Staff transfer and management in the government health sector in Balochistan, Pakistan: Problems and context

Despite the existence of rigid civil service systems in many developing countries providing relative stability of public officials, staff postings and transfers are often based on short-term political criteria. This means high staff circulation in key government posts, leading to a situation of 'instability within stability'. This article analyses high staff circulation in the government health services in Balochistan, Pakistan. The analysis is based on literature review, a small pilot study and authors' experience in the province. The article notes that high staff turnover and, more specifically, circulation are context-specific. Four issues are raised. Firstly, the extent of staff turnover is analysed and references are made to its frequency, the organization and cadre. Secondly, the social and political underpinning of high staff circulation is outlined: political patronage, low implementation of rules, staff preferences-and public sector control. Thirdly, the problems of staff turnover are raised with specific reference to the problems of continuity, change and participation. Fourthly, the issue of solutions is raised at two levels: structural change to lessen high staff turnover, and dealing with it on a day-to-day managerial level. Lastly, substantive and methodological issues are raised with respect to taking the analysis further. Copyright (C) 2000 John Wiley & Sons, Ltd.