World health report

Chapter 5

Managing exits from the workforce

Each year, substantial numbers of health workers leave the health workforce, either temporarily or permanently. These exits can provoke shortages if workers who leave are not replaced, and such shortages compromise the delivery and quality of health services (1, 2). Chapter 3 discussed the routes new workers take into the workforce; this chapter examines the other end of the spectrum – the various ways in which workers depart active service. It also suggests ways of managing exits in times of worker shortage as well as in times of surplus, in order to optimize the performance of the health workforce. Finally, it reviews and analyses the factors that influence exits and proposes strategies for managing them.

In this chapter

  • Ebbs and flows of migration
  • Occupational risks to health workers
  • Change of occupation or work status
  • Retirement
  • Conclusion