Overworked? On the relationship between workload and health worker performance
The shortage of health workers in many low-income countries poses a threat to the quality of health services. When the number of patients per health worker grows sufficiently high, there will be insufficient time to diagnose and treat all patients adequately. This paper tests the hypothesis that high caseload reduces the level of effort per patient in the diagnostic process. We observed 159 clinicians in 2095 outpatient consultations at 126 health facilities in rural Tanzania. Surprisingly, we find no association between caseload and the level of effort per patient. Clinicians appear to have ample amounts of idle time. We conclude that health workers are not overworked and that scaling up the number of health workers is unlikely to raise the quality of health services. Training has a positive effect on quality but is not in itself sufficient to raise quality to adequate levels.
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- Kenneth L. Leonard & Gilbert R. Mliga & Damen Haile Mariam, 2002. "Bypassing Health Centres in Tanzania: Revealed Preferences for Quality," Journal of African Economies, Centre for the Study of African Economies (CSAE), vol. 11(4), pages 441-471, December.
- Ofori-Adjei, David & Arhinful, Daniel K., 1996. "Effect of training on the clinical management of malaria by medical assistants in Ghana," Social Science & Medicine, Elsevier, vol. 42(8), pages 1169-1176, April.
- Jishnu Das & Jeffrey Hammer & Kenneth Leonard, 2008. "The Quality of Medical Advice in Low-Income Countries," Journal of Economic Perspectives, American Economic Association, vol. 22(2), pages 93-114, Spring.
- Das, Jishnu & Hammer, Jeffrey & Leonard, Kenneth, 2008. "The quality of medical advice in low-income countries," Policy Research Working Paper Series 4501, The World Bank.
- Paredes, Patricia & de la Peña, Manuela & Flores-Guerra, Enrique & Diaz, Judith & Trostle, James, 1996. "Factors influencing physicians' prescribing behaviour in the treatment of childhood diarrhoea: Knowledge may not be the clue," Social Science & Medicine, Elsevier, vol. 42(8), pages 1141-1153, April. Full references (including those not matched with items on IDEAS)
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