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    A rapid review of the rate of attrition from the health workforce.

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    Author
    Castro Lopes, S; Guerra-Arias, M; Buchan, J; Pozo-Martin, F; Nove, A
    Date
    2017-03-01
    Source Title
    Human Resources for Health
    Publisher
    Springer Science and Business Media LLC
    University of Melbourne Author/s
    Buchan, James
    Affiliation
    Medicine Dentistry & Health Sciences
    Metadata
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    Document Type
    Journal Article
    Citations
    Castro Lopes, S., Guerra-Arias, M., Buchan, J., Pozo-Martin, F. & Nove, A. (2017). A rapid review of the rate of attrition from the health workforce.. Hum Resour Health, 15 (1), pp.21-. https://doi.org/10.1186/s12960-017-0195-2.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/255468
    DOI
    10.1186/s12960-017-0195-2
    Open Access at PMC
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5333422
    Abstract
    BACKGROUND: Attrition or losses from the health workforce exacerbate critical shortages of health workers and can be a barrier to countries reaching their universal health coverage and equity goals. Despite the importance of accurate estimates of the attrition rate (and in particular the voluntary attrition rate) to conduct effective workforce planning, there is a dearth of an agreed definition, information and studies on this topic. METHODS: We conducted a rapid review of studies published since 2005 on attrition rates of health workers from the workforce in different regions and settings; 1782 studies were identified, of which 51 were included in the study. In addition, we analysed data from the State of the World's Midwifery (SoWMy) 2014 survey and associated regional survey for the Arab states on the annual voluntary attrition rate for sexual, reproductive, maternal and newborn health workers (mainly midwives, doctors and nurses) in the 79 participating countries. RESULTS: There is a diversity of definitions of attrition and barely any studies distinguish between total and voluntary attrition (i.e. choosing to leave the workforce). Attrition rate estimates were provided for different periods of time, ranging from 3 months to 12 years, using different calculations and data collection systems. Overall, the total annual attrition rate varied between 3 and 44% while the voluntary annual attrition rate varied between 0.3 to 28%. In the SoWMy analysis, 49 countries provided some data on voluntary attrition rates of their SRMNH cadres. The average annual voluntary attrition rate was 6.8% across all cadres. CONCLUSION: Attrition, and particularly voluntary attrition, is under-recorded and understudied. The lack of internationally comparable definitions and guidelines for measuring attrition from the health workforce makes it very difficult for countries to identify the main causes of attrition and to develop and test strategies for reducing it. Standardized definitions and methods of measuring attrition are required.

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