Retention allowances can come in the form of separate payments or salary top-ups. Donors have generally been reluctant to support retention allowances because they feel salaries are a government responsibility and because of concerns over the sustainability of such support. However, the scale of the crisis has sometimes been so great that they have stepped in to provide support.
It is generally agreed that this support cannot be ongoing and that measures should be put in place to replace external financing with additional domestic revenues. Yet external support has often had to remain in place longer than originally planned as the government has been unable to take responsibility for the additional costs.
Support is often provided by a variety of donors, and may come in the form of budget support for the government. Schemes have tended to focus on financial incentives and allowances, despite evidence indicating that a balanced package of measures is better for retaining staff.
This report provides brief case studies of donor support for retention allowances in the health sector in Zimbabwe, Malawi, Sierra Leone, Liberia and Zambia.