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Human Resources for Health Retention Scheme (HRHRS)

Crown Agents Zimbabwe > Human Resources for Health Retention Scheme (HRHRS)

Project Overview

Project Title: Human Resources for Health Retention Scheme (HRHRS)
Legal Entity: Crown Agents Zimbabwe (CAZim)
Project Location: National (Zimbabwe)
Overall Project Value: USD $250 million
Number of Staff Provided: 15
Client: Ministry of Health and Child Care (MoHCC)
Origin of Funding: Global Fund & Other Donors
Project Duration: 2009 – 2022

Project Background

The HRHRS was established in 2008 in response to a severe shortage of health workers in Zimbabwe. Following the near – collapse of public services and economic uncertainty, Zimbabwe’s health sector faced a massive workforce crisis. The country was receiving significant medical aid, but the lack of sufficient healthcare workers hindered effective service delivery.

By 2008, Zimbabwe’s health system was already struggling with issues such as:

  • Health Workforce Brain Drain: Due to economic uncertainty, many health professionals left the country in search of better opportunities.
  • Absenteeism & High Turnover: Low wages, inadequate tools of the trade and deteriorating working conditions led to widespread absenteeism and frequent staff turnover.
  • Cholera Epidemic: The country faced a devastating cholera epidemic, exacerbating the already strained health services.

As the situation worsened, CAZim, in collaboration with DFID and other donors, developed an innovative scheme to incentivize health workers to report for work and deliver essential healthcare services during this critical time.

Services Provided

  1. Human Resources Retention Allowances for Health Workers

    CAZim managed the HRHRS by designing and implementing a model that provided retention allowances to health workers across Zimbabwe. This incentivization strategy encouraged healthcare professionals to stay in their posts and report to work, particularly in rural and underserved areas.

  2. Management of HRHRS Operations
    CAZim was responsible for the day-to-day management of the HRHRS, including:
  • Coordinating the payment system for health workers
  • Ensuring accurate maintenance and updates of the Ministry of Health and Child Care (MoHCC) staff database
  • Ensuring that retention allowances were paid promptly, as per agreed rates
  • Preparing disbursement requests for donors and providing monthly/quarterly reports
  • Delivering essential healthcare services during this critical time
  1. Coordination with Stakeholders
    CAZim worked closely with the MoHCC, Health Service Board (HSB), and donor partners to ensure the smooth implementation of the HRHRS. Regular reporting and audits were conducted to ensure transparency and accountability.

Project Impact

  1. Financial Transparency and Accountability
  • A total of USD $250 million was disbursed under the HRHRS.
  • The project underwent 10 international audits, with no discrepancies found, and all funds were accounted for with zero audit comments.
  1. Increased Health Worker Attendance
  • Health worker attendance at public health institutions rose from 20% in 2008 to 99.98% in 2016 (Source: HSB Audit).
  • Some health institutions reported zero vacancies in key areas, thanks to the increased retention of health professionals.
  1. Improved Workforce Capacity
  • The number of doctors working in district hospitals increased significantly, with most district hospitals now having at least one doctor.
  • The number of doctors receiving critical post allowances rose from 82 in 2012 to 166 in 2017.
  • There was a notable increase in midwife training applications, with a high number of qualified midwives being deployed across public health institutions. Some midwives are now working in general wards due to the high demand for their services.

Key Achievements

1. Significant Improvement in Health Worker Attendance:

From 20% in 2008 to 99.98% in 2016

2. Contributed to Retention of 25,000 Health Workers:

Ensuring healthcare delivery during a critical national crisis

3. Increased Staffing in District Hospitals:

More doctors and midwives available to serve remote communities

4. Development Project of the Year Award

(British Expertise Awards)

Get in Touch

Interested in learning more about the HRHRS and how CAZim is working with the GoZ in improving health workforce retention in Zimbabwe?

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