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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Bibliographic Details
Main Author: World Bank
Format: Other Health Study
Language:English
en_US
Published: Washington, DC 2013
Subjects:
HR
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
id okr-10986-13063
recordtype oai_dc
repository_type Digital Repository
institution_category Foreign Institution
institution Digital Repositories
building World Bank Open Knowledge Repository
collection World Bank
language English
en_US
topic ACCOUNTING
AGE STRUCTURE
ALLOCATION
ANNUAL BUDGET
ANNUAL BUDGET PREPARATION
ANNUAL BUDGETS
ANNUAL REPORT
ARTICLE
BLOCK GRANT
BLOCK GRANTS
BUDGET CYCLE
BUDGET ENVELOPE
BUDGET EXECUTION
BUDGET FRAMEWORK
BUDGET LAW
BUDGET MANAGEMENT
BUDGET MANAGEMENT PROCESS
BUDGET SUPPORT
BUDGETARY ITEMS
BUDGETING PROCESS
CAPACITY CONSTRAINTS
CENTRAL GOVERNMENT
CIVIL SERVANTS
CIVIL SERVICE
CIVIL SERVICE REFORM
CIVIL SERVICE SYSTEM
COMMUNITIES
CONDITIONALITY
CONTRACTUAL ARRANGEMENTS
DECENTRALIZATION
DECENTRALIZATION POLICIES
DECENTRALIZATION PROCESS
DESCRIPTION
DOCTORS
DONOR AGENCIES
DONOR COORDINATION
DONOR FINANCING
DONOR FUNDING
DONOR FUNDS
ECONOMIC DEVELOPMENT
ECONOMIC GROWTH
ECONOMIC POLICY
EXPENDITURE CEILINGS
EXPENDITURE CONSTRAINT
EXPENDITURE LEVELS
EXPENDITURES
FINANCIAL INSTITUTIONS
FINANCIAL RESOURCES
FISCAL DECENTRALIZATION
FISCAL DEFICIT
GENDER
GOVERNMENT BUDGET
GOVERNMENT EXPENDITURE
GOVERNMENT EXPENDITURES
GOVERNMENT STRUCTURES
GROSS DOMESTIC PRODUCT
HEALTH BUDGETS
HEALTH CARE
HEALTH CARE WORKERS
HEALTH CENTERS
HEALTH EXPENDITURE
HEALTH EXPENDITURES
HEALTH FACILITIES
HEALTH ORGANIZATION
HEALTH OUTCOMES
HEALTH PLANNING
HEALTH PROFESSIONALS
HEALTH PROVIDERS
HEALTH SECTOR
HEALTH SERVICE
HEALTH SERVICE DELIVERY
HEALTH SERVICES
HEALTH SPENDING
HEALTH SYSTEM
HEALTH WORKERS
HEALTH WORKFORCE
HIV/AIDS
HOSPITAL DISTRICTS
HOSPITAL PERSONNEL
HOSPITALS
HOUSING
HR
HUMAN RESOURCE MANAGEMENT
HUMAN RESOURCES
INCENTIVE STRUCTURES
INCOME
LABOR MARKET
LAWS
LOCAL REVENUE
LOW-INCOME COUNTRIES
MACROECONOMIC POLICIES
MANAGEMENT RESPONSIBILITIES
MARKET DISTORTION
MEDIUM TERM EXPENDITURE
MEDIUM TERM EXPENDITURE FRAMEWORK
MEDIUM-TERM EXPENDITURE
MEDIUM-TERM EXPENDITURE FRAMEWORK
MINISTRY OF ECONOMY
MINISTRY OF FINANCE
MISMANAGEMENT
NATIONAL BUDGET
NATIONAL HEALTH
NATIONAL STRATEGY
NET LENDING
OPERATING EXPENDITURES
ORGANIZATIONAL STRUCTURE
PERFORMANCE CONTRACTS
PERFORMANCE CRITERIA
PERFORMANCE EVALUATION
PERFORMANCE EVALUATIONS
PERFORMANCE TARGETS
POVERTY REDUCTION
POVERTY REDUCTION STRATEGY
PROBABILITY
PROFESSIONAL ASSOCIATIONS
PROGRAMS
PUBLIC ADMINISTRATION
PUBLIC EXPENDITURE
PUBLIC EXPENDITURE REVIEW
PUBLIC FUNDING
PUBLIC HEALTH
PUBLIC INFORMATION
PUBLIC INSTITUTIONS
PUBLIC INVESTMENTS
PUBLIC SECTOR
PUBLIC SECTOR EMPLOYMENT
PUBLIC SECTOR MANAGEMENT
PUBLIC SERVICE
PUBLIC SERVICES
QUALITY ASSURANCE
QUALITY OF HEALTH
RECURRENT EXPENDITURES
REVENUE PROJECTIONS
REVENUE SOURCES
RURAL AREAS
SALARY PAYMENTS
SECTOR BUDGET
SERVICE DELIVERY
SERVICE EMPLOYMENT
SERVICE PROVISION
SHARE OF HEALTH EXPENDITURE
SHARE OF HEALTH SPENDING
SOCIAL SERVICES
TOTAL EXPENDITURE
TOTAL SPENDING
TUBERCULOSIS
URBAN AREAS
WAGE EXPENDITURE
WORKERS
spellingShingle ACCOUNTING
AGE STRUCTURE
ALLOCATION
ANNUAL BUDGET
ANNUAL BUDGET PREPARATION
ANNUAL BUDGETS
ANNUAL REPORT
ARTICLE
BLOCK GRANT
BLOCK GRANTS
BUDGET CYCLE
BUDGET ENVELOPE
BUDGET EXECUTION
BUDGET FRAMEWORK
BUDGET LAW
BUDGET MANAGEMENT
BUDGET MANAGEMENT PROCESS
BUDGET SUPPORT
BUDGETARY ITEMS
BUDGETING PROCESS
CAPACITY CONSTRAINTS
CENTRAL GOVERNMENT
CIVIL SERVANTS
CIVIL SERVICE
CIVIL SERVICE REFORM
CIVIL SERVICE SYSTEM
COMMUNITIES
CONDITIONALITY
CONTRACTUAL ARRANGEMENTS
DECENTRALIZATION
DECENTRALIZATION POLICIES
DECENTRALIZATION PROCESS
DESCRIPTION
DOCTORS
DONOR AGENCIES
DONOR COORDINATION
DONOR FINANCING
DONOR FUNDING
DONOR FUNDS
ECONOMIC DEVELOPMENT
ECONOMIC GROWTH
ECONOMIC POLICY
EXPENDITURE CEILINGS
EXPENDITURE CONSTRAINT
EXPENDITURE LEVELS
EXPENDITURES
FINANCIAL INSTITUTIONS
FINANCIAL RESOURCES
FISCAL DECENTRALIZATION
FISCAL DEFICIT
GENDER
GOVERNMENT BUDGET
GOVERNMENT EXPENDITURE
GOVERNMENT EXPENDITURES
GOVERNMENT STRUCTURES
GROSS DOMESTIC PRODUCT
HEALTH BUDGETS
HEALTH CARE
HEALTH CARE WORKERS
HEALTH CENTERS
HEALTH EXPENDITURE
HEALTH EXPENDITURES
HEALTH FACILITIES
HEALTH ORGANIZATION
HEALTH OUTCOMES
HEALTH PLANNING
HEALTH PROFESSIONALS
HEALTH PROVIDERS
HEALTH SECTOR
HEALTH SERVICE
HEALTH SERVICE DELIVERY
HEALTH SERVICES
HEALTH SPENDING
HEALTH SYSTEM
HEALTH WORKERS
HEALTH WORKFORCE
HIV/AIDS
HOSPITAL DISTRICTS
HOSPITAL PERSONNEL
HOSPITALS
HOUSING
HR
HUMAN RESOURCE MANAGEMENT
HUMAN RESOURCES
INCENTIVE STRUCTURES
INCOME
LABOR MARKET
LAWS
LOCAL REVENUE
LOW-INCOME COUNTRIES
MACROECONOMIC POLICIES
MANAGEMENT RESPONSIBILITIES
MARKET DISTORTION
MEDIUM TERM EXPENDITURE
MEDIUM TERM EXPENDITURE FRAMEWORK
MEDIUM-TERM EXPENDITURE
MEDIUM-TERM EXPENDITURE FRAMEWORK
MINISTRY OF ECONOMY
MINISTRY OF FINANCE
MISMANAGEMENT
NATIONAL BUDGET
NATIONAL HEALTH
NATIONAL STRATEGY
NET LENDING
OPERATING EXPENDITURES
ORGANIZATIONAL STRUCTURE
PERFORMANCE CONTRACTS
PERFORMANCE CRITERIA
PERFORMANCE EVALUATION
PERFORMANCE EVALUATIONS
PERFORMANCE TARGETS
POVERTY REDUCTION
POVERTY REDUCTION STRATEGY
PROBABILITY
PROFESSIONAL ASSOCIATIONS
PROGRAMS
PUBLIC ADMINISTRATION
PUBLIC EXPENDITURE
PUBLIC EXPENDITURE REVIEW
PUBLIC FUNDING
PUBLIC HEALTH
PUBLIC INFORMATION
PUBLIC INSTITUTIONS
PUBLIC INVESTMENTS
PUBLIC SECTOR
PUBLIC SECTOR EMPLOYMENT
PUBLIC SECTOR MANAGEMENT
PUBLIC SERVICE
PUBLIC SERVICES
QUALITY ASSURANCE
QUALITY OF HEALTH
RECURRENT EXPENDITURES
REVENUE PROJECTIONS
REVENUE SOURCES
RURAL AREAS
SALARY PAYMENTS
SECTOR BUDGET
SERVICE DELIVERY
SERVICE EMPLOYMENT
SERVICE PROVISION
SHARE OF HEALTH EXPENDITURE
SHARE OF HEALTH SPENDING
SOCIAL SERVICES
TOTAL EXPENDITURE
TOTAL SPENDING
TUBERCULOSIS
URBAN AREAS
WAGE EXPENDITURE
WORKERS
World Bank
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
geographic_facet Africa
Rwanda
description 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.
format Economic & Sector Work :: Other Health Study
author World Bank
author_facet World Bank
author_sort World Bank
title 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
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
publisher Washington, DC
publishDate 2013
url 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
_version_ 1764420480810352640
spelling okr-10986-130632021-04-23T14:03:02Z 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 World Bank ACCOUNTING AGE STRUCTURE ALLOCATION ANNUAL BUDGET ANNUAL BUDGET PREPARATION ANNUAL BUDGETS ANNUAL REPORT ARTICLE BLOCK GRANT BLOCK GRANTS BUDGET CYCLE BUDGET ENVELOPE BUDGET EXECUTION BUDGET FRAMEWORK BUDGET LAW BUDGET MANAGEMENT BUDGET MANAGEMENT PROCESS BUDGET SUPPORT BUDGETARY ITEMS BUDGETING PROCESS CAPACITY CONSTRAINTS CENTRAL GOVERNMENT CIVIL SERVANTS CIVIL SERVICE CIVIL SERVICE REFORM CIVIL SERVICE SYSTEM COMMUNITIES CONDITIONALITY CONTRACTUAL ARRANGEMENTS DECENTRALIZATION DECENTRALIZATION POLICIES DECENTRALIZATION PROCESS DESCRIPTION DOCTORS DONOR AGENCIES DONOR COORDINATION DONOR FINANCING DONOR FUNDING DONOR FUNDS ECONOMIC DEVELOPMENT ECONOMIC GROWTH ECONOMIC POLICY EXPENDITURE CEILINGS EXPENDITURE CONSTRAINT EXPENDITURE LEVELS EXPENDITURES FINANCIAL INSTITUTIONS FINANCIAL RESOURCES FISCAL DECENTRALIZATION FISCAL DEFICIT GENDER GOVERNMENT BUDGET GOVERNMENT EXPENDITURE GOVERNMENT EXPENDITURES GOVERNMENT STRUCTURES GROSS DOMESTIC PRODUCT HEALTH BUDGETS HEALTH CARE HEALTH CARE WORKERS HEALTH CENTERS HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH PLANNING HEALTH PROFESSIONALS HEALTH PROVIDERS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SERVICES HEALTH SPENDING HEALTH SYSTEM HEALTH WORKERS HEALTH WORKFORCE HIV/AIDS HOSPITAL DISTRICTS HOSPITAL PERSONNEL HOSPITALS HOUSING HR HUMAN RESOURCE MANAGEMENT HUMAN RESOURCES INCENTIVE STRUCTURES INCOME LABOR MARKET LAWS LOCAL REVENUE LOW-INCOME COUNTRIES MACROECONOMIC POLICIES MANAGEMENT RESPONSIBILITIES MARKET DISTORTION MEDIUM TERM EXPENDITURE MEDIUM TERM EXPENDITURE FRAMEWORK MEDIUM-TERM EXPENDITURE MEDIUM-TERM EXPENDITURE FRAMEWORK MINISTRY OF ECONOMY MINISTRY OF FINANCE MISMANAGEMENT NATIONAL BUDGET NATIONAL HEALTH NATIONAL STRATEGY NET LENDING OPERATING EXPENDITURES ORGANIZATIONAL STRUCTURE PERFORMANCE CONTRACTS PERFORMANCE CRITERIA PERFORMANCE EVALUATION PERFORMANCE EVALUATIONS PERFORMANCE TARGETS POVERTY REDUCTION POVERTY REDUCTION STRATEGY PROBABILITY PROFESSIONAL ASSOCIATIONS PROGRAMS PUBLIC ADMINISTRATION PUBLIC EXPENDITURE PUBLIC EXPENDITURE REVIEW PUBLIC FUNDING PUBLIC HEALTH PUBLIC INFORMATION PUBLIC INSTITUTIONS PUBLIC INVESTMENTS PUBLIC SECTOR PUBLIC SECTOR EMPLOYMENT PUBLIC SECTOR MANAGEMENT PUBLIC SERVICE PUBLIC SERVICES QUALITY ASSURANCE QUALITY OF HEALTH RECURRENT EXPENDITURES REVENUE PROJECTIONS REVENUE SOURCES RURAL AREAS SALARY PAYMENTS SECTOR BUDGET SERVICE DELIVERY SERVICE EMPLOYMENT SERVICE PROVISION SHARE OF HEALTH EXPENDITURE SHARE OF HEALTH SPENDING SOCIAL SERVICES TOTAL EXPENDITURE TOTAL SPENDING TUBERCULOSIS URBAN AREAS WAGE EXPENDITURE WORKERS 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. 2013-03-29T14:00:20Z 2013-03-29T14:00:20Z 2008-06-23 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 English en_US CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank Washington, DC Economic & Sector Work :: Other Health Study Economic & Sector Work Africa Rwanda