Shifting human resources for health in the context of ART provision: qualitative and quantitative findings from the Lablite baseline study

Table 2 Staff turnover in all health facilities included in the baseline survey

	Malawi			Uganda			Zimbabwe
	Primary care	Secondary care	Tertiary care	Primary care	Secondary care	Tertiary care	Primary care	Secondary care
	N = 16	N = 2^a	N = 1^b	N = 21	N = 16	N = 2	N = 16	N = 6
Physicians
Facilities where ≥ 1 staff left in 3 months	NA	0/1^c		NA	1/3	½	NA	0/5
3 month turnover over all facilities	NA	0/2^c		NA	1/45	9/20	NA	0/5
Estimated annual turnover over all facilities	NA	0%		NA	8.9%	180%	NA	0%
Clinical Officers/Medical assistants
Facilities where ≥ 1 staff left in 3 months	2/15	1/2		0/21	3/16	½	NA	1/5
3 month turnover over all facilities	2/38	2/60		0/32	3/93	1/37	NA	1/6
Estimated annual turnover over all facilities	21%	13%		0%	13%	11%	NA	67%
Midwives/nurses
Facilities where ≥ 1 staff left in 3 months	5/14	2/2	1/1	5/21	6/16	2/2	1/16	3/6
3 month turnover over all facilities	6/74	3/90	3/317	5/107	23/596	14/197	2/156	4/114
Estimated annual turnover over all facilities	32%	13%	4%	19%	15%	28%	5%	14%
Auxiliary staff
Facilities where ≥ 1 staff left in 3 months	2/15	0/2		5/14	1/11	0/2	0/16	2/6
3 month turnover over all facilities	2/97	0/137		6/42	1/161	0/113	0/98	3/391
Estimated annual turnover over all facilities	8%	0%		57%	2.5%	0%	0%	3%
Administrative staff
Facilities where ≥ 1 staff left in 3 months	1/7	0/2		0/6	1/12	2/2	0/3	0/6
3 month turnover over all facilities	1/17	0/14		0/6	1/91	2/22	0/8	0/73
Estimated annual turnover over all facilities	24%	0%		0%	4.4%	36%	0%	0%
Laboratory staff
Facilities where ≥ 1 staff left in 3 months	0/6	1/2		0/14	0/15	0/2	0/1	0/6
3 month turnover over all facilities	0/8	1/9		0/17	0/44	0/17	0/1	0/18
Estimated annual turnover over all facilities	0%	44%		0%	0%	0%	0%	0%

Facilities where ≥ 1 staff left in 3 months provides number of facilities with ≥ 1 member of staff of respective cadre leaving in 3 month period before the survey; the denominator is the number of facilities with any staff over the 3 month period of that cadre (so is less than n if one or more facilities had no staff at that level)
Three month turnover is the total number of staff members of a respective cadre leaving in the 3 month period across all facilities with the denominator equal to the number of staff employed at that level (including those who left but not replaced)
The annual estimated turnover assumes that the 3 month turnover is maintained for a year
^aNo data were available for one secondary care facility in Malawi except for physicians (4 physicians were in post and none had left); this facility is excluded throughout for consistency
^bData were available on nurses/midwives only for the tertiary care facility in Malawi
^cData missing on physicians for second facility
NA not applicable because no staff at this level

ISSN: 1472-6963