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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