Abstract

BackgroundTo strengthen rural health workforce, the Chinese government has launched a series of policies to promote the job satisfaction of village doctors since the health sector reform. The purpose of this mixed-method study is to describe village doctors’ job satisfaction under the context of health sector reform and investigate the associated factors.MethodsData was obtained from a survey of village doctors across three Chinese provinces in 2014. Using a multistage sampling process, quantitative data was collected from village doctors through the self-administered questionnaire and analyzed by multilevel logistic regression models. Qualitative data was collected through face-to-face semi-structured interviews on both village doctors and health managers. Theoretical coding was then conducted to analyze qualitative data.ResultsAmong the 1221 respondents, 48.6% felt satisfied with their job. Older village doctors with less of a workload and under high-level integrated management were more likely to feel satisfied with their job. Village doctors who earned the top level of monthly income felt more satisfied, while on the county level, those who lived in counties with the highest GDP felt less satisfied. However, enrollment in a pension plan showed no significant difference in regards to village doctors’ job satisfaction.Among 34 participants of qualitative interviews, most believed that age, income, and integrated management had a positive influence on the job satisfaction, while pension plan and basic public health care policies exhibited negative effects. Also, the increasing in availability of healthcare and health resources along with local economic development had negative effects on village doctors’ job satisfaction.ConclusionVillage doctors’ job satisfaction was quite low in regards to several determinants including age, income, workload, enrollment in a pension plan, integrated management, and county economic and medical availability development.

Highlights

  • To strengthen rural health workforce, the Chinese government has launched a series of policies to promote the job satisfaction of village doctors since the health sector reform

  • China is experiencing critical challenges in the rural health system related to the low job satisfaction of village doctors [1]

  • Many of them were originally employed as the primary rural health workforce in the 1960s, and their position in serving rural areas is still integral to basic rural healthcare provision in China nowadays [2]

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Summary

Introduction

To strengthen rural health workforce, the Chinese government has launched a series of policies to promote the job satisfaction of village doctors since the health sector reform. The purpose of this mixed-method study is to describe village doctors’ job satisfaction under the context of health sector reform and investigate the associated factors. China is experiencing critical challenges in the rural health system related to the low job satisfaction of village doctors [1]. These doctors, formerly called “barefoot doctors”, serve as the bottom-tier of the Chinese rural health system. These changes left village doctors less satisfied with their job

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