Institute of Public Health, University of Heidelberg, Heidelberg, Germany.
Trop Med Int Health. 2013 Jul;18(7):887-97. doi: 10.1111/tmi.12107.
To assess the magnitude, direction and underlying dynamics of internal health worker migration between public and faith-based health providers from a hospital perspective.
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.
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.
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.
从医院的角度评估公共和信仰为基础的卫生提供者之间内部卫生工作者迁移的规模、方向和潜在动态。
在坦桑尼亚南部的 10 家公立和 6 家信仰为基础的医院实施了两种互补工具。医院问卷调查评估了 2006 年 1 月至 2009 年 6 月期间工作人员在医院之间的迁移规模和方向。对 42 名公立和 20 名信仰为基础的产科护士进行了访谈，评估了工作人员观点和观察到的迁移模式的动机差异。
员工流动的主要方向是从信仰为基础的到公共部门：59.3%（n=86/145）的护士和 90.6%（n=77/85）的注册护士从信仰为基础的医院流失到公共部门，而公立医院报告说，13.5%（n=59/436）的护士和 24.4%（n=41/168）的注册护士是前信仰为基础的员工。访谈显示，信仰为基础的受访者的员工观点明显不如他们的公共同事。主要差异在于职业发展和培训、管理支持、员工参与和工作量。
本研究揭示了从信仰为基础的到公共部门的相当大的内部卫生工作者迁移。信仰为基础的医院内的员工保留和激励不仅仅受到财务因素的限制，而且工资差距不再是唯一能解释这种流动模式的因素。信仰为基础的医院的服务范围可能会受到严重影响，并削弱公私卫生部门之间的合作潜力。
