Where there is no policy: governing the posting and transfer of primary health care workers in Nigeria
Open Access
- 4 May 2016
- journal article
- research article
- Published by Wiley in The International Journal of Health Planning and Management
- Vol. 32 (4), 492-508
- https://doi.org/10.1002/hpm.2356
Abstract
The posting and transfer of health workers and managers receives little policy and research attention in global health. In Nigeria, there is no national policy on posting and transfer in the health sector. We sought to examine how the posting and transfer of frontline primary health care (PHC) workers is conducted in four states (Lagos, Benue, Nasarawa and Kaduna) across Nigeria, where public sector PHC facilities are usually the only form of formal health care service providers available in many communities. We conducted in-depth interviews with PHC workers and managers, and group discussions with community health committee members. The results revealed three mechanisms by which PHC managers conduct posting and transfer: (1) periodically moving PHC workers around as a routine exercise aimed at enhancing their professional experience and preventing them from being corrupted; (2) as a tool for improving health service delivery by assigning high-performing PHC workers to PHC facilities perceived to be in need, or posting PHC workers nearer their place of residence; and (3) as a response to requests for punishment or favour from PHC workers, political office holders, global health agencies and community health committees. Given that posting and transfer is conducted by discretion, with multiple influences and sometimes competing interests, we identified practices that may lead to unfair treatment and inequities in the distribution of PHC workers. The posting and transfer of PHC workers therefore requires policy measures to codify what is right about existing informal practices and to avert their negative potential. © 2016 The Authors The International Journal of Health Planning and Management Published by John Wiley & Sons LtdKeywords
Funding Information
- Rotary Foundation (GG1412096)
- Sydney Medical School Foundation
This publication has 17 references indexed in Scilit:
- How decentralisation influences the retention of primary health care workers in rural NigeriaGlobal Health Action, 2015
- Towards people-centred health systems: a multi-level framework for analysing primary health care governance in low- and middle-income countriesHealth Policy and Planning, 2014
- A description of HIV prevalence trends in Nigeria from 2001 to 2010: what is the progress, where is the problem?2014
- PATRONAGE'S PROGRESS IN POST‐SOEHARTO INDONESIAPublic Administration and Development, 2012
- Workforce Resources for Health in Developing CountriesPublic Health Reviews, 2010
- Support to the Safe Motherhood Programme in Nepal: An Integrated ApproachReproductive Health Matters, 2007
- Three Approaches to Qualitative Content AnalysisQualitative Health Research, 2005
- Staff transfer and management in the government health sector in Balochistan, Pakistan: problems and contextPublic Administration and Development, 2000
- Transformation of ministries of health in the era of health reform: the case of Colombia.Health Policy and Planning, 1998
- Voices from the inside: Managing district health services in NepalThe International Journal of Health Planning and Management, 1994