Abstract
BackgroundDeployment of health workforce in rural areas is critical to reach universal health coverage. Students’ perceptions towards practice in rural areas likely influence their later choice of a rural post. We aimed at exploring perceptions of students from health professions about career choice, job expectations, motivations and potential incentives to work in a rural area.MethodsIn-depth interviews and focus groups were conducted among medical, nursing and midwifery students from universities of two Peruvian cities (Ica and Ayacucho). Themes for assessment and analysis included career choice, job expectations, motivations and incentives, according to a background theory a priori built for the study purpose.ResultsPreference for urban jobs was already established at this undergraduate level. Solidarity, better income expectations, professional and personal recognition, early life experience and family models influenced career choice. Students also expressed altruism, willingness to choose a rural job after graduation and potential responsiveness to incentives for practising in rural areas, which emerged more frequent from the discourse of nursing and midwifery students and from all students of rural origin. Medical students expressed expectations to work in large urban hospitals offering higher salaries. They showed higher personal, professional and family welfare expectations. Participants consistently favoured both financial and non-financial incentives.ConclusionsNursing and midwifery students showed a higher disposition to work in rural areas than medical doctors, which was more evident in students of rural origin. Our results may be useful to improve targeting and selection of undergraduate students, to stimulate the inclination of students to choose a rural job upon graduation and to reorient school programmes towards the production of socially committed health professionals. Policymakers may also consider using our results when planning and implementing interventions to improve rural deployment of health professionals.
Highlights
Deployment of health workforce in rural areas is critical to reach universal health coverage
This study aimed at identifying factors related to students’ reasons for career choice, job expectations, intrinsic motivations and incentives to work in rural areas
Motivations to work in a rural area We considered as motivations those factors “intrinsic” to students, not immediately explained by external factors related to some way of retribution that would contribute to personal, professional and social development
Summary
Deployment of health workforce in rural areas is critical to reach universal health coverage. We aimed at exploring perceptions of students from health professions about career choice, job expectations, motivations and potential incentives to work in a rural area. Peru has recently progressed to the upper middleincome country category [1] and has achieved sustained economic growth for several years, along with significant improvements in maternal and child health [2,3,4]. Despite this progress, rural and remote areas of the Amazon and the Andes still have high poverty rates [5] and high maternal, neonatal and under-five mortality rates [6]. Students think that a health career can help them to gain professional, economic and social recognition
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