Abstract
The availability and retention of healthcare professionals in rural areas and remote areas is a challenge to the health sector worldwide. Attracting people who are most likely to be interested in rural practice can be conducive to the sustainable availability of health services in rural areas where health facilities are typically understaffed and existing professionals often underqualified. This article aims to contribute to the rural pipeline evidence, and reports on the findings of a study that investigated the career choices of midwifery and obstetric nurse students in Mali. The article enquires into the relationship between their intention to practice in rural areas and the different components of the rural pipeline. A mixed method study using a survey, semi-structured interviews, and document analysis was conducted from October to December 2017 on third-year midwifery and obstetric nurse students and school-managers. Descriptive statistics and bivariate analysis were performed for quantitative data, and content analysis was carried out for the qualitative data. Key findings suggest that students prefer urban locations for living and for work. The intention to work in rural areas seems to be influenced by the current living situation (currently living in a rural area) or having attended secondary school or professional training in rural areas.
Highlights
Qualified and available health care providers are essential for delivering quality health care and improving the health status of populations
The concept of rural pipeline has four components [9]: i) advocating health professions among rural students, ii) ensuring that more rural students are selected into programs, iii) developing a curriculum oriented towards rural health and rural exposure during training and iv) ensuring retention of health workers in rural areas through educational and professional support
We first present rural pipeline components in use, and students’ perceptions about and willingness to practice in rural areas
Summary
Qualified and available health care providers are essential for delivering quality health care and improving the health status of populations. There is an acute shortage of qualified professionals in low-income countries that bear the greatest burden of maternal and child illnesses and deaths. According to its latest Demographic and Health Surveys (DHS IV and V), maternal mortality in Mali has declined from 464 to 368 deaths per 100,000 births [1]. It is still among the highest in the world, far beyond the 70 per 100,000 live births targeted by the Sustainable Development Goals by 2030 [2].
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