Abstract
Background Shortages of health workers in rural areas are a global problem. The problem is more acute in poorer countries where the distribution of skilled, supported and motivated health workers is affected by internal and international migration. In Nepal, most women deliver at home, and the government has prioritized training and recruitment of nurses in rural areas to meet development goals. Health sector reform for increased retention: Decentralisation of authority to district level health facility management committees (HFMCs) has the potential to increase public accountability and make health services more locally responsive. The Government of Nepal is encouraging local recruitment of nurses by HFMCs to increase access to maternal health care. Our research describes the differences between nurses on different contracts, examining their motivation, job satisfaction and retention in rural areas.
Highlights
Shortages of health workers in rural areas are a global problem
We found few staff nurses in post, and it was difficult to recruit this cadre in rural areas
Community members and in-charges felt that contract nurses were more motivated and worked harder than permanent nurses
Summary
Shortages of health workers in rural areas are a global problem. The problem is more acute in poorer countries where the distribution of skilled, supported and motivated health workers is affected by internal and international migration. In Nepal, most women deliver at home, and the government has prioritized training and recruitment of nurses in rural areas to meet development goals. Health sector reform for increased retention: Decentralisation of authority to district level health facility management committees (HFMCs) has the potential to increase public accountability and make health services more locally responsive. The Government of Nepal is encouraging local recruitment of nurses by HFMCs to increase access to maternal health care. Our research describes the differences between nurses on different contracts, examining their motivation, job satisfaction and retention in rural areas
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