作者简介：Nakpakpere Bante，管理硕士，单位：首都经济贸易大学企业管理专业，工商管理学院，研究方向：组织行为与人力资源管理。
　　Abstract：Supported by an ever increasing body of literature，it is clear that the challenge of today any health care system is to implement a good policy of workers satisfaction in the aim to retain them more in the organization.Workers retention has become a center of debate of Enterprises HRM Strategy and still a topical issue in todays health care system.Specifically，the phenomenon is more encounters in the health systems of developed countries where workers retention is seen to be the thorny problem of managers.
　　So，a poor system of retention in health sanitary system particularly in Togolese health sanitary system led to a high staff-turnover health professional from public sector to private sector and to developed countries.This situation is not isolated；it is related in general to dissatisfaction，demotivation of health workers.Indeed，the salary levels are low and does not respect national and international standard，to the poor management，missing of medical equipment，and the facilities.
　　To shed this problem of health sanitary system，it is imperative to optimize the sanitary management system.Additionally its vital to develop equity and transparency method，that includes more heath employees in the management system and to review their remuneration regularly.
　　Key words：Human resource management，retention，Motivation，Health workers，Healthcare system
　　Background
　　“More than other institution，the hospital reflects the economic and scientific situation of any state，technical and social situation of the society in which it operates”.The health of any population must be placed in government priority policy action.It is important to implement a real policy of human resources in the health sector.That means increasing the numbers of health workers，motivate them and provide them best working conditions encourage them，in order to ensure their fundamental mission，which is to supply to the poor and the rich people，continuous and integrated quality care.
　　However，it can easily notice today，repetitive strikes that succeeded over the years in Togolese health care system，and the daily difficulties that face the human resources management department.These movements of strikes，have a negative effect on the patient.It lead to the decrease in the rate of attendance in the public hospitals.This dsituation can be explain by the lack of commitement in the public hospital than the private.There is a fact that actually，the healthcare workers prefer more and more activities outside of the hospital，this led to the arrangement with patients who receive care at domicile and in private health institution.

    Recently Togos health system as other develop countries has to face the most difficulties that WHO considers as a global problem.It is the shortage of health personnel.The report reveals an estimated shortage of almost 4.3 million doctors，midwives，nurses and support workers worldwide.This shortage can be explained by the insufficiency of medical staff trained in these countries，but another main reason remain the departure of the medical agents to the developed country and to the private sectors where the remuneration seems to be very important or very high.As an example we can remind that in United States，the number of physicians trained abroad which succeed the stage three of the USMLE examination procedure（Step needed to see if the physicians qualification is fully recognized in the United States）has increased by 70% between 2001 and 2008.Over the same period，the flow of temporary migration of the physicians has been multiplied by two in Australia and grew by 40% in Canada.Even in some countries，the expatriation rate of physicians is greater than 50%.Among these countries we have Mozambique，Angola，Sierra Leone，United Republic of Tanzania and Liberia.For several French speaking African countrie the high expatriation rates is greater than 40%.In Togo，40% of Togolese physicians work in France.
　　The question is how to retain or how to improve the health workers retention in those countries especialy in Togo？
　　Methods
　　In our research，we were interested at the first moment to the exploitation of writing document which are related to health human resource management in Central and south African countries.We were focus mostly on articles and thesis relate it to the field.This allows us to discover the conclusion which has been made.The reports emanating from the organizations such as the WHO，the World Bank，USAID，GTZ，Ministry of Health，and from the management of the health system was very useful.
　　Secondly，in-depth study design entailed structured qualitative interviews with health workers from public，and private health sector in north main town of Togo.We process to an elaboration of a questionnaire in the aim of collecting the reliable information on the variables of workers motivation and retention in the health care system.The questionnaire designed consists of multiple choice questions，and an open question. (责任编辑：南粤论文中心)转贴于南粤论文中心: http://www.nylw.net(代写代发论文_毕业论文带写_广州职称论文代发_广州论文网）