Regulatory mechanisms for absenteeism in the health sector: a systematic review of strategies and their implementation
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Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of healthcare leadership
Abstract
A systematic review was undertaken to identify regulatory mechanisms aimed
at mitigating health care worker absenteeism, to describe where and how they have been implemented
as well as their possible effects. The goal was to propose potential policy options for
managing the problem of absenteeism among human resources for health in low- and middleincome
countries. Mechanisms described in this review are at the local workplace and broader
national policy level.
Methods: A comprehensive online search was conducted on EMBASE, CINAHL, PubMed,
Google Scholar, Google, and Social Science Citation Index using MEDLINE search terms.
Retrieved studies were uploaded onto reference manager and screened by two independent
reviewers. Only publications in English were included. Data were extracted and synthesized
according to the objectives of the review.
Results: Twenty six of the 4,975 published articles retrieved were included. All were from highincome
countries and covered all cadres of health workers. The regulatory mechanisms and possible
effects include 1) organizational-level mechanisms being reported as effective in curbing absenteeism
in low- and middle-income countries (LMICs); 2) prohibition of private sector activities
in LMICs offering benefits but presenting a challenge for the government to monitor the health
workforce; 3) contractual changes from temporary to fixed posts having been associated with no
reduction in absenteeism and not being appropriate for LMICs; 4) multifaceted work interventions
being implemented in most settings; 5) the possibility of using financial and incentive regulatory
mechanisms in LMICs; 6) health intervention mechanisms reducing absenteeism when integrated
with exercise programs; and 7) attendance by legislation during emergencies being criticized for
violating human rights in the United States and not being effective in curbing absenteeism.
Conclusion: Most countries have applied multiple strategies to mitigate health care worker
absenteeism. The success of these interventions is heavily influenced by the context within
which they are applied.
Description
Keywords
Absenteeism, Health workers, Regulatory mechanisms, Systematic review
Citation
Kisakye, A. N., Tweheyo, R., Ssengooba, F., Pariyo, G. W., Rutebemberwa, E., & Kiwanuka, S. N. (2016). Regulatory mechanisms for absenteeism in the health sector: a systematic review of strategies and their implementation. Journal of healthcare leadership, 8, 81.