Loubna Belaid1, Christian Dagenais2, Mahaman Moha3, Valéry Ridde4,5. 1. École de santé publique, département de médecine sociale et préventive de l'Université de Montréal, 7101 Av du Parc, 3e étage, Montréal, Québec, H3N 1X9, Canada. belaid.loubna@gmail.com. 2. Université de Montréal, département de psychologie, Pavillon Marie Victorin, 90 Avenue Vincent D'indy & Boulevard Mont-Royal, Montréal, Québec, H2V 2S9, Canada. 3. Laboratoire d'études et recherches sur les dynamiques sociales et le développement local (LASDEL), BP:12901, Niamey, Niger. 4. École de santé publique, département de médecine sociale et préventive de l'Université de Montréal, 7101 Av du Parc, 3e étage, Montréal, Québec, H3N 1X9, Canada. 5. Institut de recherche en santé publique de l'Université de Montreal (IRSPUM), Montreal, Quebec, Canada.
Abstract
BACKGROUND: The critical shortage of human resources in health is a critical public health problem affecting most low- and middle-income countries, particularly in sub-Saharan Africa. In addition to the shortage of health professionals, attracting and retaining them in rural areas is a challenge. The objective of the study was to understand the factors that influence the attraction and retention of health professionals working in rural areas in Niger. METHODS: A mixed-method study was conducted in Tillabery region, Niger. A conceptual framework was used that included five dimensions. Three data collection methods were employed: in-depth interviews, documentary analysis, and concept mapping. In-depth interviews were conducted with three main actor groups: policy-makers and Ministry of Health officials (n = 15), health professionals (n = 102), and local health managers (n = 46). Concept mapping was conducted with midwifery students (n = 29). Multidimensional scaling and cluster analysis were performed to analyse the data from the concept mapping method. A content analysis was conducted for the qualitative data. RESULTS: The results of the study showed that the local environment, which includes living conditions (no electricity, lack of availability of schools), social factors (isolation, national and local insecurity), working conditions (workload), the lack of financial compensation, and individual factors (marital status, gender), influences the attraction and retention of health professionals to work in rural areas. Human resources policies do not adequately take into account the factors influencing the retention of rural health professionals. CONCLUSION: Intersectoral policies are needed to improve living conditions and public services in rural areas. The government should also take into account the feminization of the medical profession and the social and cultural norms related to marital status and population mobility when formulating human resources management policies.
BACKGROUND: The critical shortage of human resources in health is a critical public health problem affecting most low- and middle-income countries, particularly in sub-Saharan Africa. In addition to the shortage of health professionals, attracting and retaining them in rural areas is a challenge. The objective of the study was to understand the factors that influence the attraction and retention of health professionals working in rural areas in Niger. METHODS: A mixed-method study was conducted in Tillabery region, Niger. A conceptual framework was used that included five dimensions. Three data collection methods were employed: in-depth interviews, documentary analysis, and concept mapping. In-depth interviews were conducted with three main actor groups: policy-makers and Ministry of Health officials (n = 15), health professionals (n = 102), and local health managers (n = 46). Concept mapping was conducted with midwifery students (n = 29). Multidimensional scaling and cluster analysis were performed to analyse the data from the concept mapping method. A content analysis was conducted for the qualitative data. RESULTS: The results of the study showed that the local environment, which includes living conditions (no electricity, lack of availability of schools), social factors (isolation, national and local insecurity), working conditions (workload), the lack of financial compensation, and individual factors (marital status, gender), influences the attraction and retention of health professionals to work in rural areas. Human resources policies do not adequately take into account the factors influencing the retention of rural health professionals. CONCLUSION: Intersectoral policies are needed to improve living conditions and public services in rural areas. The government should also take into account the feminization of the medical profession and the social and cultural norms related to marital status and population mobility when formulating human resources management policies.
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Authors: Jeanette L Kaiser; Rachel M Fong; Thandiwe Ngoma; Kathleen Lucile McGlasson; Godfrey Biemba; Davidson H Hamer; Misheck Bwalya; Maynards Chasaya; Nancy A Scott Journal: Hum Resour Health Date: 2019-12-04