Posting and transfer (P&T) refers to the deployment and transfer of health care workers and administrators. These practices are regulated by the following: |
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• formal policies enshrined in public administration structures, such as a public service commission, under the executive branch (for example, the Indian Administrative Service) |
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• formal policies particular to the line ministry (MoH) and even to particular cadres. Some decisions, such as intra-district transfer, might be made at decentralized levels, while others, such as recruitment or termination, may be made at the central level |
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• practical norms (implicit, tacit norms) [1] relating to political patronage, nepotism, impunity, cronyism, compassion, gendered responsibilities of family caretaking, professional power, multiple accountabilities, etc. |
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P&T may be consistent with health worker wishes (for example, bribing a decision-maker to secure an urban post), or they may be inconsistent with these wishes (for example, transferring a poorly performing health worker to a remote rural area). One’s ability to negotiate a preferred outcome likely depends on one’s professional status, with some cadres enjoying more power than others. |
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Policies themselves (or the available space to circumvent policy) may be in turn shaped by multiple factors, including lobbying by professional associations/unions and competition among political parties seeking to curry favour with public employee constituencies. |
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