Resources from ReBUILD’s work on health worker incentives in Sierra Leone, and on health worker experiences during the Ebola outbreak
Below are details of all outputs from ReBUILD’s work on health worker incentives and remuneration in Sierra Leone, including on health worker experiences during the Ebola outbreak.
For more information on ReBUILD’s work on human resources for health in Sierra Leone, contact Professor Sophie Witter.
Introduction: ReBUILD’s research on human resources for health in post-conflict Sierra Leone
Human resources development, a critically important part of health systems rebuilding after conflict or crisis, has received relatively little attention in the literature (see the paper Human resource management in post-conflict health systems: review of research and knowledge gaps). and there has been consequently little to inform decision-makers and donors. ReBUILD’s overall work on human resources for health (HRH) therefore focused on how the decisions made, or not made, in the post-conflict period can affect the longer term pattern of attraction, retention, distribution and performance of health workers, and thus ultimately the performance of the sector.
ReBUILD worked in Sierra Leone in 2011-18, with research primarily focusing on health worker incentives and on health financing. The large body of work on health worker incentives in Sierra Leone was complemented by additional work looking at the effects on the Ebola outbreak on health workers and the health system, and also by one of ReBUILD’s affiliate research partners on Health Workers’ Remuneration, Incentives and Accountability in Sierra Leone.
ReBUILD’s work in Sierra Leone also focused on close-to-community health workers, performance-based financing, and household demographics and healthcare access after conflict.
Running through all ReBUILD’s research was a focus on gender and equity, and outputs from much of the specific work on gender had relevance for human resources.
Resources specifically on HRH in Sierra Leone:
Health worker incentives in Sierra Leone
Journal articles and working papers:
- Bertone MP, Lagarde M, Witter S, (2016) Performance-Based Financing in the context of the complex remuneration of health workers: findings from a mixed-method study in rural Sierra Leone. BMC Health Services Research 16:286 http://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-016-1546-8
- Wurie, H., Samai, M., Witter, S. (2016) Retention of health workers in rural Sierra Leone: findings from life histories. Human Resources for Health, 14 (3). http://www.human-resources-health.com/content/pdf/s12960-016-0099-6.pdf
- Bertone, M. and Lagarde, M. (2016) Sources, determinants and utilization of health workers’ revenues: evidence from Sierra Leone Health Policy & Planning (2016) doi: 10.1093/heapol/czw031 http://heapol.oxfordjournals.org/content/early/2016/04/06/heapol.czw031.abstract
- Bertone, M. and Witter, S. (2015) An exploration of the political economy dynamics shaping health worker incentives in three districts in Sierra Leone. Social Science and Medicine, volume 141, pp.56-63. http://www.sciencedirect.com/science/article/pii/S0277953615300447
- Witter, S., Wurie, H. And Bertone, M. (2015) The Free Health Care Initiative: how has it affected health workers in Sierra Leone? Health Policy and Planning journal, 1-9 http://heapol.oxfordjournals.org/content/31/1/1
- Bertone, M., Samai, M., Edem-Hotah, J. and Witter, S. (2014) A window of opportunity for reform in post-conflict settings? The case of Human Resources for Health policies in Sierra Leone, 2002-2012. Conflict and Health, 8:11. http://www.conflictandhealth.com/content/pdf/1752-1505-8-11.pdf
- Witter, S., Wurie, H. and Bertone, M. (2014) The Free Health Care Initiative: how has it affected health workers in Sierra Leone? Report for ReBUILD. https://rebuildconsortium.com/media/1014/the-free-health-care-initiative-how-has-it-affected-health-workers-in-sierra-leone.pdf
- Wurie, H., Samai, M. and Witter, S. (2014) Policies to attract and retain health workers in Sierra Leone: routine human resource data analysis. Report for ReBUILD.
- Witter, S., Bertone, M, Wurie, H, Samai, M., Edem-Hotah, J., Amara, R. (2014) Health worker incentives post-conflict: survey report from Sierra Leone. Report for ReBUILD. http://www.rebuildconsortium.com/media/1193/hwisreportslfinal.pdf
- Bertone, M. and Witter, S. (2014) The development of HRH policy in Sierra Leone, 2002-2012 – report on key informant interviews. Report for ReBUILD.
- Wurie, H. And Witter, S. (2014) Serving through and after conflict: life histories of health workers in Sierra Leone. Report for ReBUILD.
- Bertone, M, Edem-Hotah, J., Samai, M. and Witter, S. (2014) The development of HRH policy in Sierra Leone, 2002-2012 – a document review. Report for ReBUILD. http://www.rebuildconsortium.com/media/1019/the-development-of-hrh-policy-in-sierra-leone-2002-2012-a-document-review.pdf
- Evidence for supporting a skilled health workforce for all in Sierra Leone. https://rebuildconsortium.com/media/1269/rebuild-sl-policy-brief-4-evidence-for-supporting-a-skilled-health-workforce.pdf
- A window of opportunity for reform? The case of policy on human resources for health in Sierra Leone after the conflict (2002-2012). https://rebuildconsortium.com/media/1101/rebuildconsort-aspecialbrief.pdf
- Incentives to improve health workers’ retention and motivation: implementation challenges and informal practices at district level. The role of DHMTs and NGOs https://rebuildconsortium.com/media/1268/rebuild-sl-policy-brief-3-hrh-practices-at-district-level.pdf
- Exploring the remuneration of primary healthcare workers: findings on incomes and income use strategies. What lessons can be learnt to design effective financial incentives? https://rebuildconsortium.com/media/1267/rebuild-sl-policy-brief-2-hw-incomes.pdf
- Evidence for supporting a health workforce for all in Sierra Leone. Combined presentations given at a stakeholder meeting to present ReBUILD findings and discuss HRH priorities and challenges in Sierra Leone. http://www.slideshare.net/ReBUILD_Consortium/evidence-for-supporting-a-health-workforce-for-all-in-sierra-leone-rebuild-hrh-research
Health workers and Ebola in Sierra Leone
Journal articles and Working Papers:
- Raven, J, Wurie, HR and Witter, S. (2018). Health workers’ experiences of coping with the Ebola epidemic in Sierra Leone’s health system: a qualitative study. (2018) BMC Health Services research 18:251 https://doi.org/10.1186/s12913-018-3072-3
- Wurie, H., Witter, S. & Raven, J. (2016) ‘Fighting a battle’: Ebola, health workers and the health system in Sierra Leone. ReBUILD Working Paper
- Haja Wurie speaks about the health workforce and Ebola in Sierra Leone. This video was made by the COUNTDOWN RPC but covers evidence and experiences from ReBUILD’s research during the Ebola outbreak.
- After Ebola: supporting frontline health workers (LSHTM website). (2014, Witter/Wurie. Health Policy & Planning)
- Ebola’s collision with the Sierra Leone post-conflict health system – (Wurie H, 2014, Health Systems Global blog) http://www.healthsystemsglobal.org/GetInvolved/Blog/TabId/155/PostId/27/ebolas-collision-with-the-sierra-leone-post-conflict-health-system.aspx
Cross-cutting resources from ReBUILD’s HRH research which includes material from Sierra Leone
Journal articles and Working Papers:
- Bertone, M., Falisse, J-B., Russo, G., Witter, S. (2018) Context matters (but how and why?) A hypothesis-led literature review of performance based financing in fragile and conflict-affected health systems. PLOS ONE, 13(4): e0195301.
- Raven J, Baral S, Wurie H, Witter S, Samai M, Paudel P, Subedi H, Martineau T, Elsey H, Theobald S. (2018) What adaptation to research is needed following crises?: a comparative, qualitative study of the health workforce in Sierra Leone and Nepal. Health Research Policy & Systems, 16:6.
- Witter, S, Wurie, H, Namakula, J, Mashange, W, Chirwa, Y and Alonso‐Garbayo, A (2018) Why do people become health workers? Analysis from life histories in 4 post‐conflict and post‐crisis countries. Int J Health Plann Mgmt. 2018; 1–11; http://onlinelibrary.wiley.com/doi/10.1002/hpm.2485/epdf
- Witter, S., Namakula, J., Wurie, H., Chirwa, Y., So, S., Vong, S., Ros, B., Buzuzi, S. and Theobald, S; The gendered health workforce: mixed methods analysis from four fragile and post-conflict contexts, Health Policy and Planning, 32, suppl 5, 1 December 2017 pp. v52–v62, https://doi.org/10.1093/heapol/czx102
- Witter, S., Wurie, H., Chandiwana, P., Namakula, J., Sovannarith, S., Alonso-Garbayo, A., Ssengooba, F and Raven, J. (2017) How do health workers experience and cope with shocks? Learning from four fragile and conflict-affected health systems in Uganda, Sierra Leone, Zimbabwe and Cambodia. Health Policy and Planning, Volume 32, Issue suppl_3, 1 November 2017, pp. iii3–iii13, https://doi.org/10.1093/heapol/czx112
- Witter, S. et al. (2017) The Free Health Care Initiative in Sierra Leone – evaluating a health system reform, 2010-2015. International Journal of Health Planning and Management, pp.1-15.
- Witter, S., Namakula, J., Alonso-Garbayo, A., Wurie, H., Theobald, S., Mashange, W., Ros, B., Buzuzi, S., Mangwi, R and Martineau, T. (2017) Experiences of using life histories with health workers in post-conflict and crisis settings: methodological reflections. Health Policy Plan 2017, pp.1–7 https://academic.oup.com/heapol/article-lookup/doi/10.1093/heapol/czw166
- Witter, S., Bertone, M., Chirwa, Y., Namakula, J., So, S and Wurie, H. (2017) Evolution of policies on human resources for health: opportunities and constraints in four post-conflict and post-crisis settings. Conflict and Health 2017 10:31 http://conflictandhealth.biomedcentral.com/articles/10.1186/s13031-016-0099-0
- Bertone, M. and Witter, S. (2015) The complex remuneration of Human Resources for Health in low income settings: policy implications and a research agenda for designing effective financial incentives. Human Resources for Health, 13; 62. http://www.human-resources-health.com/content/pdf/s12960-015-0058-7.pdf
- Witter, S. Falisse, J-B., Bertone, M, Alonso-Garbayo, A., Martins, J., Salehi, A., Pavignani, E. and Martineau, T. (2015) State-building and human resources for health in fragile and conflict-affected states: exploring the linkages http://human-resources-health.biomedcentral.com/articles/10.1186/s12960-015-0023-5
- Establishing a responsive and equitable health workforce post conflict and post crisis: lessons from ReBUILD. https://rebuildconsortium.com/media/1486/health-workers-brief-2016.pdf
- Research on health worker policies, incentives and retention in post-conflict countries: an overview of ReBUILD work. Combined presentations given at the 22nd Canadian Conference on Global Health, 5th November 2015, Montreal http://www.slideshare.net/ReBUILD_Consortium/research-on-health-worker-policies-incentives-and-retention-in-postconflict-countries-an-overview-of-rebuild-work-62753579
ReBUILD’s background, cross-cutting and general resources on HRH in conflict and crisis affected settings
Background literature reviews on health worker incentives and deployment
Journal articles and Working Papers:
- Roome, E., Raven, J. and Martineau, T. (2014) Human resource management in post-conflict health systems: review of research and knowledge gaps. Conflict and Health 2014, 8:18 http://conflictandhealth.biomedcentral.com/articles/10.1186/1752-1505-8-18
- Witter, S., Tulloch, O. & Martineau, T. (2012) Health workers’ incentives in post-conflict settings – a review of the literature and framework for research. ReBUILD Research Report. https://rebuildconsortium.com/media/1265/rebuild_report_2_v6.pdf
- Managing human resources in post-conflict health systems: a review of research and knowledge gaps https://rebuildconsortium.com/media/1102/rebuildconsort-managinghumanresourcev3.pdf
Cross-cutting and general health systems articles:
Journal articles and Working Papers:
- Martineau, T., McPake, B., Theobald, S., Raven, J., Ensor, T., Fustukian, S., Ssengooba, F., Chirwa, Y., Vong, S., Wurie, H, Hooton, N and Witter, S. (2017) Leaving no one behind: lessons on rebuilding health systems in conflict and crisis-affected states. BMJ Global Health Jul 2017, 2 (2) http://gh.bmj.com/content/2/2/e000327
- McPake, B., Witter, S., Ssali, S., Wurie, H., Namakula, J. and Ssengooba, F. (2015) Ebola in the context of conflict affected states and health systems: case studies of Northern Uganda and Sierra Leone. Conflict and Health; 9; 23. http://www.conflictandhealth.com/content/9/1/23
- McPake, B., Witter, S., Ensor, T., Fustukian, S., Newlands, D., Martineau, T. and Chirwa, Y. (2013) Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources. Human Resources for Health, 11(1):46. http://www.human-resources-health.com/content/11/1/46/abstract
- Human Resources in Fragile and Conflict-Affected settings – cross sectoral issues between health and education. Overview presentation by Tim Martineau for seminar on human resources in health and education in fragile and conflict affected settings, organised by HEART in June 2016.
- Human Resources for Health in Post-Conflict settings – Findings from ReBUILD research. Presentation given in June 2016 by Sophie Witter on the ReBUILD programme’s findings on Human Resources for Health in Post-Conflict settings, at a meeting exploring cross-sectoral learning on human resources in health and education sectors in fragile settings. https://rebuildconsortium.com/resources/presentations/human-resources-for-health-in-post-conflict-settings-_-findings-from-rebuild-research/
- Health workforce recruitment and financing – selected issues for consideration. Presentation given by Tim Martineau at the Human Resources for Health Summit in Freetown, Sierra Leone, 2nd June 2016
- Universal health coverage amid conflict and fragility: ten lessons from research. (Witter, S., Dec 2015, Lancet Global Health) http://globalhealth.thelancet.com/2015/12/14/universal-health-coverage-amid-conflict-and-fragility-ten-lessons-research