What Is iHRIS Retain?

iHRIS Retain is an open source tool to cost health worker retention interventions and develop retention strategies to be implemented at the district, regional, or national level. The newest product in the CapacityPlus iHRIS Suite of health workforce software, iHRIS Retain is structured around the 2010 WHO Global Policy Recommendations for Increasing Access to Health Workers in Remote and Rural Areas through Improved Retention. The software guides the user through the costing process step by step to capture the needed financial and health workforce data. Based on the inputs entered, iHRIS Retain calculates the total costs and generates reports for each retention intervention and targeted cadre, as well as different packages of interventions and ultimately the aggregated cost of the retention strategy and compares it to available health sector funds. The resulting cost figures can then be shared with relevant stakeholders to discuss and determine the feasibility of the retention interventions within the available fiscal space and to budget for actual implementation.

For a more detailed overview of the modules and data inputs, we encourage you to review the iHRIS Retain User Manual first.

How Was iHRIS Retain Developed?

The development and dissemination of iHRIS Retain version 1.2 was a joint collaboration between CapacityPlus and World Health Organization's (WHO) Department for Health Systems Policies and Workforce.


CapacityPlus is the USAID-funded global project uniquely focused on the health workforce needed to achieve the Millennium Development Goals. A trained, motivated, and supported health workforce provides access to vital health information, services, and commodities. Yet there is a global shortage of 4.3 million health workers and the World Health Organization has named 57 countries facing a health worker crisis. Placing health workers at the center of every effort, CapacityPlus helps countries achieve significant progress in addressing the health worker crisis while also having global impact through alliances with multilateral organizations. CapacityPlus serves partner countries and multilaterals by offering state-of-the-art expertise, models, tools, training, and analyses adapted to each context. These services help countries move closer to having the right health worker in the right place with the right skills and support. The project works with public, nonprofit, faith-based, and for-profit organizations contributing to better human resources for health.

The CapacityPlus Partnership is composed of:

The CapacityPlus Associate Partners are:

  • African Population and Health Research Center (APHRC)
  • Asia-Pacific Action Alliance on Human Resources for Health (AAAH)
  • West African Institute of Post-Graduate Management Studies (CESAG)
  • Partners in Population and Development (PPD)

World Health Organization

The WHO Department for Health Systems Policies and Workforce (HPW) supports member states, and collaborates with development partners and other parts of the WHO Secretariat to improve health systems performance and health outcomes, particularly for poor people. Its main functions are to provide global leadership and strategic direction for WHO in relation to strengthening of national health systems including human resources for health, health systems governance, and improving service delivery and aid effectiveness. The department is concerned with WHO's overall contribution to the attainment of universal health coverage and the transformation of health systems based on primary health care.

Why the Need for iHRIS Retain?

Retention is a complex issue. Many social, professional, and economic factors influence a health worker’s decision to work in rural or other underserved areas. Evidence and experience show that no single retention intervention will be effective, but rather an appropriate combination or “bundle” of complementary and well selected interventions is needed to retain health workers (WHO 2010).

The 2010 WHO Global Policy Recommendations for Increasing Access to Health Workers in Remote and Rural Areas through Improved Retention recommend that in order to motivate health workers to serve in hard-to-reach areas, health service organizations must implement a package of well-selected retention interventions. While country stakeholders recognize the need to address health worker retention, health sector budgets in developing countries are limited.

Questions to consider are: "Which interventions should be included in a health worker retention strategy?" — and more importantly from the feasibility standpoint — "How much will the intervention packages cost?" iHRIS Retain was designed to address this second question.

Who Are the Users of iHRIS Retain?

Instead of depending on external technical assistance, iHRIS Retain was designed with the noneconomist in mind, such as HRH managers and other health officials. One does not need to be an economist to take advantage of the tool and understand and use the results.

What Are the Benefits of iHRIS Retain?

iHRIS Retain helps remove some of the mysticism of health economics by putting a powerful tool in the hands of human resources for health (HRH) managers that yields results close to a traditional costing exercise at a fraction of the cost, without requiring guidance from a senior health economist. The software provides the flexibility of inputting different retention interventions for targeted cadres to obtain the most accurate financial scenarios for decision-making. With its focus on self-reliance, the retention costing tool: promotes country ownership, increases self-sufficiency of host country counterparts in making and acting on HRH decisions, reduces reliance on external technical assistance, and empowers stakeholders to implement economically affordable retention strategies. iHRIS Retain can be used in conjunction with the CapacityPlus Rapid Retention Survey Toolkit. The Rapid Retention Survey Toolkit can be used to determine health worker preferences for the combinations of retention interventions and incentives which would most likely motivate health workers. When the Rapid Retention Survey Toolkit and iHRIS Retain are used together, they can help stakeholders to design a more affordable, cost-effective retention strategy.


  1. World Health Organization. 2010. Global Policy Recommendations: Increasing access to health workers in remote and rural areas through improved retention: global policy recommendations. Geneva, Switzerland: World Health Organization.
  2. United Nations Department of Economic and Social Affairs. 2008. World Urbanization Prospects: The 2007 revision population database. New York, NY: United Nations Department of Economic and Social Affairs.
  3. World Health Organization. 2006. World Health Report: Working together for health. Geneva,Switzerland: World Health Organization.