Answer:
In Latin America and the European Union, for example, 12 and 37 percent of health workers are public sector employees, respectively. Hence wage increases may reduce funding available for other critical medical supplies and equipment, particularly in developing countries with limited fiscal resources. Wage increases for one category of workers, however well justified, can also trigger demands from other workers, particularly in countries with strong trade unions. Temporary salary increases or supplementary payments also tend to become permanent, thereby creating long-term distortions and problems of fiscal sustainability. The first step, then, is to quickly assess the level and structure of health worker compensation to quantify the amount of additional wages that should be paid. Health facility staff consists of frontline medical staff (doctors, nurses, community health workers) as well as non-medical administrative and support staff. In many World Bank client countries, the total gross wages of health workers will consist of:
1.Basic salary. This is based on pay grades in civil service pay laws, or wage legislation for public health workers.
2.Overtime allowance or compensation for overtime work. This is usually in the form of a percentage of basic pay for additional hours worked beyond what is normally specified.
3.Hazard allowance or harmful work conditions allowance. These will be allowances as a percentage of pay for working conditions that are considered risky to the individual.
Other allowances.
4.Other allowances. These typically factor in seniority, additional training, or educational qualifications, as well as working in rural areas or remote locations
5.Performance pay. These are additional payments conditional on either inputs (e.g., working hours), outputs (e.g., patients treated), or outcomes (e.g., patient satisfaction).
6.Per diems or salary supplements. These are usually for attending workshops or training and can be a significant (more than 10 percent) proportion of gross wages.
Cross-national data on health worker wages is very limited. The data that the World Bank has for 10 countries in Latin America and 27 in the European Union shows that while health care workers do enjoy a premium over workers in other sectors of the economy, the premium decreases with country income levels. For countries in the upper income category, they experience a penalty compared to similar workers in lower-income countries (controlling for sex, education, and location). These averages, however, hide variations across different categories of health workers (medical workers represent between 20 and 50 percent of all health care sector workers for countries in Latin America and the European Union).