Background:One of the District Health Teams (DHT) in Uganda is struggling with chronic health workers absenteeism at health facilities. Absenteeism has affected service delivery at the health facilities within the district, led to a reduction in health services consumer satisfaction, and directly impacts the performance appraisal of the DHT. To address this challenge, a member of the DHT is seeking evidence on the causes of absenteeism among health workers and possible options of addressing this challenge to register improvements in health worker attendance at their work. Rapid Response Question:What are the causes of absenteeism among health workers, and what are the available options for reducing it at the local government level in Uganda? Findings:Absenteeism from work is a function of two variables; (a) ability to attend and (b) motivation to attend. Low motivation and absenteeism are closely related, and therefore it is crucial to understand factors influencing both phenomena.The causes of absenteeism are;1. Ill health2. Institutional absence norms3. Prior absence patterns4. Limited job involvement5. Low job satisfaction6. Low commitment to the organisation7. Poor leadership and management8. Burnout and stress9. Infrequent supervision10. Infrequent supervision11. Lack of recognition/ appreciation12. Dual employmentThe factors that affect staff motivation are;1. Availability of incentives2. Opportunities for carrier development3. Management characteristics4. Further training/ education opportunities5. Availability of resources6. Recognition/ appreciation of staffTo address absenteeism and low motivation, you need to identify the cause and tailor the appropriateintervention for it. Whenever possible, the intervention design should be participatory to get the buy-in of the staff and the team to have full knowledge of the interventions. Below are the options for addressing absenteeism of health workers;Positive impact interventions Mixed impact interventions No impact interventions⢠Instituting policies to address absenteeism⢠Financial and non-financial incentives⢠Recognising dual employment⢠Changing staff contracts⢠Restricting/ prohibiting private practice⢠Stress management training for staff⢠Building capacity of managers to solve problems and handle organisational changesThe management must deliberately maintain records on absenteeism, create and maintain a communication system and institute rewards for those adhering to and failing to adhere to the absenteeism policy for these interventions to work.Conclusions:To address absenteeism, the DHT should identify its causes and institute the appropriate measures. However, for the measures to be successful, they should be designed with the health workers' active participation. The management should also deliberately institute measures to identify and reward those who adhere to and do not adhere to the set attendance policies accordingly
