Health workers' preferences and policy interventions to improve retention in rural areas in Thailand

Pagaiya N, Sriratana S, Tangchareonsathien V, Noree T, Lagarde M & Blaauw D, 2011 CREHS

Because the health workforce is a crucial component of the health system, a shortage of health workers could negatively affect health outcomes. The shortage of doctors and nurses in rural areas is a recurring concern in Thailand. While the demand for health care services has grown, public sector doctors and nurses have been lost to the private sector and, at the same time, the number of those working in rural health facilities has declined.. Significant attention has been focused on strategies to address the problem, but it is not clear which policy interventions would be most effective. This study set out to examine the job preferences of newly graduated doctors and nurses to identify effective policy interventions that could improve the recruitment and retention of doctors and nurses in rural areas.

The results show that high salary, workplace close to hometown, small hospital size, less overtime work, opportunity for specialty training opportunities and faster career promotion were important for young doctors to choose rural posts. Nurses seemed to be more optimistic about working in rural areas than their doctor counterparts; however, they hesitated to choose to work in rural areas. We found that nurses were particularly sensitive to the type of facility where they would be posted in rural areas, with a very strong preference for hospitals versus health centres.

In conclusion, the results suggest that a range of interventions, including financial and non-financial incentives that would attract doctors and nurses to rural areas, are available and are important. In addition, recruiting students from rural backgrounds, as a strategy in combination with financial and non-financial incentives, seems to be good policy option.

Research report | Thailand | Health workforce