Table 1. HIV/AIDS staff loss rates by cadre, Zambia
Cadre
Number
currently at
work
Number who left
in last 12 months
Loss rate
Doctors 23 7 30%
Midwives 50 18 36%
Nurses 42 14 33%
Clinical officers 10 2 20%
Lab technicians 19 4 21%
Other 30 9 30%
Volunteers 31 8 26%
Total: All staff 205 62 30%
Source
: Huddart J, Furth R, Lyons J. 2004.
The Zambia HIV/AIDS workforce study: preparing for scale-up
. Quality Assurance Project,
University Research Co.,LLC.
Why are health workers absent?
Within the formal health sector, data from an assessment of health workers in Kenya and Malawi has
shown that the major reason for absences from work is related to illness. In Kenya, 34% of
absenteeism was due to personal illness a
nd 6% to attending to a sick person (
7
)This was followed by
29% unknown, 17% “personal reasons,” and 14% attending funerals. In Malawi, personal illness was
similar at 38%, followed by caring for relatives (27%) (
8
). Kenyan health workers cited the need for
support to deal with the increased number of de
aths, grief due to losing family and friends from
AIDS, and general fatigue due to work demands. Th
ey also highlighted the importance of access to
counselling and psychosocial support to deal with the increased number of deaths (
9
).
Unfilled posts in the health sector
Due to local economic constraints and structural ad
justment programmes imposed by the international
donor agencies and governance issues, many posts in developing country health systems remain
unfilled for many years. Yet, the numbers of service providers in the face of the staggering demands
imposed by the HIV/AIDS epidemic is too small to respond to the needs. In Malawi, for example,
over 64% of all nurse posts are vacant (
10
). A World Bank report states that Malawi faces a grave
health personnel shortage (
11
).
Human capital can be conserved, however, by giving
antiretroviral treatment (ART) priority to nurses,
teachers, engineers, judges, police officers a
nd other skilled workers whose contributions are
important to economic development or social stability (
12
). An issue that complicates this solution is
that ART cannot be separated from the need for basic primary health care services, a human right for
all. Though difficult, a policy response must be developed and implemented in the context of a
comprehensive approach to enhance weak health systems.
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