Beyond Wage Bill Ceilings : The Impact of Government Fiscal and Human Resource Management Policies on the Health Workforce in Developing Countries, Background Country Study for Rwanda
One of the main explanations put forth on why access to health workers is so low in developing countries is that there are insufficient resources within the public sector to pay the wage bill - the salary and allowance payments - of an expanded hea...
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| Format: | Other Health Study |
| Language: | English en_US |
| Published: |
Washington, DC
2013
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| Online Access: | http://documents.worldbank.org/curated/en/2008/06/16332540/rwanda-beyond-wage-bill-ceilings-impact-government-fiscal-human-resource-management-policies-health-workforce-developing-countries http://hdl.handle.net/10986/13063 |
| Summary: | One of the main explanations put forth
on why access to health workers is so low in developing
countries is that there are insufficient resources within
the public sector to pay the wage bill - the salary and
allowance payments - of an expanded health workforce. In
turn, the lack of wage bill resources for the health sector
is thought to be a direct result of restrictive
macroeconomic policies that limit the expansion of the
overall public sector wage bill. The overarching message in
this report is that, despite the relative contraction of the
public sector wage bill, Rwanda has not only protected the
health sector, but has succeeded through decentralization
and the introduction of performance-based financing in
linking salaries to performance in the health sector. The
decentralization of budgets, along with the implementation
of the performance-based grants scheme, has had two major
effects. First, it has increased the resource envelope
available for hiring health workers since there is a lot of
flexibility in how the performance based grants can be used.
Second, it has linked payments to health workers with
performance, since the salary top amounts paid out of the
grants are linked to service delivery results. |
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