NDLI: Postings and transfers in the Ghanaian health system: a study of health workforce governance

Content Provider	Springer Nature : BioMed Central
Author	Kwamie, Aku Asiamah, Miriam Schaaf, Marta Agyepong, Irene Akua
Abstract	Background Decision-making on postings and transfers – that is, the geographic deployment of the health workforce – is a key element of health workforce governance. When poorly managed, postings and transfers result in maldistribution, absenteeism, and low morale. At stake is managing the balance between organisational (i.e., health system) and individual (i.e., staff preference) needs. The negotiation of this potential convergence or divergence of interests provides a window on practices of postings and transfers, and on the micro-practices of governance in health systems more generally. This article explores the policies and processes, and the interplay between formal and informal rules and norms which underpin postings and transfers practice in two rural districts in the Greater Accra Region of Ghana. Methods Semi-structured interviews were conducted with eight district managers and 87 frontline staff from the district health administration, district hospital, polyclinic, health centres and community outreach compounds across two districts. Interviews sought to understand how the postings and transfers process works in practice, factors in frontline staff and district manager decision-making, personal experiences in being posted, and study leave as a common strategy for obtaining transfers. Results Differential negotiation-spaces at regional and district level exist and inform postings and transfers in practice. This is in contrast to the formal cascaded rules set to govern decision-making authority for postings and transfers. Many frontline staff lack policy clarity of postings and transfers processes and thus ‘test’ the system through informal staff lobbying, compounding staff perception of the postings and transfers process as being unfair. District managers are also challenged with limited decision-space embedded in broader policy contexts of systemic hierarchy and resource dependence. This underscores the negotiation process as ongoing, rather than static. Conclusions These findings point to tensions between individual and organisational goals. This article contributes to a burgeoning literature on postings and transfers as a distinct dynamic which bridges the interactions between health systems governance and health workforce development. Importantly, this article helps to expand the notion of health systems governance beyond ‘good’ governance towards understanding governance as a process of negotiation.
Related Links	https://equityhealthj.biomedcentral.com/counter/pdf/10.1186/s12939-017-0583-1.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	14759276
DOI	10.1186/s12939-017-0583-1
Journal	International Journal for Equity in Health
Issue Number	1
Volume Number	16
Language	English
Publisher	BioMed Central
Publisher Date	2017-09-15
Access Restriction	Open
Subject Keyword	Public Health Health Promotion and Disease Prevention Health Services Research Health Policy Social Justice Equality and Human Rights Social Policy Postings and transfers Health workforce Governance District health systems Ghana
Content Type	Text
Resource Type	Article
Subject	Health Policy Public Health, Environmental and Occupational Health
Journal Impact Factor	4.5/2023
5-Year Journal Impact Factor	4.7/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Realigning global health governance: WHO at a crossroads

Practicing governance towards equity in health systems: LMIC perspectives and experience

Economic burden of family caregiving for elderly population in southern Ghana: the case of a peri-urban district

Inequality of obstetric and gynaecological workforce distribution in China

Local health governance in Tajikistan: accountability and power relations at the district level

A study on the equality and benefit of China’s national health care system

Health reform in Mexico: governance and potential outcomes

Devolution and its effects on health workforce and commodities management – early implementation experiences in Kilifi County, Kenya

Measuring inequalities in the public health workforce at county-level Centers for Disease Control and Prevention in China

Postings and transfers in the Ghanaian health system: a study of health workforce governance

Similar Documents

Realigning global health governance: WHO at a crossroads

Practicing governance towards equity in health systems: LMIC perspectives and experience

Economic burden of family caregiving for elderly population in southern Ghana: the case of a peri-urban district

Inequality of obstetric and gynaecological workforce distribution in China

Local health governance in Tajikistan: accountability and power relations at the district level

A study on the equality and benefit of China’s national health care system

Health reform in Mexico: governance and potential outcomes

Devolution and its effects on health workforce and commodities management – early implementation experiences in Kilifi County, Kenya

Measuring inequalities in the public health workforce at county-level Centers for Disease Control and Prevention in China

Postings and transfers in the Ghanaian health system: a study of health workforce governance