Health Worker Attitudes toward Rural Service in India : Results from Qualitative Research

The paucity of qualified health workers in rural areas is a critical challenge for India's health sector. Although state governments have instituted several mechanisms, salary and non-salary, to attract health workers to rural areas, individually these mechanisms typically focus on single issues (e.g. salary). This qualitative study explores the career preferences of under-training and in-service doctors and nurses and identifies factors important to them to take up rural service. It then develops a framework for clustering these complex attributes into potential ?incentive packages for better rural recruitment and retention. The study was carried out in two geographically diverse Indian states, Uttarakhand and Andhra Pradesh. A total of 80 in-depth interviews were conducted with a variety of participants: medical students (undergraduate, postgraduate, and Indian system of medicine), nursing students, and doctors and nurses in primary health centers. The information collected was clustered by constructing several hierarchical displays, and collated into job-attribute matrixes. The findings indicate that, while financial and educational incentives attract doctors and nurses to rural postings, they do not make effective retention strategies. Frustration among rural health workers often stems from the lack of infrastructure, support staff, and drugs, a feeling exasperated by local political interference and lack of security.

Bibliographic Details

Main Authors:	Rao, Krishna D., Ramani, Sudha, Murthy, Seema, Hazarika, Indrajit, Khandpur, Neha, Chokshi, Maulik, Khanna, Saujanya, Vujicic, Marko, Berman, Peter, Ryan, Mandy
Format:	Working Paper biblioteca
Language:	English en_US
Published:	World Bank, Washington, DC 2010-11
Subjects:	ACCREDITATION, BUS SERVICE, BUSES, CAR, CAREER, CAREER PROSPECTS, CAREERS, CLEANLINESS, COLLEGES, COMMUNITIES, DECISION MAKING, DESCRIPTION, DISEASES, DRAINAGE, DRUGS, ELDERLY, EMERGENCIES, EMPLOYMENT, EQUAL OPPORTUNITIES, FAMILIES, FAMILY WELFARE, FEMALE, FEMALE STUDENTS, FURTHER EDUCATION, GENDER, GEOGRAPHIC DISTRIBUTION, GYNECOLOGY, HEALTH CENTERS, HEALTH FACILITIES, HEALTH POLICY, HEALTH PROVIDERS, HEALTH SECTOR, HEALTH SYSTEM, HEALTH WORKERS, HIGHER EDUCATION, HIGHER EDUCATION OPPORTUNITIES, HOMEOPATHY, HOSPITAL, HOSPITALS, HOUSEHOLDS, HOUSING, HOUSING CONDITIONS, HUMAN DEVELOPMENT, HUMAN RESOURCES, HUSBANDS, HYGIENE, ILLITERACY, IMMUNIZATION, ISOLATION, JOB MARKET, JOB SATISFACTION, JOB SECURITY, LANGUAGE BARRIERS, LEARNING, LEARNING OPPORTUNITIES, LEGAL PROTECTION, LEVEL OF EDUCATION, LIVING CONDITIONS, LOCAL TRANSPORT, MARITAL STATUS, MEDICAL COLLEGE, MEDICAL COLLEGES, MEDICAL DOCTORS, MEDICAL FACILITIES, MEDICAL PERSONNEL, MEDICAL PROFESSIONALS, MEDICAL SCHOOLS, MEDICAL SPECIALISTS, MEDICAL STUDENTS, MEDICINES, MIDWIFE, MIDWIFERY, MINISTRY OF HEALTH, NURSE, NURSES, NURSING, NURSING SCHOOLS, NURSING STUDENTS, NUTRITION, ON THE JOB TRAINING, ON THE JOB · TRAINING, PAPERS, PATIENT, PATIENTS, PEDIATRICS, PENSIONS, PERSONAL SAFETY, PHYSICAL WORK, POLICY PROCESSES, POLICY RESPONSE, POOR HEALTH, POOR HOUSING, POSTGRADUATE STUDENTS, POSTGRADUATE STUDIES, PRACTITIONERS, PRIMARY HEALTH CARE, PRIVATE SCHOOLS, PROFESSIONAL DEVELOPMENT, PROVIDER ATTITUDES, PUBLIC HEALTH, PUBLIC SERVICE, PUBLIC TRANSPORT, RECREATION, RESEARCH OPPORTUNITIES, RESPECT, ROAD, ROAD CONDITIONS, ROADS, RURAL AREA, RURAL AREAS, RURAL DEVELOPMENT, SAFETY OF WOMEN, SANITATION, SCHOOL BUS, SCHOOLS, SERVICE PROVIDER, SERVICE PROVIDERS, SICK LEAVE, SKILL DEVELOPMENT, SMALLER NUMBER, SPOUSE, STATE GOVERNMENTS, SUPERMARKETS, SUPPORT TO PARENTS, SURGERY, TEACHERS, TEACHING, TELEVISION, TOWNS, TRAINING HEALTH WORKERS, TRAINING OPPORTUNITIES, TRANSPORT, TRANSPORT FACILITIES, TV, UNDERGRADUATE STUDENTS, UNDERGRADUATES, URBAN AREA, URBAN AREAS, URBAN CENTER, VACCINES, VEHICLE, VIOLENCE, VULNERABILITY, WALKING, WASTE, WORK ENVIRONMENT, WORKERS, WORKFORCE, WORKING CONDITIONS, YOUNG CHILDREN,
Online Access:	http://documents.worldbank.org/curated/en/2010/11/13151191/health-worker-attitudes-toward-rural-service-india-results-qualitative-research http://hdl.handle.net/10986/13605
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