Factors associated with the choice of public health service among nursing students in Thailand
Public and private nursing schools have contributed significantly to the Thai health system, but it is not clear to what extent job preferences differ between training institutions.
This paper examines attitudes towards rural practice, intention to work in public service after graduation and factors affecting workplace selection among nursing students in both public and private institutions. The study used a descriptive, comparative, cross-sectional sample survey to study the job intentions of nursing students from public and private nursing training institutions. The data was collected between February and March 2012.
- A higher proportion of public nursing students (86.4% from the Ministry of Publuic Health and 74.1% from the Ministry of Eduction) preferred working in the public sector, compared to 32.4% of students from the private sector.
- Rural upbringing and entering a nursing education programme by local recruitment were positively associated with rural attitude.
- Students who were trained in public nursing schools were less motivated by financial incentives regarding workplace choices relative to students trained by private institutions.
- Nursing schools should continue to selectively recruit students from rural areas as they are more likely to choose to work for public institutions.
- Curriculum content and training experience in nursing schools should be more focused on promoting a positive student attitude toward rural areas by providing more exposure to rural practice and environments during their education.
- The government could provide scholarships to private students with a period of compulsory work in rural areas after graduation.
- Since salary appears to be the main determinant of job choice for nursing students, particularly right after graduation, there needs to be a greater focus on non-financial incentives (e.g., mentoring, in-service training, awards, advancement potential) to attract nurse graduates and retain them in the public sector. Public healthcare providers may not be able to compete with private hospitals on wages, but the additional recruitment/retention strategies of tuition reimbursement and earning more social benefits of public service more quickly might prove significant.