Exploring factors motivating health workers to choose and maintain a career in rural health practice in South Africa

Includes bibliographical references (leaves 159-168).The South African National Department of Health (NDoH) has committed itself to ensure that there is equity in the distribution of health workers especially to rural areas primarily through service requirements and incentives. Despite all initiatives put in place, the national health system struggles to recruit and retain health workers in rural health system struggles to recruit and retain health workers in rural health facilities. While the majority of health workers choose to practise in urban areas, some choose to pursue and persist in a career in rural health practice. This study determines, in the South African context, factors that motivate health workers to choose and maintain a career in rural health practice. It establishes what makes health workers choose to work in rural areas, what encourages them to stay in rural health practice and what tempts them to leave rural health practice. These factors interact at different levels, at the level of an individual health worker, of a rural health organisation or level of a rural community, to influence the decision of a health worker to choose, stay in or leave rural health pratice. The study combines both quantitative and qualitative methods in a cross-sectional survey to identify these factors from the perspective of rural health workers. It invites rural health workers to identify those factors that are applicable to them from the list of factors and rank them according to the degree of importance in their decision-making. A self-administered structured questionnaire and key informant interviews were used to collect data. The findings of this study show that rural background, desire to gain work experience, family obligations, prior interest in underserved area practice, desire or requirement to perform community service, desire to live in a rural area, family friendly enviornment and having friends living in a rural area are very important factors motivating health workers to choose a career in rural health practice