Posting and transfer: key to fostering trust in government health services

Kabir Sheikh, Lynn Freedman, Abdul Ghaffar, Bruno Marchal, Fadi el-Jardali, Jim McCaffery, Jean-Pierre Olivier de Sardan, Mario Dal Poz, Walter Flores, Surekha Garimella, Marta Schaaf

Appropriate deployment or posting and transfer (P&T) of health workers - placing the right people in the right positions at the right time - lies at the heart of fostering communities' faith in government health services and cementing the role of the health system as a core social institution. The authors of this paper have been involved in an ongoing transnational dialogue about P&T practices and determinants. This dialogue seeks to call attention to the importance of P&T as a health system function; to urge donors and policy-makers working in health systems, HRH and public administration governance to consider how to address issues around P&T; and to suggest avenues and approaches to research.P&T is a vexed and unresolved issue in many low- and middle-income countries that requires, above all, political commitment to improving public sector services and to new thinking and research. It holds promise as a focal point for inter-disciplinary collaboration in research and implementation that can inform other areas in HRH and health systems strengthening. Innovative social science and management theorizing, and iterative, locally driven interventions that focus on establishing transparent professional norms and building the credibility of government administration, including the health services, are likely the way forward.