Human resources for health shortages have reached epic proportions worldwide. Africa has the largest share of these shortages. The scarcity is compounded among other factors by mal-distribution and erosion of skilled health workforce. Developing countries struggle to produce, recruit and most importantly retain skilled health workers. There exists a perpetual poor retention cycle in many developing countries. This has a negative bearing on the effort to attain universal access to health care. A myriad of factors affect retention of skilled health workers in developing countries and these factors are examined at length in this book. Appropriate strategies to improve attraction and retention of health workers can only be devised with a vivid understanding of the factors that influence the decision by health workers to join and stay in the sector. This book will be of importance to researchers in the field of Human Resources for Health and Human Resources practitioners.

Health service delivery in Uganda has been decentralised since the 1990s as part of the reform processes. Uganda is among the 57 countries with critical human resource shortages. Several reports provide staggering evidence regarding health worker performance problems in decentralised health services. These include; absenteeism, neglect of patients, drug pilferage and poor staff motivation among others. The Ugandan Ministry of Health annual report of 2007/2008 indicates that some health indicators are either stagnating or deteriorating, thanks to inadequate health worker performance. This book highlights factors influencing the performance of health workers in decentralised services. The author developed a performance management framework for improving health worker performance. The book will be of use to human resources for health practitioners, performance management researchers, general human resources managers and individuals with interest in decentralised health services.