PPHI Strategies for Recruitment and Retention of Physicians in KP Like in all other provinces in Pakistan, a BHU in KP has one designated post for physician, titled Medical Officer (MO). An MO is in-charge of the BHU and besides his primary outpatient duty, he supervises the other staff including paramedics, lady health visitors (LHV), and other auxiliary staff like xxxx orderly, watchman. He is also responsible for all the preventive and promotive health care services offered through a BHU. In the contract agreement, PPHI administration at district level was authorized to hire any staff on contract including the MO, LHVs and paramedics. However, the majority of these facilities had ample staff with the exception of an MO. PPHI’s approach to increasing health staff mainly focused on physicians and to some extent LHVs. Recruitment was relatively simple. There was a formal walk-in interview and validation of medical practicing license. MOs hired by PPHI received the same salary as their counterparts in non-PPHI districts. In addition, MOs who were working in these health facilities before PPHI took over and chose to stay were also managed by PPHI. These MOs maintained their status as regular employees of DoH and received their salaries from the said department. The main focus of PPHI was to ensure the availability of MOs in each health facility under its control. For this purpose, PPHI introduced a “cluster model”. In cluster model, MOs were given option of managing a cluster of two or three nearby BHUs. An MO was given extra financial supplements for each additional BHU he managed. The purpose was to ensure availability of MOs in each facility and to enhance utilization of these facilities. If the MO was a woman (titled WMO for government employed and FMO for PPHI contracted), she was also obligated to deliver mother and child health care (MCH) services together with an LHV, another strategy which was exclusive to PPHI. PPHI categorized the districts into Category-I and Category-II, based on territorial accessibility and provided extra financial incentives to the MOs. Incentives for Category-I were doubled compared to Category-II which were comparatively less hard to reach. DoH employed staff, like medical technicians, LHVs and auxiliary staff in these categories were also incentivized, usually half the amount an MO received.
