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Trop Med Int Health. 2013 Jul;18(7):887-97.

The internal migration between public and faith-based health providers: a cross-sectional, retrospective and multicentre study from southern Tanzania.

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1
Institute of Public Health, University of Heidelberg, Heidelberg, Germany. patriktabatabai@web.de

Abstract

OBJECTIVE:

To assess the magnitude, direction and underlying dynamics of internal health worker migration between public and faith-based health providers from a hospital perspective.

METHODS:

Two complementary tools were implemented in 10 public and six faith-based hospitals in southern Tanzania. A hospital questionnaire assessed magnitude and direction of staff migration between January 2006 and June 2009. Interviews with 42 public and 20 faith-based maternity nurses evaluated differences in staff perspectives and motives for the observed migration patterns.

RESULTS:

The predominant direction of staff movement was from the faith-based to the public sector: 69.1% (n = 105/152) of hospital staff exits and 60.6% (n = 60/99) of hospital staff gains. Nurses were the largest group among the migrating health workforce. Faith-based hospitals lost 59.3% (n = 86/145) of nurses and 90.6% (n = 77/85) of registered nurses to the public sector, whereby public hospitals reported 13.5% (n = 59/436) of nurses and 24.4% (n = 41/168) of registered nurses being former faith-based employees. Interviews revealed significantly inferior staff perspectives among faith-based respondents than their public colleagues. Main differences were identified regarding career development and training, management support, employee engagement and workload.

CONCLUSION:

This study revealed considerable internal health worker migration from the faith-based to the public sector. Staff retention and motivation within faith-based hospitals are not restricted to financial considerations, and salary gaps can no longer uniquely explain this movement pattern. The consequences for the catchment area of faith-based hospitals are potentially severe and erode cooperation potential between the public and private health sector.

PMID:
23914366
[Indexed for MEDLINE]
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