of the IAPB family and would continue to depend on this support for the development of HREH in WA at least until 2015 and possibly beyond.

30. Thank you for your attention. Merci pour votre attention.