Abstract
BackgroundThe critical shortage of human resources in health is a critical public health problem affecting most low- and middle-income countries, particularly in sub-Saharan Africa. In addition to the shortage of health professionals, attracting and retaining them in rural areas is a challenge. The objective of the study was to understand the factors that influence the attraction and retention of health professionals working in rural areas in Niger.MethodsA mixed-method study was conducted in Tillabery region, Niger. A conceptual framework was used that included five dimensions. Three data collection methods were employed: in-depth interviews, documentary analysis, and concept mapping. In-depth interviews were conducted with three main actor groups: policy-makers and Ministry of Health officials (n = 15), health professionals (n = 102), and local health managers (n = 46). Concept mapping was conducted with midwifery students (n = 29). Multidimensional scaling and cluster analysis were performed to analyse the data from the concept mapping method. A content analysis was conducted for the qualitative data.ResultsThe results of the study showed that the local environment, which includes living conditions (no electricity, lack of availability of schools), social factors (isolation, national and local insecurity), working conditions (workload), the lack of financial compensation, and individual factors (marital status, gender), influences the attraction and retention of health professionals to work in rural areas. Human resources policies do not adequately take into account the factors influencing the retention of rural health professionals.ConclusionIntersectoral policies are needed to improve living conditions and public services in rural areas. The government should also take into account the feminization of the medical profession and the social and cultural norms related to marital status and population mobility when formulating human resources management policies.
Highlights
IntroductionWork bonus Civil servants occupying a position or performing health care in hospital and non-hospital health facilities
Introduction dateCompensation and targetsIsolation pay Health personnelRolling compensation Surgeon general of a department or wingTelephone allowance Hospital directors and CHD, surgeons, gynecologists, financial officers of national hospitals and maternity wards, hospital administrators, health department directors, medical supervisors, department or wing doctors, family health officers of CHD and CMDecree 94-196/PRN/MSPHousing allowance Doctors, pharmacists, dental surgeonsWork bonus Civil servants occupying a position or performing health care in hospital and non-hospital health facilitiesPremium suggestion Risk allowance Personnel occupying positions in hospital and non-hospital health facilitiesDecree 2006-079/PRN/MSP/ LEDecree 2012-61/PRN/MSP /MF/PF/PE/MFP/T/MF 29 February 2012
The results of this study showed that the attraction and retention of health professionals in rural areas are influenced by the local environment, which encompasses living conditions, social factors, working conditions, salaries, financial compensation, and assigned responsibilities, along with individual factors such as marital status and gender (Table 3)
Summary
Work bonus Civil servants occupying a position or performing health care in hospital and non-hospital health facilities. Premium suggestion Risk allowance Personnel occupying positions in hospital and non-hospital health facilities. The critical shortage of human resources in health is a critical public health problem affecting most lowand middle-income countries, in sub-Saharan Africa. In addition to the shortage of health professionals, attracting and retaining them in rural areas is a challenge. The objective of the study was to understand the factors that influence the attraction and retention of health professionals working in rural areas in Niger. Many studies have focused on factors influencing the attraction and the retention of health professionals in rural areas in low- and middle-income countries [2, 4, 5]. In Vietnam, low salaries and problematic working conditions
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