AbstractIntroductionThe shortage of health professionals in rural areas is a global problem. The urban and rural maldistribution of doctors results in severe problems regarding access to and performance of health care services. Retaining doctors in rural areas is a challenging task for a number of reasons, ranging from personal preferences to difficult work conditions and low remuneration. The objective of the study was to understand the factors influencing medical and dental intern’s choice to work in rural PHC’s as a basis for designing policies to redress geographic imbalances in health professional’s distribution.MethodsA total of 385 dental and medical interns in Andhra Pradesh provided a unique contingent valuation data in a cross sectional survey conducted in 4 medical and 4 dental colleges in Andhra Pradesh, using a questionnaire concerning their preferences, related incentives to work in various rural and remote primary health centres of Andhra Pradesh state, India.ResultsThe response rate of the study was 89 %, (n= 344), with only 24% of interns expressing their willingness to serve in rural/remote primary health centres. Most of the interns stressed for increase in salary, better accommodation and infrastructure of the hospitals as the factors for increasing their retention in remote rural areas.ConclusionsAlthough most Indian students are motivated to study medicine and dentistry by the desire to help others, this does not translate into willingness to work in rural areas. Efforts from the government to build intrinsic motivation during medical and dental training to serve in these deprived areas should be in focus with addition to improved working and living conditions and better remuneration.
Carmen D, Stormont L, Zurn P, Shaw D et al. Increasing access to health workers in remote and rural areas through improved retention. Geneva : WHO Press, 2010.
Serneels P, Jose G, Pettersson G. Who Wants to Work in a Rural Health Post? The Role of Intrinsic Motivation, Rural Background and Faith- Based Institutions in Rwanda and Ethiopia. Bull World Health Organ. 2010; 88:342–349.
Balarajan Y, Selvaraj S, Subramanian SV. Towards Universal Health Coverage 4 Health care and equity in India. Lancet. 2011; 377: 505–15.
Joshi D, Mahambare V, Munja P. Skilling India The Billion People Challenge. CRISIL Centre for Economic Research. 2010; 1-24.
Government of India, Ministry of home affairs [internet]. [cited 2011 august 23]. Available from: http://censusindia.gov.in/Census_Data_2001/India_at_glance/rural.aspx.
Nanda kishor KM. Public Health Implications of Oral Healh- Inequity in India. J Adv Dental research. 2010; 1(1): 1-10.
Sheikh K. Why some doctors serve in rural areas: A qualitative assessment from Chhattisgarh state. PHFI; 2010:1-80.
Wilson NW, Couper ID, Vries ED, Reid S, Fish T, Marais BJ. A critical review of interventions to redress the inequitable distribution of healthcare professionals to rural and remote areas. Rural Remote Health. 2009; 9 (1060):1-21.
Lehmann U, Dieleman M, Martineau T. Staffing remote rural areas in middle- and low-income countries: A literature review of attraction and retention. BMC Health Services Research. 2008; 8(19):1-10.
Zurn P, Mario R, Band S et al. A review on imbalance in the health workforce. Human Resources for Health. 2004; 2(13):1-12.
Snow RC, Asabir K, Mutumba M et al. Key factors leading to reduced recruitment and retention of health professionals in remote areas of Ghana: a qualitative study and proposed policy solutions. Hum Resources for Health. 2011;9(13):1-11.
List of medical and dental colleges in Andhra Pradesh. [Internet]. 2011[cited 2011 august 21]. Available from http://18.104.22.168/pg2012/College.asp.
Baffour PA, Shuda R, Kotha R,et al. Willingness to work in rural areas and the role of intrinsic versus extrinsic professional motivations - a survey of medical students in Ghana. BMC Medical Education. 2011;11(56):1-8.
Wandira G, Everd Maniple E. Do Ugandan medical students intend to work in rural health facilities after training. Health policy and development. 2009; 7(3) : 203-214.
Raha S, Berman P, Bhatnagar A. Career preferences of medical and nursing students in Uttar Pradesh. India Health Beat.2009;1(6):1-4.
Polasek O, Kolcic I, Dzakula A, Bagat M. Internship workplace preferences of final-year medical students at Zagreb University Medical School, Croatia: all roads lead to Zagreb. Human Resources for Health. 2006; 4(7).1-5.
Bärnighausen T, Bloom DE. Financial incentives for return of service in underserved areas: a systematic review. BMC Health Services Research. 2009; 9(8)6:1-13.
Huicho L, Dieleman M, Campbell J. Increasing access to health workers in underserved areas: a conceptual framework for measuring results. Bull World Health Organ. 2010; 88:357-363.
Girasek E, Eke E, Szócska EM. Analysis of a survey on young doctors' willingness to work in rural Hungary. Human Resources for Health. 2010; 8(13):1-6.
Pathman DE, Konrad TR, Dann R, et al. Retention of Primary Care Physicians in Rural Health Professional Shortage Areas. Am J Public Health. 2004;94: 1723–1729.
Hill D, Martin I, Farry P. What would attract general practice trainees into rural practice in New Zealand. N Z Med J. 2002; 115(1161) 1-9.
Henry JA, Edwards BJ, Crotty B. Why do medical graduates choose rural careers. Rural and Remote Health.2009; 9: (1083). 1-13.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.