Zambia’s Ministry of Health works with economists to determine how best to recruit and retain community health workers

Oriana Bandiera describes the close collaboration between a team of economists and the Government of Zambia to evaluate strategies to recruit, motivate and retain agents in the rollout of its National Community Health Assistant Programme. Using a randomised experiment the findings illustrate that there is no tradeoff between career incentives, skills and social values. Providing career opportunities attracts more skilled individuals who perform better and seem to be equally socially motivated. The findings also provide empirical insight into how governments can implement and manage large-scale civil service initiatives.