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CHAPTER 7

Core Factors Affecting Labor Market Dynamics

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his report has suggested that the dynamics of entry and exit and performance of HRH within the health labor market are affected primarily by:

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Inefficient management arrangements and highly centralized decision making on HRH. Inadequate training capacity leading to low production of skilled workers. Inadequate work environment and conditions of service—including perceptions of low remuneration. HIV/AIDS related mortality and morbidity.

This section reflects on and discusses each of these areas in greater detail. Summary of main findings • Management of HRH is highly centralized (after an experiment with decentralization), and evidence confirms that some aspects of management performance may be weak. • Pre-service education capacity—physical, technical, and organizational—is extremely weak. Zambia has only one medical school. • Monetary compensation in the public sector is not as low as sometimes suggested. After benchmarking salaries and allowances against the average gross national income in Zambia, doctors do very well. • A detailed assessment of nonmonetary factors, beyond those discussed in the report, is not available. • HIV/AIDS is a real problem in Zambia, one of a handful of countries that suffers simultaneously from an HIV/AIDS crisis and an HRH crisis.

Centralized HRH Management Capacity This report has shown that labor market dynamics and performance in the public sector, time and again, are negatively influenced by highly centralized and inefficient HRH management. Ineffective and inefficient management procedures linked to centralized HRH decision making was thus one key contributing factor shown to explain the low stock, inequitable distribution, and inadequate performance. This section assesses the extent and story of the centralized decision making on HRH and the capacity at the central level to govern and manage it.

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The Human Resources for Health Crisis in Zambia  

Despite reporting some health gains since the 1990s, health outcomes remain poor in Zambia and it will be very challenging to achieve the he...

The Human Resources for Health Crisis in Zambia  

Despite reporting some health gains since the 1990s, health outcomes remain poor in Zambia and it will be very challenging to achieve the he...