Incentives to attract and retain qualified health workers to under-served areas within low- and middle-income countries
Incentives and employment preferences in an under-served area of Peru: a combined qualitative study and discrete choice experiment
Peru is a low- and middle-income country with huge health inequities characterized by subnational heterogeneous patterns of death and burden of disease. This presents a strong challenge to the health system in developing effective preventive and control interventions. The health workforce is unevenly distributed, with physicians and qualified health workers concentrated in the capital city and a scarcity – or outright absence – in inner rural areas. There are no systematic studies on factors influencing recruitment and retention of health workers in under-served areas, let alone on evaluation of interventions effectiveness.
The Research Project aims to answer the following questions:
Question 1: What are the main financial and non-financial motivations of different cadres of health workers to choose Ayacucho´s under-served areas as their practice location?
Question 2: Which financial and non-financial factors do they consider as “real” incentives for remaining in under-served areas that, in turn, should be promoted by policy-makers?
Question 3: What are the employment preferences of different categories of health workers in under-served areas of Peru?
The study will pursue a combined qualitative evaluation of the factors behind health workers’ choice of practice location and a discrete choice experiment through in-depth interviews and focus groups in Ayacucho. This will also identify the job attributes and levels that will be analysed for the probability of choosing a job. Doctors, nurses, midwives, and nurse technicians will be included for both components, as well as central, regional and local managers and policy-makers for the qualitative component. In this way the study expects to define the local scenario, and to understand health workers´ values and motivations for remaining in Ayacucho, and thus the main components that any attraction/retention strategy should include.
Advocacy addressed to policy-makers will be actively pursued, so they can incorporate the identified incentives in the design and implementation of new or modified retention/attraction strategies.
Project description
Programme: Incentives to attract and retain qualified health workers to under-served areas within low- and middle-income countries
Research title: Incentives and employment preferences in an under-served area of Peru: a combined qualitative study and discrete choice experiment
Thematic Research Area: Human Resources for Health
Grantee Country: Peru
Grantee Institution: Universidad Peruana Cayetano Heredia
Program Coordinator/Principle Investigator: Professor Luis Huicho
Start date: May 2009
Status of grant: Completed