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Overworked? On the relationship between workload and health worker performance

  • Mæstad, Ottar
  • Torsvik, Gaute
  • Aakvik, Arild

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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Article provided by Elsevier in its journal Journal of Health Economics.

Volume (Year): 29 (2010)
Issue (Month): 5 (September)
Pages: 686-698

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Handle: RePEc:eee:jhecon:v:29:y:2010:i:5:p:686-698
Contact details of provider: Web page: http://www.elsevier.com/locate/inca/505560

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  2. Leonard, Kenneth & Masatu, Melkiory C., 2006. "Outpatient process quality evaluation and the Hawthorne Effect," Social Science & Medicine, Elsevier, vol. 63(9), pages 2330-2340, November.
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  7. 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.
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