Abstract
BackgroundAn unequal distribution of health personnel, leading to unfavourable differences in health status between urban and rural populations, is a serious cause for concern globally. Part of the solution to this problem lies in attracting medical doctors to rural, remote communities, which presents a real challenge. The present study therefore explored the factors that influence medical doctors’ decision to practise in rural Ghana.MethodsWe conducted a cross-sectional descriptive study based on questionnaires. Participants were doctors working in health facilities in the districts and rural areas of the Northern Region, Ghana. The qualitative data analysis consisted of an iterative process of open, axial and selective coding.ResultsWe administered the questionnaires to 40 doctors, 27 of whom completed and returned the form, signalling a response rate of 67.5%. The majority of the doctors were male (88.9%) and had been trained at the University for Development Studies, School of Medicine and Health Sciences (UDS-SMHS) (63%). Although they had chosen to work in the remote areas, they identified a number of factors that could prevent future doctors from accepting rural postings, such as: a lack of social amenities, financial and material resources; limited career progression opportunities; and too little emphasis on rural practice in medical school curricula. Moreover, respondents flagged specific stakeholders who, in their opinion, had a major role to play in the attraction of doctors and in convincing them to work in remote areas.ConclusionsThe medical doctors we surveyed had gravitated to the rural areas themselves for the opportunity to acquire clinical skills and gain experience and professional independence. Nevertheless, they felt that in order to attract such cadre of health professionals to rural areas and retain them there, specific challenges needed addressing. For instance, they called for an enforceable, national policy on rural postings, demanding strong political commitment and leadership. Another recommendation flowing from the study findings is to extend the introduction of Community-Based Education and Service (COBES) or similar curriculum components to other medical schools in order to prepare students for rural practice, increasing the likelihood of them accepting rural postings.
Highlights
An unequal distribution of health personnel, leading to unfavourable differences in health status between urban and rural populations, is a serious cause for concern globally
Other factors potentially influencing health workers’ willingness to practise in remote communities, as studies in the field of primary care have revealed, are socioeconomic status, rural background, gender, culture, and individual and curriculum characteristics, some variations may occur across settings [8, 10,11,12]
Qualitative results In the following paragraphs, we will expand on each of the themes that emerged from the qualitative data analysis
Summary
An unequal distribution of health personnel, leading to unfavourable differences in health status between urban and rural populations, is a serious cause for concern globally. The unequal global distribution of health personnel is a serious problem confronting the health sector This disparity of health personnel between the rural and urban populations can contribute to differences in health outcomes [1]. The Ghanaian government has resorted to a 20–30% salary top-up and a staff vehicle hire purchase scheme for health staff in an effort to attract and retain health workers in rural areas. Neither of these has yielded the desired results in addressing the lack of health professionals in rural areas. Other factors potentially influencing health workers’ willingness to practise in remote communities, as studies in the field of primary care have revealed, are socioeconomic status, rural background, gender, culture, and individual and curriculum characteristics, some variations may occur across settings [8, 10,11,12]
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