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Job Preferences of Frontline Health Workers in Ghana - A Discrete Choice Experiment

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  • Dunsch, Felipe Alexander
  • Velenyi, Edit

Abstract

The lack of supply of adequately skilled and motivated health workers especially in rural areas poses a major obstacle to health service delivery in Ghana, as well as in many other developing countries. In this paper, we present the results of a discrete choice experiment (DCE) conducted with community health officers (CHO) and community health volunteers (CHV), which are extension workers that provide health services and consultations to mostly rural populations. CHOs and CHVs completed the cadre-specifi?c discrete choice experiment that elicited preferences for attributes of potential job postings. Data was collected from 404 CHOs and 206 CHVs in 8 Ghanaian districts in 4 regions. For CHOs, next to increases in salary, the choice of job posting was most strongly influenced by facility quality, followed by career development opportunities and transport subsidies. Additional supervision showed no effects. For CHVs, next to receiving a monthly stipend, facility quality was also most important, followed by training opportunities. We are corroborating the notion that other non-fi?nancial incentives can have strong effects on job preferences, for example the equipment of the facilities, which includes housing, as well as training and career development and training opportunities. Given that Ghana's health wage bill is already very high (in relative terms), this may open new policy avenues for health worker recruitment and retention to converge towards universal health coverage.

Suggested Citation

  • Dunsch, Felipe Alexander & Velenyi, Edit, 2019. "Job Preferences of Frontline Health Workers in Ghana - A Discrete Choice Experiment," SocArXiv bqx5k, Center for Open Science.
    • Handle: RePEc:osf:socarx:bqx5k
    DOI: 10.31219/osf.io/bqx5k
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    as
    1. Gneezy, Uri & Rustichini, Aldo, 2000. "A Fine is a Price," The Journal of Legal Studies, University of Chicago Press, vol. 29(1), pages 1-17, January.
    2. Nazmul Chaudhury & Jeffrey Hammer & Michael Kremer & Karthik Muralidharan & F. Halsey Rogers, 2006. "Missing in Action: Teacher and Health Worker Absence in Developing Countries," Journal of Economic Perspectives, American Economic Association, vol. 20(1), pages 91-116, Winter.
    3. Jean Tirole & Roland Bénabou, 2006. "Incentives and Prosocial Behavior," American Economic Review, American Economic Association, vol. 96(5), pages 1652-1678, December.
    4. Camerer, Colin F & Hogarth, Robin M, 1999. "The Effects of Financial Incentives in Experiments: A Review and Capital-Labor-Production Framework," Journal of Risk and Uncertainty, Springer, vol. 19(1-3), pages 7-42, December.
    5. Ernesto Dal Bó & Frederico Finan & Martín A. Rossi, 2013. "Strengthening State Capabilities: The Role of Financial Incentives in the Call to Public Service," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 128(3), pages 1169-1218.
    6. de Walque, Damien & Gertler, Paul J. & Bautista-Arredondo, Sergio & Kwan, Ada & Vermeersch, Christel & de Dieu Bizimana, Jean & Binagwaho, Agnès & Condo, Jeanine, 2015. "Using provider performance incentives to increase HIV testing and counseling services in Rwanda," Journal of Health Economics, Elsevier, vol. 40(C), pages 1-9.
    7. Dunsch, Felipe A. & Evans, David K. & Eze-Ajoku, Ezinne & Macis, Mario, 2017. "Management, Supervision, and Health Care: A Field Experiment," IZA Discussion Papers 10967, Institute of Labor Economics (IZA).
    8. Esther W. de Bekker‐Grob & Mandy Ryan & Karen Gerard, 2012. "Discrete choice experiments in health economics: a review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 21(2), pages 145-172, February.
    9. Carl Mellström & Magnus Johannesson, 2008. "Crowding Out in Blood Donation: Was Titmuss Right?," Journal of the European Economic Association, MIT Press, vol. 6(4), pages 845-863, June.
    10. Michael Clark & Domino Determann & Stavros Petrou & Domenico Moro & Esther Bekker-Grob, 2014. "Discrete Choice Experiments in Health Economics: A Review of the Literature," PharmacoEconomics, Springer, vol. 32(9), pages 883-902, September.
    11. Daniel McFadden, 1986. "The Choice Theory Approach to Market Research," Marketing Science, INFORMS, vol. 5(4), pages 275-297.
    12. Ebenezer Appiah-Denkyira & Christopher H. Herbst & Agnes Soucat & Christophe Lemiere & Karima Saleh, 2013. "Towards Interventions in Human Resources for Health in Ghana : Evidence for Health Workforce Planning and Results," World Bank Publications - Books, The World Bank Group, number 13116, December.
    13. Kelvin J. Lancaster, 1966. "A New Approach to Consumer Theory," Journal of Political Economy, University of Chicago Press, vol. 74(2), pages 132-132.
    14. Julie Riise Kolstad, 2011. "How to make rural jobs more attractive to health workers. Findings from a discrete choice experiment in Tanzania," Health Economics, John Wiley & Sons, Ltd., vol. 20(2), pages 196-211, February.
    15. Ashraf, Nava & Bandiera, Oriana & Jack, B. Kelsey, 2014. "No margin, no mission? A field experiment on incentives for public service delivery," Journal of Public Economics, Elsevier, vol. 120(C), pages 1-17.
    16. Antwi, James & Phillips, David C., 2013. "Wages and health worker retention: Evidence from public sector wage reforms in Ghana," Journal of Development Economics, Elsevier, vol. 102(C), pages 101-115.
    17. Benjamin A. Olken & Junko Onishi & Susan Wong, 2014. "Should Aid Reward Performance? Evidence from a Field Experiment on Health and Education in Indonesia," American Economic Journal: Applied Economics, American Economic Association, vol. 6(4), pages 1-34, October.
    18. Scott, Anthony, 2002. "Identifying and analysing dominant preferences in discrete choice experiments: An application in health care," Journal of Economic Psychology, Elsevier, vol. 23(3), pages 383-398, June.
    19. Huihui Wang & Nathaniel Otoo & Lydia Dsane-Selby, 2017. "Ghana National Health Insurance Scheme," World Bank Publications - Books, The World Bank Group, number 27658, December.
    20. Akbar Zaidi, S., 1986. "Why medical students will not practice in rural areas: Evidence from a survey," Social Science & Medicine, Elsevier, vol. 22(5), pages 527-533, January.
    21. Luis Huicho & J Jaime Miranda & Francisco Diez-Canseco & Claudia Lema & Andrés G Lescano & Mylene Lagarde & Duane Blaauw, 2012. "Job Preferences of Nurses and Midwives for Taking Up a Rural Job in Peru: A Discrete Choice Experiment," PLOS ONE, Public Library of Science, vol. 7(12), pages 1-9, December.
    22. Xiaojie Sun & Xiaoyun Liu & Qiang Sun & Winnie Yip & Adam Wagstaff & Qingyue Meng, 2016. "The Impact of a Pay‐for‐Performance Scheme on Prescription Quality in Rural China," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 706-722, June.
    23. Frederico Finan & Benjamin A. Olken & Rohini Pande, 2015. "The Personnel Economics of the State," NBER Working Papers 21825, National Bureau of Economic Research, Inc.
    24. Emir Kamenica, 2012. "Behavioral Economics and Psychology of Incentives," Annual Review of Economics, Annual Reviews, vol. 4(1), pages 427-452, July.
    25. Mandy Ryan & Karen Gerard & Gillian Currie, 2012. "Using Discrete Choice Experiments in Health Economics," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 41, Edward Elgar Publishing.
    26. Emily Lancsar & Denzil G. Fiebig & Arne Risa Hole, 2017. "Discrete Choice Experiments: A Guide to Model Specification, Estimation and Software," PharmacoEconomics, Springer, vol. 35(7), pages 697-716, July.
    27. A. Colin Cameron & Pravin K. Trivedi, 2010. "Microeconometrics Using Stata, Revised Edition," Stata Press books, StataCorp LP, number musr, March.
    28. Ruth F. G. Williams & Ka C. Chan & Christopher T. Lenard & Terence M. Mills, 2018. "Cancer Risk Messages: Public Health and Economic Welfare," Papers 1807.03045, arXiv.org, revised Jul 2018.
    29. Renske J. Hoefman & Job van Exel & John M. Rose & E. J. van de Wetering & Werner B. F. Brouwer, 2014. "A Discrete Choice Experiment to Obtain a Tariff for Valuing Informal Care Situations Measured with the CarerQol Instrument," Medical Decision Making, , vol. 34(1), pages 84-96, January.
    30. Marc-Francois Smitz & Sophie Witter & Christophe Lemiere & Patrick Hoang-Vu Eozenou & Tomas Lievens & Rashid U Zaman & Kay Engelhardt & Xiaohui Hou, 2016. "Understanding Health Workers’ Job Preferences to Improve Rural Retention in Timor-Leste: Findings from a Discrete Choice Experiment," PLOS ONE, Public Library of Science, vol. 11(11), pages 1-14, November.
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