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Table 4 Suggested areas for future research

From: Human resource management in post-conflict health systems: review of research and knowledge gaps

HRM functional area/topic area Areas for future research Rationale
Workforce supply
Recruitment and selection Strategies to assess health workers’ knowledge and skills to facilitate their reintegration into the public health workforce Appropriateness of skills of reintegrated health workers is often overlooked
  Implementation of ‘basic’ HR data systems at an early stage, which can be further developed Important to support workforce distribution and performance
  Equal opportunities including gender-equitable and ethnically sensitive policies to recruit and support health workers in conflict-affected areas Evidence on gender-equitable and ethnically sensitive policies is lacking
Pay How to implement pay reforms effectively under new post-conflict leadership and governance while minimising unintended consequences for the health workforce and wider health system Post-conflict pay reforms risk failing to meet their intended objectives of attracting, motivating and retaining health workers
Pre-service education and training Sustainable strategies and policies to attract, train and support qualified trainers and educators after conflict Lack of qualified trainers and educators undermines rapid scale-up strategies
Workforce distribution
Deployment Opportunities for strengthening governance and administration of deployment in the crucial post-conflict moment and ensuring linkages with training Weak governance creates scope for interference in deployment; lack of evidence on administrative systems for deployment; deployment and training systems become unlinked during conflict
  Financial and non-financial incentives to attract and retain health workers in rural and conflict-affected areas within a competitive incentive environment Large influx of non-state employers post-conflict offering attractive salaries and increasing the competition for skilled health workers; conflict-affected rural areas particularly unattractive
Workforce performance
Work organisation and job design Approaches to reviewing overall workloads and reallocating work to different cadres to address near-term shortages, but which support longer-term planning Few published studies addressing work reorganisation and job redesign at different stages post-conflict
  Unintended consequences of task shifting on health workers, service provision and utilisation, and the wider health system Longer-term effects of formal and informal task shifting are unknown
  Use of coordinated stakeholder approach to develop interim job descriptions Job descriptions may have become irrelevant during conflict; NGO-introduced job descriptions proliferate after conflict and are often uncoordinated
Management and supervision Interventions to support health workers affected by conflict to perform well and contribute to safe and effective service delivery Health workers targeted during violent conflict may need psychosocial support, but managers may be untrained and themselves affected by conflict
Performance appraisal Development of basic performance appraisal systems that could be advanced as HRM systems become more formalised and governance strengthened Very limited evidence on performance appraisal in post-conflict settings
Performance-related incentives Understanding the impact of financial and non-financial incentives on different facets of performance (e.g. productivity, competence, availability) in changing employment contexts Incentives used by NGOs in the immediate post-conflict period may impact on the ability of public sector employers to use comparable incentives in the longer term
In-service training Understanding how wider health system factors can facilitate or constrain efforts to scale-up in-service training interventions after conflict Inadequate funding, lack of supplies and equipment, poor working conditions etc. hinder effective provision of new or upgraded skills