About iHRIS Retain

Before You Begin

Getting Started

What is a Costing Exercise?

Creating a New Costing Exercise

Step 1 - Financial Information

Budget Section

Step 2 - Select Cadres

Cadre Information

Step 3 - Select Interventions

Education Interventions

A1. Students from Rural Backgrounds

A2. Health Professional Schools Outside of Major Cities

A3. Clinical Rotations in Rural Areas During Studies

A4. Curricula that Reflect Rural Health Issues

A5. Continuous Professional Development for Rural Health Workers

Regulatory Interventions

B1. Enhanced Scope of Practice

B2. Different Types of Health Workers

B3. Compulsory Service

B4. Subsidized Education for Return of Service

Financial Incentive Interventions

C1. Appropriate Financial Incentives

Professional and Personal Support Interventions

D1. Better Living Conditions

D2. Safe and Supportive Working Environment

D3. Outreach Support

D4. Career Development Programs

D5. Professional Networks

D6. Public Recognition

Review Costing Results

Summary of Costing Exercise

Basic Information

Priority Cadres

Reports

Saving Report Graphs

Interventions

File Management

Compare Files

Resources

Feedback


About iHRIS Retain

Version 1.1

Health worker retention is critical to ensure better access to health services. There are many ways health workers can be motivated to accept posts and remain in underserved areas. In order to help make decisions about which retention strategies to pursue, and to advocate for funding support, you will need to know how much different retention options will cost.

To respond to this need CapacityPlus, a human resources for health systems strengthening project of the U.S. Agency for International Development (USAID), and the World Health Organization (WHO), joined together to develop this retention intervention costing tool, iHRIS Retain. This tool, based on the 2010 WHO Global Policy Recommendations for Retention, will allow you to determine the costs of different combinations of interventions across various cadres of the health workforce at a national, regional, district or facility level. Stakeholders can use the costing results to determine the economic feasibility of different retention intervention scenarios.

A decision maker within the organization can analyze this data to answer key staff retention questions, such as:

  1. What might be affecting the performance of our rural and urban health workers?
  2. Is the cause of health worker turnover isolated to a type of cadre and/or region or does it affect all workers regardless of cadre or location?
  3. What types of incentives should be considered to help retain health workers?
  4. Factoring in inflation, currency fluctuations and donor contributions, what will our organization be spending in country “X” over the next few years?

You do not need to be a health economist to use this tool; it will guide you through each step of the costing process.

Welcome to the iHRIS Retain User's Manual!


Before You Begin

Before you begin using iHRIS Retain, consider the following:

  1. Most use the web version of the software.  However, there is an offline version. If you expect that you will need access to your Costing Exercises and projects offline, or on poor Internet connections, you will likely want to use the offline version.
  2. iHRIS Retain is constructed to use standard web technologies. This means it looks and operates like a sophisticated web application.  Although it should work with most modern web browsers, it has only been tested in the following: IE7 and IE8, Firefox, Chrome, and Safari.
  3. Some of the terminology used in this manual and the software itself may be new to you or the people with whom you are working.  The Glossary of Terminology is located at the end of the document and explains and defines technical terms.  If you see any phrase with a (?) beside it, clicking the (?) will take you directly to its definition.
  4. For the user who does not read English, there are translations of this guide and of the software itself.
  5. The version of the software you are using will determine the version of the guide you are using.


Getting Started

When you first visit the Retain landing page, you will see several options for navigating the software.  At the very top of the screen there are tabs labeled: “Home”, “About iHRIS Retain”, “Resources” “Feedback”, “iHRIS Website”, and “Help”.  These are all links that contain valuable information about the tool such as feedback from users and links to our help documentation.

To begin setting up your first project, select Setup Costing Exercise from the iHRIS Retain landing page.

Fig. 1


What is a Costing Exercise?

Costing exercises allow the user to quickly determine the costs associated with different combinations of intervention activities at a national, regional, or district level, depending on the particular health workers targeted.  Because there are many ways in which health workers can be motivated to work in under-served areas, in order to help make decisions about which retention strategies to pursue, you will need to know how much different intervention activities will cost.

The interventions fall under four categories: education, regulation, financial incentives, and personal and professional support. Costing exercises allow you to project these costs and adjust the components used to design a corresponding budget.  

Retain is powerful because it takes the intervention strategies you design and projects the expected costs outwards, for multiple years, while factoring in local inflation, expected growth, currency fluctuations and more. This makes it an invaluable budgeting tool for project managers, Ministries of Health, and donors alike.


Creating a New Costing Exercise

In this section you will  learn how to setup a new Costing Exercise from the beginning.

After clicking through Setup Costing Exercise on the landing page, you will be taken to the next screen where you will see several options related to naming and configuring a new Costing Exercise file. (As the instructions on screen indicate, any field marked with * is mandatory and cannot be skipped.)

Fig. 2

You will need to Name this Exercise, and, while optional, it is recommended that you add a Description of the project.

For Date of Exercise enter the date that the project was started on.  This is important in case the costs of your project change over time.  Change in costs might be the result of new information, inflation, a new donor, or new partners.   It is important to keep a record of when your projections were made so that you know what stage of your project your projections reflect.

For Costing Start Year, set the date that the Costing Exercise itself begins. This is the date that your theoretical project would begin.

For Costing Timeframe (in years), you are projecting out the length of time of the project.  This is the time frame you are using to project your costings. (Example - from today until one year from today.)


Step 1 - Financial Information

Once you have completed naming your file and and setting the timeframe, you will need to complete three more steps. These steps are the actual parameters of the costing exercise.  The first is the Financial Information that will be used on which the costing analysis will be based.

Budget Section

Here, you define the overall amount of money available to your project using five indicators. This section contains data fields as seen below in Figure 4 for entering values that correspond with the number of years you defined in the previous section.  In this example the Costing Exercise was set up for a total of two years.

Fig. 3

The Currency section allows the user to set the local currency.  If your entire budget is in dollars, you’ll want to want to set is as such (even though you’ll be essentially telling the system to convert from dollars to dollars).

The Total Health Sector Expenditures/Budget is the area for defining the amount, in US dollars, that your project has to spend in the corresponding year.

The Total Recurrent Expenditures/Budget is the area for items in your budget that will recur from year to year. For example, the rent for a facility, Internet costs, or employee visas might all be considered recurrent expenditures.

The Total Personnel Expenditures/Budget is the fiscal amount the user wishes to assign to his or her personnel staff for the given fiscal year.  Example - we have six employees whom have a gross cost of $12,000 per year. Our personnel cost would then be $72,000.

The Donor Contributions to Personnel Costs section is for adding a dollar amount that the user’s donor is contributing towards costs of personnel directly.  This amount would calculated from your personnel costs, allowing the user to know how much their personnel costs in total, as well as how much it costs them directly.

The Exchange Rate section allows the user to define the current exchange rate from the local currency, set above in the Budget Section, to US dollars. The user is also able to specify the date from which the exchange rate was selected.

Many projects decide to use a specific date’s exchange rate for their costing exercises.  This is because it is impossible to predict what the actual rates will be over time; rates change daily with global financial markets.

Inflation is the rise in the general level of prices of goods and services in an economy over a period of time. If the user knows it and cares to include it, they can use the Inflation section they can project the Inflation rate over time, so that it can be used to help project long-term costs.


Step 2 - Select Cadres

Retain has the option to define Cadres of health workers. A cadre is a job classification in the health sector.   Different countries will have different levels of granularity for cadres.  An example set of cadres would be "Nurse", "Midwife", "Doctor", "Pharmacist" or "Allied Health Professional".  This allows the user to segment their staff appropriately.

Cadre Information

In Retain, each cadre can have up to four Filled Positions, or the number of paid staff in those roles. The positions available are: Filled (Urban), Approved (Urban), Filled (Rural) and Approved (Rural). Filled positions represent staff that are currently employed; approved positions represent staff who are budgeted for but may not yet be hired.

There is also an area for projecting the number of filled positions, either as a pre-determined number, or  as a percentage of the number of approved positions.

Step 3 - Select Interventions

Selecting interventions is what Retain is primarily designed for. Interventions allow the decision maker to decide what preemptive actions can be taken to prevent the turnover of health workers.

Retention is a complex issue. Many social, professional, and economic factors influence a health worker’s decision to work in a rural or other under-served area. Evidence and experience show that no single retention intervention will be effective, but rather an appropriate combination or “bundle” of complementary interventions is needed to retain health workers [2010 WHO Policy Recommendations for Rural Retention].

The user will select as many of the retention interventions as are appropriate to their specific context. Each intervention will need to be configured individually.

Education Interventions

Education is the foundation for producing health workers who are competent and motivated. Thus, it is important to train them appropriately in the locations they are and to use methods and curricula that will influence their future practice.

It is also important to support the health worker's need for continued learning, particularly in the isolated areas where access to knowledge and information will be challenging.

A1. Students from Rural Backgrounds

Develop rural recruitment plan

The rural recruitment plan is an intervention targeting students from rural backgrounds.  The exercise is configured to allow the decision maker to design workshops and consultations intended to improve the confidence and capability of health workers.

To use this intervention:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Set the number of workdays and respective number of consultants.
  3. Plan review/emphasis workshops for health workers and associated costs.
  4. Specify other costs associated with the recruitment plan.

You will notice that this section allows the user to define a number of the costs related to organizing these retention workshops, including the costs of the venue, consultants and travel. To successfully use Retain, the user should fill in all fields as accurately as possible.

There is a field for including ‘other costs’. If there are other costs to be considered that do not fit into the other categories, please enter it.

Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Provide ongoing management of program

Ongoing management of programs is a very important part of a successful retention strategy.  Here the user can design such a strategy.

To use this intervention:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Set a dollar amount for the manager of the selected cadre’s monthly salary.
  3. Set whether the manager is working full or partial time.  This number should be a percentage of time worked.  If the manager is working full-time this should be 100%.
  4. Set a dollar amount for the supporting staff’s monthly salary.
  5. Set whether the supporting staff is working full or partial time.  This number should be a percentage of time worked.  If the supporting staff member is working full-time this should be 100%.
  6. Set a dollar amount for any other staff member’s monthly salary.
  7. Set a dollar amount for any other staff member’s supporting staff  working full or partial time.  This number should be a percentage of time worked.  If the supporting staff member is working full-time this should be 100%.
  8. Include the cost of any office supplies or communications related to on-going management of program.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Conduct regular recruitment visits

To calculate the costs of regular site recruitment visits, use this intervention.

To use this intervention:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Enter the number of trips your organization plans to organize to visit the cadre.
  3. Enter the budget for transportation costs to the site.
  4. Enter the budget for local transportation while at the site.
  5. Enter the budget for lodging and per diem per trip.
  6. Enter the amount each recruiter earns per trip.

There is a field for calculating ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Provide educational support programs for students from rural areas

To calculate the costs of an intervention that provides support programs in the rural area where health workers are, use this activity.

To use it:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Enter the total number of students.
  3. Enter the tuition costs for each program in which the student is enrolled.
  4. Enter the cost of housing per student. 
  5. Enter the budget for stipends per student.
  6. Enter the budget for any other support offered to students.

Provide stipend for students from rural areas

This section allows you to design interventions that provide stipends for students from rural areas.

To use this intervention:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Enter the number of students.
  3. Enter the cost of tuition for each program, per student.
  4. Enter the cost of housing per student.
  5. Enter the stipend allotted per student.
  6. Enter the dollar amount for any other support offered to each student.

There is a field for calculating ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Additional activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you simply wish to customize the interventions even more, the Additional Activities area is designed to allow you to essentially design your own interventions for students from rural backgrounds. Simply name your activity, select the cadres to target, then use the other costs area to enter annual costs for whatever activity you desire.

A2. Health Professional Schools Outside of Major Cities

Construct new facilities (including school, dormitory, staff housing, etc.)

This section allows users to budget the costs associated with financing the construction of a new facility.

To use this intervention:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Enter the name of the Facility or Location.
  3. Enter the estimated construction cost per square foot (m2).
  4. Enter the estimated size of the training facility in square feet (m2).
  5. Enter the estimated size of student dorms in square feet (m2).
  6. Enter the estimated size of staff housing units in square feet (m2).
  7. Enter the estimated size of the clinical facilities in square feet (m2). 

Equip/Furnish School

This section allows the user to calculate the costs associated with equipping or furnishing a school.

First, as with all the other intervention activities, you’ll want to select the cadre the activity relates to.  Next, you’ll notice that there are four equipment options to configure: Computer, Furniture, Electrical and Other Training Equipment. Each of these items has the option to enter the total cost or to alternatively enter itemized costs.

Entering the total cost is simple, and assumes that you’ve already calculated the itemized costs elsewhere.  However, if you do need to enter the costs in an itemized format, in the field titled Do you want to enter itemized costs?” simply select yes and the form will change appropriately.

To enter the itemized costs,  input the cost per unit, and the number of units required. Each of the equipment options has default unit titles, but you can choose to enter your own using the Other (Specify) field.

Equip/furnish Dorms

This section allows you to calculate the costs associated with equipping a dorm room. Enter either the total cost for furnishing the dorm or the itemized costs.  

The default itemized fields are for tables, desks, chairs, beds, or shelves and cabinets.  Of course, there is also the option for entering any other unspecified item the user wants.

Equip/furnish attached health facility

This section allows the user to calculate the costs associated with equipping or furnishing a health facility.

First, as with all the other intervention activities, you’ll want to select the cadre the activity relates to.  Next, you’ll notice that there are four equipment options to configure: Computer, Furniture, Electrical and Other Training Equipment. Each of these items has the option to enter the total cost or to alternatively enter itemized costs.

Entering the total cost is simple, and assumes that you have already calculated the itemized costs elsewhere.  However, if you do need to enter the costs in an itemized format, in the field titled Do you want to enter itemized costs?” simply select yes and the form will change appropriately.

To enter the itemized costs, simply input the cost per unit, and number of units required. Each of the equipment options has default unit titles, but feel free to enter your own using the Other (Specify) field.

Ongoing management for attached health facility

This section allows you to calculate the costs associated with the ongoing management of the attached health facility.

To use this section:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Set a dollar amount for the Dean or Director’s monthly salary.
  3. Set whether the manager is working full or partial time.  This number should be a percentage of time worked.  If the manager is working full-time this should be 100%.
  4. Repeat the previous steps for the Assistant Director, support staff and other staff.
  5. Set the dollar amount for their monthly salary.
  6. Set whether they are working full or partial time.  This number should be a percentage of time worked.  If the supporting staff member is working full-time this should be 100%.
  7. Include the cost of any office supplies or communications related to on-going management of the facility.
  8. If there are other items you need to calculate that have not been included, you can simply create fields for as many as you’d like by using the Add Other option.

Maintenance/repair for all facilities

This section allows you calculate the long term costs for maintaining the facilities configured in the previous areas of this step.

To use this section:

  1. First, select the cadres the estimates relate to. (The cadres to select from are the same that were listed in Step 2.)
  2. Use the Reserve/buffer for repairs option to enter a dollar amount that will be reserved for the annual repairs of the facility. This ‘buffer’ is intended to be for unexpected repairs (for example: computer viruses, roof leaks or a broken printer).
  3. Use the Ongoing maintenance costs option to enter a dollar amount that will be dedicated to the long-term upkeep of the facilities (for example: replacements for lighting fixtures, tools, the cost of fuel for a backup generator etc.).

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you simply wish to further customize the interventions, the Additional Activities area is designed to allow you to design your own interventions for students from rural backgrounds.

  1.  Name your activity
  2. Select the cadres to targe
  3. Use the other costs area to enter annual costs for whatever activity you desire.

A3. Clinical Rotations in Rural Areas During Studies

Design and plan program

This activity is configured to allow the user to design programs for clinical rotations in rural areas.

To use this intervention:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Set the number of workdays and respective number of consultants.
  3. Plan review/emphasis workshops for health workers and associated costs.
  4. Specify other costs associated with the recruitment plan.

Notice that this section allows the user to define a number of the related costs, including the costs of the venue, consultants and travel. To successfully use Retain, the user should fill in all of these fields as accurately as possible.

There is a field for including ‘other costs’ that do not fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Provide ongoing management of program

Ongoing management of programs is a very important part of a successful retention strategy.  In this activity,  the user can design such a strategy.

To use this intervention activity:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Set a dollar amount for the manager of the selected cadre’s monthly salary.
  3. Set whether the manager is working full or partial time.  This number should be a percentage of time worked.  If the manager is working full-time this should be 100%.
  4. Set a dollar amount for the supporting staff’s monthly salary.
  5. Set whether the supporting staff is working full or partial time.  This number should be a percentage of time worked.  If the supporting staff member is working full-time this should be 100%.
  6. Set a dollar amount for any other staff member’s monthly salary.
  7. Set a dollar amount for any other staff member’s supporting staff is working full or partial time.  This number should be a percentage of time worked.  If the supporting staff member is working full-time this should be 100%.
  8. Include the cost of any office supplies or communications related to on-going management of program.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Support student cost of rural rotations

This section allows the user to calculate the cost of their student’s rural rotations.

To configure this activity:

  1. Select the cadres to be targeted.
  2. Enter the number of students per year.
  3. Enter the budgeted travel allowances per student.
  4. Enter the budgeted accommodation allowance per student.
  5. If there are other costs, you can enter them by selecting Add Other Costs.

Training for mentors and supervisors during rotation

To calculate the costs of training mentors and supervisors during rotation, enter totals into this section.

Instructions for using this section:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Enter the number of deliveries that will be made each year.
  3. Enter the corresponding values for Participant costs, Facilitator costs, and Venue costs.
  4. Enter any other costs.

This section includes fields that may need additional explanation:

  1. Number of participants (per delivery) refers to the number of participants expected for each year of the intervention strategy defined in Step 1.
  2. Travel and transport (per person) refers to the expected cost of transporting an individual participant.
  3. Lodging and per diem (per person) refers to the expected cost of lodging an individual. This should include any travel per diems that would be offered to the individual.
  4. Training materials/stationary (per person) refers to the expected cost of training an individual participant.
  5. Number of facilitator (per delivery) refers to the number of facilitators expected for each year of the intervention strategy defined in Step 1.
  6. Travel and transport (per person) refers to the estimated cost of transportation of each facilitator.
  7. Lodging and per diem (per person) refers to the estimated cost of lodging a facilitator. This should include any travel per diems that would be offered to the individual.
  8. Fees (per facilitator) refers to the estimated fees beyond travel and lodging that the facilitator may charge for his or her services.
  9. There is also a section for budgeting the cost of the lunches for the participants of the delivery. Note: this is the aggregate cost of the lunch, and not the cost per individual.
  10. Likewise, the venue cost is the cost of a full rental, not the cost per individual.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you simply wish to customize the interventions even more, the Additional Activities area is designed to allow you to design your own interventions for students from rural backgrounds.

  1. Name your activity
  2. Select the cadres to target
  3. Use the other costs area to enter annual costs for whatever activity you desire.

A4. Curricula that Reflect Rural Health Issues

Development of rural health curricula:

This activity is configured to allow the user to design programs for the development of rural health curricula.

To use this intervention:

  1. Select the cadres this intervention activity is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Set the number of workdays and respective number of consultants or staff.
  3. Plan review/emphasis workshops for health workers and associated costs.
  4. Specify other costs associated with the recruitment plan.

Notice that this section allows the user to define a number of ther costs related to the development of curricula, including the costs of the venue, consultants and travel. To successfully use Retain, the user should fill in all these fields as accurately as possible.

There is a field for including ‘other costs’ that do not fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Disseminate new materials to instructors/trainers

This section is for projecting the costs of distributing new materials to instructors and trainers.

Instructions for using this section:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Enter the number of deliveries that will be made each year.
  3. Enter the corresponding values for Participant costs, Facilitator costs, and Venue costs.
  4. Enter any other costs.

This section includes fields that may need additional explanation:

  1. Number of participants (per delivery) refers to the number of participants expected for each year of the intervention strategy defined in Step 1.
  2. Travel and transport (per person) refers to the expected cost of transporting an individual participant.
  3. Lodging and per diem (per person) refers to the expected cost of lodging an individual. This should include any travel per diems that would be offered to the individual.
  4. Training materials/stationary (per person) refers to the expected cost of training an individual participant.
  5. Number of facilitators (per delivery) refers to the number of facilitators expected for each year of the intervention strategy defined in Step 1.
  6. Travel and transport (per person) refers to the estimated cost of transportation of each facilitator.
  7. Lodging and per diem (per person) refers to the estimated cost of lodging a facilitator. This should include any travel per diems that would be offered to the individual.
  8. Fees (per facilitator) refers to the estimated fees beyond travel and lodging that the facilitator may charge for his or her services.
  9. There is also a section for budgeting the cost of the lunches for the participants of the delivery. Note: this is the aggregate cost of the lunch, and not the cost per individual.
  10. Likewise, the venue cost is the cost of a full rental, not the cost per individual.

There is a field for including ‘other costs’ that do not fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Prepare new training/education materials

This activity allows for the budgeting of costs related to the preparation of new training materials.  

To use this activity:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Input the number of workdays for the activity.
  3. Input the cost per day, per consultant or staff.

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you simply wish to further customize the interventions, the Additional Activities area is designed to allow you to design your own interventions for students from rural backgrounds.

  1. Name your activity
  2. Select the cadres to target
  3. Use the other costs area to enter annual costs for whatever activity you desire.

A5. Continuous Professional Development for Rural Health Workers

Design of new education programs for professional development

This activity is configured to allow the user to design education programs for the professional development of health workers.

To use this intervention:

  1. Select the cadres this intervention activity is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Set the number of workdays and respective number of consultants.
  3. Plan review/emphasis workshops for health workers and associated costs.
  4. Specify other costs associated with the recruitment plan.

Notice that this section allows the user to define a number of other costs related to this intervention. To successfully use Retain, the user should fill in all these fields as accurately as possible.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Delivery of professional development programs

This section is for projecting the costs of distributing development programs to health workers.

Instructions for using this section:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Enter the number of deliveries that will be made each year.
  3. Enter the corresponding values for Participant costs, Facilitator costs, and Venue costs.
  4. Enter any other costs.

This section includes fields that may need additional explanation:

  1. Number of participants (per delivery) refers to the number of participants expected for each year of the intervention strategy defined in Step 1.
  2. Travel and transport (per person) refers to the expected cost of transporting an individual participant.
  3. Lodging and per diem (per person) refers to the expected cost of lodging an individual. This should include any travel per diems that would be offered to the individual.
  4. Training materials/stationary (per person) refers to the expected cost of training an individual participant.
  5. Number of facilitator (per delivery) refers to the number of facilitators expected for each year of the intervention strategy defined in Step 1.
  6. Travel and transport (per person) refers to the estimated cost of transportation of each facilitator.
  7. Lodging and per diem (per person) refers to the estimated cost of lodging a facilitator. This should include any travel per diems that would be offered to the individual.
  8. Fees (per facilitator) refers to the estimated fees beyond travel and lodging that the facilitator may charge for his or her services.
  9. There is also a section for budgeting the cost of the lunches for the participants of the delivery. Note: this is the aggregate cost of the lunch, and not the cost per individual.
  10. Likewise, the venue cost is the cost of a full rental, not the cost per individual.

There is a field for including ‘other costs’ that do not fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Support health workers to attend existing training programs (at universities/colleges)

This section allows the user to calculate the cost of supporting health workers so that they may attend additional training programs at universities or colleges.

To configure this activity:

  1. Select the cadres to be targeted.
  2. Enter the number of students attending such programs per year.
  3. Enter the budgeted travel allowance per student.
  4. Enter the budgeted accommodation allowance per student.

There is a field for including ‘other costs’ that do not fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you simply wish to customize the interventions even more, the Additional Activities area is designed to allow you to essentially design your own interventions for students from rural backgrounds. Simply name your activity, select the cadres to target, then use the other costs area to enter annual costs for whatever activity you desire.

Regulatory Interventions

Regulatory measures encompass any government control exercised through legislative, administrative, legal or policy tools. They can range from parliamentary laws/statutes to state regulations, policies and guidelines developed by line ministries and program guidance.

Interventions that require regulatory measures are related to expanding the scope of practice of working with rural health workers.

B1. Enhanced Scope of Practice

Design of Enhanced Scope of Practice:

This activity is configured to allow the user to budget the costs of designing enhanced practices for health workers.

To use this intervention:

  1. Select the cadres the intervention activity is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Set the number of workdays and respective number of consultants.
  3. Plan review/emphasis workshops and associated costs.
  4. Specify other costs associated with the recruitment plan.

Notice that this section allows the user to define a number of other  costs related to this intervention. To successfully use Retain, the user should fill in all these fields as accurately as possible.

There is a field for including ‘other costs’ that do not fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Prepare Training for health workers to enhance scope of practice

This activity allows for budgeting the cost of preparing enhanced scope training materials.  

To use this activity:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Input the number of workdays for the activity.
  3. Input the cost per day, per consultant or staff member.

Delivery of Training

This section is for projecting the costs of delivering training to health workers.

Instructions for using this section:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Enter the number of deliveries that will be made each year.
  3. Enter the corresponding values for Participant costs, Facilitator costs, and Venue costs.
  4. Enter any other costs.

This section includes fields that may need additional explanation:

  1. Number of participants (per delivery) refers to the number of participants expected for each year of the intervention strategy defined in Step 1.
  2. Travel and transport (per person) refers to the expected cost of transporting an individual participant.
  3. Lodging and per diem (per person) refers to the expected cost of lodging an individual. This should include any travel per diems that would be offered to the individual.
  4. Training materials/stationary (per person) refers to the expected cost of training an individual participant.
  5. Number of facilitator (per delivery) refers to the number of facilitators expected for each year of the intervention strategy defined in Step 1.
  6. Travel and transport (per person) refers to the estimated cost of transportation of each facilitator.
  7. Lodging and per diem (per person) refers to the estimated cost of lodging a facilitator. This should include any travel per diems that would be offered to the individual.
  8. Fees (per facilitator) refers to the estimated fees beyond travel and lodging that the facilitator may charge for his or her services.
  9. There is also a section for budgeting the cost of the lunches for the participants of the delivery. Note: this is the aggregate cost of the lunch, and not the cost per individual.
  10. Likewise, the venue cost is the cost of a full rental, not the cost per individual.

There is a field for including ‘other costs’ that do not fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Training for supervisors to support enhanced scope

This section is for projecting the costs of distributing training materials to supervisors.

Instructions for using this section:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Enter the number of deliveries that will be made each year.
  3. Enter the corresponding values for Participant costs, Facilitator costs, and Venue costs.
  4. Enter any other costs.

This section includes fields that may need additional explanation:

  1. Number of participants (per delivery) refers to the number of participants expected for each year of the intervention strategy defined in Step 1.
  2. Travel and transport (per person) refers to the expected cost of transporting an individual participant.
  3. Lodging and per diem (per person) refers to the expected cost of lodging an individual. This should include any travel per diems that would be offered to the individual.
  4. Training materials/stationary (per person) refers to the expected cost of training an individual participant.
  5. Number of facilitator (per delivery) refers to the number of facilitators expected for each year of the intervention strategy defined in Step 1.
  6. Travel and transport (per person) refers to the estimated cost of transportation of each facilitator.
  7. Lodging and per diem (per person) refers to the estimated cost of lodging a facilitator. This should include any travel per diems that would be offered to the individual.
  8. Fees (per facilitator) refers to the estimated fees beyond travel and lodging that the facilitator may charge for his or her services.
  9. There is also a section for budgeting the cost of the lunches for the participants of the delivery. Note: this is the aggregate cost of the lunch, and not the cost per individual.
  10. Likewise, the venue cost is the cost of a full rental, not the cost per individual.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you wish to further customize the interventions, the Additional Activities area is designed to allow you to design your own interventions for students from rural backgrounds.

  1. Name your activity
  2. Select the cadres to target
  3. Use the other costs area to enter annual costs for whatever activity you desire.

B2. Different Types of Health Workers

Consultations regarding new cadres

This activity allows you to cost consultations regarding new cadres.

To use this intervention:

  1. Select the cadres the intervention activity is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Set the number of workdays and respective number of consultants.
  3. Plan review/emphasis workshops and associated costs.
  4. Specify other costs associated with the recruitment plan.

Notice that this section allows the user to define “Other Costs” related to this intervention. To successfully use Retain, the user should fill in all these fields as accurately as possible.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Develop new cadre proposal and plan roll-out

Should you need to develop a new cadre, this activity allows the user to cost the development of the proposal and subsequent roll-out.

To configure this activity:

  1. Select the cadres the intervention activity is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Enter the number of days needed to define the scope of practice, placement plans, pre-qualifications, training curriculum, and implementation plan respectively.
  3. Enter a number for any additional days needed.
  4. Enter a dollar amount for the cost per day of each consultant or staff member.
  5. Enter the number of participants for a Workshop, their travel allowances and per diems and the cost of lunch or venue access per person.
  6. Enter any other workshop costs, per person.

Design training for new cadre

This activity allows you to calculate the costs of designing training programs for new cadres.  

To use this activity:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Input the number of workdays for the activity.
  3. Input the cost per day, per consultant or staff member.

Conduct training to develop new cadre (government led training)

This section is for projecting the costs of conducting trainings led by the government.

Instructions for using this section:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Enter the number of deliveries that will be made each year.
  3. Enter the corresponding values for Participant costs, Facilitator costs, and Venue costs.
  4. Enter any other costs.

This section includes fields that may need additional explanation:

  1. Number of participants (per delivery) refers to the number of participants expected for each year of the intervention strategy defined in Step 1.
  2. Travel and transport (per person) refers to the expected cost of transporting an individual participant.
  3. Lodging and per diem (per person) refers to the expected cost of lodging an individual. This should include any travel per diems that would be offered to the individual.
  4. Training materials/stationary (per person) refers to the expected cost of training an individual participant.
  5. Number of facilitator (per delivery) refers to the number of facilitators expected for each year of the intervention strategy defined in Step 1.
  6. Travel and transport (per person) refers to the estimated cost of transportation of each facilitator.
  7. Lodging and per diem (per person) refers to the estimated cost of lodging a facilitator. This should include any travel per diems that would be offered to the individual.
  8. Fees (per facilitator) refers to the estimated fees beyond travel and lodging that the facilitator may charge for his or her services.
  9. There is also a section for budgeting the cost of the lunches for the participants of the delivery. Note: this is the aggregate cost of the lunch, and not the cost per individual.
  10. Likewise, the venue cost is the cost of a full rental, not the cost per individual.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Provide support during education (at university or training center)

This section allows you to design interventions that provide support for health workers during additional education.

To use this intervention:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Enter the number of students.
  3. Enter the cost of tuition for each program, per student.
  4. Enter the cost of housing per student.
  5. Enter the stipend allotted per student.
  6. Enter the dollar amount for any other support offered to each student.

There is a field for calculating ‘other costs’ that do not fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Training for supervisors to support new cadre

This section is for projecting the costs of conducting trainings for supervisors to support the new cadre.

Instructions for using this section:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Enter the number of deliveries that will be made each year.
  3. Enter the corresponding values for Participant costs, Facilitator costs, and Venue costs.
  4. Enter any other costs.

This section includes fields that may need additional explanation:

  1. Number of participants (per delivery) refers to the number of participants expected for each year of the intervention strategy defined in Step 1.
  2. Travel and transport (per person) refers to the expected cost of transporting an individual participant.
  3. Lodging and per diem (per person) refers to the expected cost of lodging an individual. This should include any travel per diems that would be offered to the individual.
  4. Training materials/stationary (per person) refers to the expected cost of training an individual participant.
  5. Number of facilitator (per delivery) refers to the number of facilitators expected for each year of the intervention strategy defined in Step 1.
  6. Travel and transport (per person) refers to the estimated cost of transportation of each facilitator.
  7. Lodging and per diem (per person) refers to the estimated cost of lodging a facilitator. This should include any travel per diems that would be offered to the individual.
  8. Fees (per facilitator) refers to the estimated fees beyond travel and lodging that the facilitator may charge for his or her services.
  9. There is also a section for budgeting the cost of the lunches for the participants of the delivery. Note: this is the aggregate cost of the lunch, and not the cost per individual.
  10. Likewise, the venue cost is the cost of a full rental, not the cost per individual.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you simply wish to customize the interventions even more, the Additional Activities area is designed to allow you to essentially design your own interventions for students from rural backgrounds. Simply name your activity, select the cadres to target, then use the other costs area to enter annual costs for whatever activity you desire.

B3. Compulsory Service

Develop compulsory service policy

This activity allows you to cost the development of compulsory service policies.

To use this intervention:

  1. Select the cadres the intervention activity is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Set the number of workdays and respective number of consultants.
  3. Plan review/emphasis workshops and associated costs.
  4. Specify other costs associated with the recruitment plan.

Notice that this section allows the user to define a number of other costs related to this intervention. To successfully use Retain, the user should fill in all these fields as accurately as possible.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Training for mentors/supervisors

This activity will help you cost the trainings of mentors and supervisors of the compulsory policies.

Instructions for using this section:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Enter the number of deliveries that will be made each year.
  3. Enter the corresponding values for Participant costs, Facilitator costs, and Venue costs.
  4. Enter any other costs.

This section includes fields that may need additional explanation:

  1. Number of participants (per delivery) refers to the number of participants expected for each year of the intervention strategy defined in Step 1.
  2. Travel and transport (per person) refers to the expected cost of transporting an individual participant.
  3. Lodging and per diem (per person) refers to the expected cost of lodging an individual. This should include any travel per diems that would be offered to the individual.
  4. Training materials/stationary (per person) refers to the expected cost of training an individual participant.
  5. Number of facilitator (per delivery) refers to the number of facilitators expected for each year of the intervention strategy defined in Step 1.
  6. Travel and transport (per person) refers to the estimated cost of transportation of each facilitator.
  7. Lodging and per diem (per person) refers to the estimated cost of lodging a facilitator. This should include any travel per diems that would be offered to the individual.
  8. Fees (per facilitator) refers to the estimated fees beyond travel and lodging that the facilitator may charge for his or her services.
  9. There is also a section for budgeting the cost of the lunches for the participants of the delivery. Note: this is the aggregate cost of the lunch, and not the cost per individual.
  10. Likewise, the venue cost is the cost of a full rental, not the cost per individual.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Support (housing, stipend, other) during compulsory service

This section allows you to design interventions that provide support for health workers during compulsory service.

To use this intervention:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Enter the number of students.
  3. Enter the cost of tuition for each program, per student.
  4. Enter the cost of housing per student.
  5. Enter the stipend allotted per student.
  6. Enter the dollar amount for any other support offered to each student.

There is a field for calculating ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Relocation support at end of service

This activity allows you to budget for costs of offering relocation support to health workers at the end of compulsory service assignments.

To use this activity:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Enter the number of students.
  3. Enter the relocation cost for each new posting.
  4. Enter any other relocation costs per student.

There is a field for calculating ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Conduct compliance monitoring

This activity is for tracking the costs of conducting compliance monitoring.

To configure this activity:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Enter the number of compliance monitoring trips per year.
  3. Enter the number of travelers per trip. If you are hiring a driver, include them here.
  4. Likewise, enter the budget for lodging and per diems per person, per trip. Again, you will need to include any hired drivers.
  5. Enter any other costs per person per trip.

There is a field for calculating ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Provide ongoing management of program

Use this section to calculate the cost of providing ongoing management of the compulsory service program.

To use this intervention:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Set a dollar amount for the manager of the selected cadre’s monthly salary.
  3. Set whether the manager is working full or partial time.  This number should be a percentage of time worked.  If the manager is working full-time this should be 100%.
  4. Set a dollar amount for the supporting staff’s monthly salary.
  5. Set whether the supporting staff is working full or partial time.  This number should be a percentage of time worked.  If the supporting staff member is working full-time this should be 100%.
  6. Set a dollar amount for any other staff member’s monthly salary.
  7. Set a dollar amount for any other staff member’s supporting staff is working full or partial time.  This number should be a percentage of time worked.  If the supporting staff member is working full-time this should be 100%.
  8. Include the cost of any office supplies or communications related to on-going management of program.

There is a field for including ‘other costs’ that do not fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you simply wish to customize the interventions even more, the Additional Activities area is designed to allow you to essentially design your own interventions for students from rural backgrounds. Simply name your activity, select the cadres to target, then use the other costs area to enter annual costs for whatever activity you desire.

B4. Subsidized Education for Return of Service

Design subsidized education policy

This activity allows you to cost the development of education policies.

To use this intervention:

  1. Select the cadres the intervention activity is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Set the number of workdays and respective number of consultants for the consultation.
  3. Plan review/emphasis workshops and associated costs.
  4. Specify other costs associated with the recruitment plan.

Notice that this section allows the user to define a number of other costs related to this intervention. To successfully use Retain, the user should fill in all these fields as accurately as possible.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Provide tuition and other subsidies

If your education subsidy for return of service program includes providing tuition for health workers, you would include those details here.

To configure this intervention:

  1. Select the cadres the intervention activity is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Enter the number of students.
  3. Enter the amount budgeted for tuition subsidies.
  4. Enter the accommodation allowance per student.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Conduct compliance monitoring

This activity is for tracking the costs of conducting compliance monitoring of the subsidized education program.

To configure this activity:

  1. Select the cadres the intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Enter the number of compliance monitoring trips per year.
  3. Enter the number of travelers per trip. If you are hiring a driver, include them here.
  4. Likewise, enter the budget for lodging and per diems per person, per trip. Again, you will need to include any hired drivers.
  5. Enter any other costs per person per trip.

There is a field for calculating ‘other costs’ that do not fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Provide ongoing management of program

Use this section to calculate the cost of providing ongoing management of the subsidized education program.

To use this intervention:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Set a dollar amount for the manager of the selected cadre’s monthly salary.
  3. Set whether the manager is working full or partial time.  This number should be a percentage of time worked.  If the manager is working full-time this should be 100%.
  4. Set a dollar amount for the supporting staff’s monthly salary.
  5. Set whether the supporting staff is working full or partial time.  This number should be a percentage of time worked.  If the supporting staff member is working full-time this should be 100%.
  6. Set a dollar amount for any other staff member’s monthly salary.
  7. Set a dollar amount for any other staff member’s supporting staff is working full or partial time.  This number should be a percentage of time worked.  If the supporting staff member is working full-time this should be 100%.
  8. Include the cost of any office supplies or communications related to on-going management of program.

There is a field for including ‘other costs’ that do not fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you wish to further customize the interventions, the Additional Activities area is designed to allow you to design your own interventions for students from rural backgrounds.

  1. Name your activity
  2. Select the cadres to target
  3. Use the other costs area to enter annual costs for whatever activity you desire.

Financial Incentive Interventions

For the purpose of these exercises, financial incentives encompass all benefits paid or provided to health workers to encourage work in remote or rural areas. These incentives can include monetary bonuses, in-kind benefits (a free house or vehicle), and any other benefits that reduce risks (also known as opportunity costs) associated with working in rural areas.

C1. Appropriate Financial Incentives

Conduct health worker research and consultations regarding financial incentives

This activity is configured to allow the user to budget the costs of conducting research into financial incentives for health workers.

To use this intervention:

  1. Select the cadres the intervention activity is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Set the number of workdays and respective number of consultants.
  3. Plan review/emphasis workshops and associated costs.
  4. Specify other costs associated with the recruitment plan.

Notice that this section allows the user to define a number of other costs related to this intervention. To successfully use Retain, the user should fill in all these fields as accurately as possible.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Provide financial incentives

After research has been conducted, financial incentives can be provided accordingly.

To use this activity:

  1. Select the cadres the intervention activity is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Input the number of health workers from the cadre.
  3. Input the dollar amount budgeted for additional salary per health worker.
  4. Input the dollar amount budgeted for offsetting rural hardship per health worker.
  5. Input the number of paid vacations allowed per health worker.
  6. Input the housing allowance budget per health worker. This should be a dollar amount.
  7. Input the transportation budget per health worker. This should be a dollar amount.
  8. Input the dollar amount for performance based incentives, per health worker.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can select ‘cancel’ if they wish to back out of this intervention without saving.

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you simply wish to customize the interventions even more, the Additional Activities area is designed to allow you to essentially design your own interventions for students from rural backgrounds. Simply name your activity, select the cadres to target, then use the other costs area to enter annual costs for whatever activity you desire.

Professional and Personal Support Interventions

Health workers in remote settings have similar support needs.  They will need support in the form of good infrastructure, opportunities to socialize, employment opportunities for their spouses (if relocating an entire family unit), and schooling for their children. Likewise, health workers will require support in a professional capacity.  This might include opportunities for advancement, or the ability to communicate with peers over long distances.

For all types of health workers, public recognition of the value they offer to their communities is essential in improving morale, status and subsequent desire to work in rural areas.

D1. Better Living Conditions

Construct and furnish new staff housing

This section allows users to budget the costs associated with the per unit cost of construction for new staff housing.

To configure this activity:

  1. Select the cadres the intervention activity is targeting.  (The cadres to select from are the same that were listed in STEP 2.)
  2. Enter the estimated cost of construction per square foot.
  3. Enter the estimated size per unit in square feet.
  4. Enter the number of units for each year in the exercise.

In the section below, you can include the costs per unit for Furniture and Power and Water. For each you can either enter the total cost or the itemized cost.

When entering the itemized costs for furniture, enter the unit cost and number of each required:

When entering the itemized costs for power and water, enter the unit cost and number of each required:

Upgrade electricity in existing accommodations

This activity is for upgrading the electricity in existing accommodations.

Enter the number of units that need to be improved per year and the cost of the improvements.

Provide water in existing accommodations:

You can budget the costs associate with provisioning water for existing accommodations here.

Enter the number of units to be improved and the cost of improving each unit.

Improve telecommunications

Input the number of units as well as the allowances for cellphones and Internet access here.

Improve schooling for children

Input the number of children that need to be supported as well as the total allowances for each school.

Conduct regular maintenance/repairs

This section is for calculating the costs of regular maintenance and repairs for housing. Enter the amount that will be reserved for unexpected repairs as well as the expected maintenance costs.

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you simply wish to customize the interventions even more, the Additional Activities area is designed to allow you to essentially design your own interventions for students from rural backgrounds. Simply name your activity, select the cadres to target, then use the other costs area to enter annual costs for whatever activity you desire.

D2. Safe and Supportive Working Environment

Structural repairs for health facilities

This activity calculates the costs of structural repairs for health facilities. Select the cadre the activity will target, then enter the cost of repairs per unit, followed by the number of units that need structural repairs.

Upgrade/replace equipment in health facilities

This activity is for calculating the costs of equipment upgrades in health facilities. Select the cadre the activity will target, then enter the cost of equipment upgrades per unit, followed by the number of units.

Improve medicines and supplies

To calculate the cost of the improvement of medical supplies, enter the cost of supplies per unit followed by the number of units.

Train managers to be more supportive

To calculate the costs of training managers to be more supportive, you will enter totals into this section.

Instructions for using this section:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Enter the number of deliveries that will be made each year.
  3. Enter the corresponding values for Participant costs, Facilitator costs, and Venue costs.
  4. Enter any other costs.

This section includes fields that may need additional explanation:

  1. Number of participants (per delivery) refers to the number of participants expected for each year of the intervention strategy defined in Step 1.
  2. Travel and transport (per person) refers to the expected cost of transporting an individual participant.
  3. Lodging and per diem (per person) refers to the expected cost of lodging an individual. This should include any travel per diems that would be offered to the individual.
  4. Training materials/stationary (per person) refers to the expected cost of training an individual participant.
  5. Number of facilitator (per delivery) refers to the number of facilitators expected for each year of the intervention strategy defined in Step 1.
  6. Travel and transport (per person) refers to the estimated cost of transportation of each facilitator.
  7. Lodging and per diem (per person) refers to the estimated cost of lodging a facilitator. This should include any travel per diems that would be offered to the individual.
  8. Fees (per facilitator) refers to the estimated fees beyond travel and lodging that the facilitator may charge for his or her services.
  9. There is also a section for budgeting the cost of the lunches for the participants of the delivery. Note: this is the aggregate cost of the lunch, and not the cost per individual.
  10. Likewise, the venue cost is the cost of a full rental, not the cost per individual.

There is a field for including ‘other costs’ that do not fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Provide on-site supervision and support

This activity will allow you to budget for providing on-site supervision and support.

To use this intervention activity:

  1. Select the cadre this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Enter the number of sites that will need to be visited.
  3. Enter the number of travelers that will visit each site.
  4. Input the amount budgeted for lodging and per diems, per traveler.
  5. Input the number of facilitators visiting each site.
  6. Input the number of days each site will be visited.
  7. Input the amount budgeted for the fees of the facilitator.

There is a field for including ‘other costs’ that do not fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Conduct regular maintenance/repairs

This section is for calculating the costs of regular maintenance and repairs for the units. Enter the amount that will be reserved for unexpected repairs as well as the expected maintenance costs.

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you simply wish to customize the interventions even more, the Additional Activities area is designed to allow you to essentially design your own interventions for students from rural backgrounds. Simply name your activity, select the cadres to target, then use the other costs area to enter annual costs for whatever activity you desire.

D3. Outreach Support

Design Outreach Support Program

This activity is configured to allow the user to design outreach support programs.

To use this intervention:

  1. Select the cadre this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Set the number of workdays and respective number of consultants.
  3. Plan review/emphasis workshops for health workers and associated costs.
  4. Specify other costs associated with the recruitment plan.

Notice that this section allows the user to define a number of other costs associated with this intervention. To successfully use Retain, the user should fill in all these fields as accurately as possible.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Support urban Health Workers to visit rural areas

This action allows the user to budget the cost of supporting health workers who will visit rural areas.

First, select the cadre this action is intended to target.  Then, enter the travel and accommodation allowances per health worker as well as the number of health workers.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Support rural Health Workers to visit urban areas

This action allows the user to budget the cost of supporting health workers who will visit urban areas.

First, select the cadre this action is intended to target.  Then, enter the travel and accommodation allowances per health worker as well as the number of health workers.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Grants to support telehealth networks

If you have telehealth networks, you will use this section to budget for grants to support them.

First, select the cadre this action is intended to target and the number of health workers affected. Then enter the grant amount (in dollars) for internet access, cellphones and any other expenses.  

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Provide ongoing management of program

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you wish to customize the interventions even more, the Additional Activities area is designed to allow you to essentially design your own interventions for students from rural backgrounds. Simply name your activity, select the cadres to target, then use the other costs area to enter annual costs for whatever activity you desire.

D4. Career Development Programs

Consultations regarding career development and career paths

In this section, you can budget for consultations regarding career development and career paths.

  1. Select the cadre this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Set the number of workdays and respective number of consultants.
  3. Plan review/emphasis workshops for health workers and associated costs.
  4. Specify other costs associated with the recruitment plan.

Notice that this section allows the user to define a number of other related costs to this intervention. To successfully use Retain, the user should fill in all these fields as accurately as possible.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Design education programs to support staff advancement

This activity allows you to calculate the costs of designing education programs to support staff advancement.  

To use this activity:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Input the number of workdays for the activity.
  3. Input the cost per day, per consultant or staff member.

Conduct training to support staff advancement

This activity will allow you to calculate the costs of training support staff for advancement.

Instructions for using this activity:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Enter the number of deliveries that will be made each year.
  3. Enter the corresponding values for Participant costs, Facilitator costs, and Venue costs.
  4. Enter any other costs.

This section includes fields that may need additional explanation:

  1. Number of participants (per delivery) refers to the number of participants expected for each year of the intervention strategy defined in Step 1.
  2. Travel and transport (per person) refers to the expected cost of transporting an individual participant.
  3. Lodging and per diem (per person) refers to the expected cost of lodging an individual. This should include any travel per diems that would be offered to the individual.
  4. Training materials/stationary (per person) refers to the expected cost of training an individual participant.
  5. Number of facilitator (per delivery) refers to the number of facilitators expected for each year of the intervention strategy defined in Step 1.
  6. Travel and transport (per person) refers to the estimated cost of transportation of each facilitator.
  7. Lodging and per diem (per person) refers to the estimated cost of lodging a facilitator. This should include any travel per diems that would be offered to the individual.
  8. Fees (per facilitator) refers to the estimated fees beyond travel and lodging that the facilitator may charge for his or her services.
  9. There is also a section for budgeting the cost of the lunches for the participants of the delivery. Note: this is the aggregate cost of the lunch, and not the cost per individual.
  10. Likewise, the venue cost is the cost of a full rental, not the cost per individual.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Support Health Workers to attend existing training

This activity allows you to budget for the costs of supporting health workers attending training sessions.

To use this activity:

  1. Select the cadre it is intended to affect.
  2. Input the number of students.
  3. Input the tuition, travel allowance and accommodation allowance per student.
  4. Input any other per student allowance.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you simply wish to customize the interventions even more, the Additional Activities area is designed to allow you to essentially design your own interventions for students from rural backgrounds. Simply name your activity, select the cadres to target, then use the other costs area to enter annual costs for whatever activity you desire.

D5. Professional Networks

Grants to develop rural professional associations or rural health journals

To use this activity, simply enter the number of grants, and the amount of each grant, to be used for developing rural professional associations.

Sponsor rural Health Worker conference

This activity is for budgeting the costs of sponsoring conferences for health worker staff.

Instructions for using this activity:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Enter the number of conferences that will be made each year.
  3. Enter the corresponding values for Participant Costs, Facilitator costs, and Venue costs.
  4. Enter any other costs.

This section includes fields that may need additional explanation:

  1. Number of participants (per conference) refers to the number of participants expected for each year of the intervention strategy defined in Step 1.
  2. Travel and transport (per person) refers to the expected cost of transporting an individual participant.
  3. Lodging and per diem (per person) refers to the expected cost of lodging an individual. This should include any travel per diems that would be offered to the individual.
  4. Training materials/stationary (per person) refers to the expected cost of training an individual participant.
  5. Number of facilitator (per conference) refers to the number of facilitators expected for each year of the intervention strategy defined in Step 1.
  6. Travel and transport (per person) refers to the estimated cost of transportation of each facilitator.
  7. Lodging and per diem (per person) refers to the estimated cost of lodging a facilitator. This should include any travel per diems that would be offered to the individual.
  8. Fees (per facilitator) refers to the estimated fees beyond travel and lodging that the facilitator may charge for his or her services.
  9. There is also a section for budgeting the cost of the lunches for the participants of the conferences. Note: this is the aggregate cost of the lunch, and not the cost per individual.
  10. Likewise, the venue cost is the cost of a full rental, not the cost per individual.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Provide grants to Health Workers to support networking

Use this activity for budget for support provided to health workers to support networking.

First, select the cadre this action is intended to target and the number of health workers affected. Then, enter the grant amount (in dollars) for internet access, cellphones and any other expenses.  

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you simply wish to customize the interventions even more, the Additional Activities area is designed to allow you to essentially design your own interventions for students from rural backgrounds. Simply name your activity, select the cadres to target, then use the other costs area to enter annual costs for whatever activity you desire.

D6. Public Recognition

Design program for Health Worker awards

This activity would be used to design programs for health worker awards.

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Set the number of workdays and respective number of consultants.
  3. Plan review/emphasis workshops for health workers and associated costs.
  4. Specify other costs associated with the recruitment plan.

Notice that this section allows the user to define a number of the related costs, including the costs of the venue, consultants and travel. To successfully use Retain, the user should fill in all these fields as accurately as possible.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Provide national awards to rural Health Workers

This activity is for offering rewards to rural health workers.

To use this activity:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Enter the number of awardees.
  3. Enter the amount of each award.
  4. Enter the cost for each accompanying media event.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Grants to regions/districts to provide Health Workers awards

Use this activity to budget for the cost of providing health workers awards.

To use this activity:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Enter the number of events per year.
  3. The number of years should have been previously defined.
  4. Enter the amount spent per event.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Sponsor rural Health Workers to attend international conferences

To use this activity:

  1. Select the cadres this intervention is targeting.  (The cadres to select from are the same that were listed in Step 2.)
  2. Enter the number of regions.
  3. Enter the budget for each region.

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Support rural health days

There is a field for including ‘other costs’ that don’t fit into the above categories. Once completed, select ‘save this intervention’. The user can also select ‘cancel’ if they wish to back out of this intervention without saving.

Additional Activities

If none of the above Intervention activities speak to you or your organization’s needs, or if you simply wish to customize the interventions even more, the Additional Activities area is designed to allow you to essentially design your own interventions for students from rural backgrounds. Simply name your activity, select the cadres to target, then use the other costs area to enter annual costs for whatever activity you desire.


Review Costing Results

Retain contains so much information related to an organization’s intervention strategy that we have included a section that allows users to summarize, compare, and visualize their information.  (Note: We have used a few test files in this section help show you what this area will look like with your data. However, these same test files may not appear in your version of iHRIS Retain.)

Summary of Costing Exercise

Basic Information

Like the title suggests, the Basic Information area offers a summary of the information contained within the active file.

Priority Cadres

Here you will find a list of the health worker cadres that are targeted by the Intervention strategy.  You can also add additional cadres to the file from here.

In the left column, you will  see the option to click to editing the cadre information. The right column gives you a high level summary of the cadre.

Reports

In the Reports tab you will find many tools for viewing and analyzing information.  You will immediately notice that an overview of the project costs for the entire project are included, factoring the intervention activities provided throughout.

In the area labeled Projected Total Costs you will see this.  There are six columns which correspond with the project budget:

Year - the corresponding year for the projected numbers

All Interventions - the projected cost of all intervention activities

Education Incentives - the projected cost of all education intervention activities

Regulatory Incentives - the projected cost of all regulatory intervention activities

Financial Incentives - the projected cost of all financial intervention activities

Professional and Personal Support - the projected costs of all intervention activities which provide direct support to health workers

Total Health Sector Budget - the total amount of spending on health sector costs

Health Worker Costs - the amount spent on health workers (across all cadres and all activities)

This high-level view of all Intervention activities and planning should be very useful.  In fact, you may want to export it to draw insight using a different program such as Excel.  We have included this useful ‘download’ button which will allow you to do just that.

To the left of the Download button you will notice an area labeled Other Available Reports. This link allows you to dive deeper into your iHRIS Retain intervention strategy.

Clicking the Other Available Reports link will reveal the following drop-down menu.

The menu includes the following options:

Summary (U.S. Dollars) - allows the report to be viewed in the local currency

Yearly Intervention Breakdown - generates a bar graph that compares costs annually. This offers a useful way to visually compare the projected costs of one or more years to each other.

Intervention Costs as a Percentage of Total Budget - allows the columns to be viewed as percentages of the total budget.

Intervention Costs as a Percentage of Recurrent Expenditures - allows the columns to be viewed as percentages of the recurrent expenditures.

Intervention Costs as a Percentage of Interventions by Personnel Budget - allows the columns to be viewed as percentages of the personnel budget intervention activities.

Intervention Costs by Total Budget - generates a bar graph comparing the annual total costs to the costs of the intervention activities for that same year.

Intervention Costs by Personnel Budget - generates a bar graph comparing the total cost of interventions to the amount spent on personnel and salaries.

Intervention Costs by Recurrent Expenditures - generates a bar graph comparing the total cost of interventions to the total cost of recurrent expenditures.  

Intervention Costs by Cadre - generates a bar graph comparing the costs associated with each cadre targeted by an intervention action strategy. This offers a quick way to visually identify and compare how much is being spent on each cadre.

Cost Per Rural Healthworker (By Cadre) - generates a bar graph comparing the costs of each health worker type of a cadre.  This is a quick way to visually identify and compare how much of the budget is going to a specific job type.

Saving Report Graphs

After generating reports using the Reports tab in summary costing exercise, you may want to save the visual for later referral.  iHRIS Retain does not have a native option for exporting these images.  However, the following instructions provide a way to do this.

These instructions will work across all web browsers (Firefox, Chrome, Safari, Internet Explorer and others) but the command options will vary depending upon your operating system:

On a Windows PC

Right click on the image and select ‘Save Image’ or ‘Save Image As’.

Move your mouse over the image you want to save and CTRL + Click.  Then select ‘Save Image’ or ‘Save Image As’ from the menu that will appear.

On a Linux computer

Move your mouse over the image you want to save and CTRL + Click.  Then select ‘Save Image’ or ‘Save Image As’ from the menu that will appear.

On a Mac computer

Move your mouse over the image you want to save and CTRL + Click.  Then select ‘Save Image’ or ‘Save Image As’ from the menu that will appear.

If you are using a mouse with two-buttons, right click on the image and select ‘Save Image’ or ‘Save Image As’.

Interventions

If you or someone at your organization has already set-up Intervention activities that you would like to go back to edit or modify, this area will allow you to quickly find existing Intervention activities.  From here you can also create new Interventions.

You will find that the column on the right gives you an at-a-glance summary of the respective Interventions.

File Management

The file management section allows you to export and copy files that you have created while working with Retain.

To export a file, look for this button. (You will find it on the far right of the screen.)

To copy a file, look for this button. (You will find this on the far right of the screen.)

You might consider exporting a file if you wanted to output your Intervention data to Microsoft Excel or some other program that could be used to draw additional insight from it.

One might consider copying a file to make adjustments to a pre-existing Intervention strategy, without overwriting the original values.

Compare Files

Using this section effectively allows you to compare two different files, to see how costs compare over time.

The graph includes a key that indicates what the bars represent. The color blue is used to show figures for the current file, while the color red is used for the file you wish to compare to.


Resources

If you are looking for additional resources for iHRIS Retain or information about health workers, this tab will take you to an up-to-date list of information sources.


Feedback

If at any point you run into trouble using the IHRIS Retain software or would like to offer feedback about improvement, do so here.  Use the comment section to write your request or to report an error.

Be sure to fill out the form as completely as possible as that will improve the likelihood of a response. However, please note that because of the volume of communication performed this way, a response is not guaranteed.