Researching interventions to address the human resources for health crisis - an application of discrete choice experiments in Kenya, Thailand and South Africa
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Researching interventions to address the human resources for health crisis - an application of discrete choice experiments in Kenya, Thailand and South Africa
1. RESEARCHING INTERVENTIONS TO ADDRESS THE HUMAN RESOURCES FOR HEALTH CRISIS – AN APPLICATION OF DISCRETE CHOICE EXPERIMENTS IN KENYA, THAILAND AND SOUTH AFRICA
2. Identifying policies to improve nurse recruitment and retention in rural Kenya: Results of a discrete choice experiment Sandra Mudhune, Kethi Mullei, Jackline Wafula, Mike English, Catherine Goodman, Mylene Lagarde, Duane Blaauw
12. Population Characteristics Variable Pre-service Nurses (n=166) Distance Learning Nurses (n=179) P value Mean age (SD) 23.96 (2.32) 37.53 (6.39) <0.0001 Gender – female 68.07% 82.12% <0.0001 Marital status – married 10.24% 70.95% <0.0001 Rural background 90.36% 96.65% <0.0001 Maternal education 72.29% 40.22% <0.0001 Happy to accept rural posting 58.43% 46.37% <0.0001 Nursing 1 st career choice 61.45% 77.65% <0.0001
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Editor's Notes
HR plays a critical role in any attempt to improve health outcome The world redrawn according to the presence of nurses in health systems (for the map on top) and redrawn according to maternal mortality – this juxtaposition of maps illustrates one of the issues of the HR global crisis, which is the shortage of nurses where they are needed the most.
This shortage of HW is particularly seen in virtually all countries in rural areas. In Kenya the nursing HR crisis is of particular importance and over the years only short terms solutions have been found to solve this issue
Work is part of a larger study exploring RNs employment preferences
one of the objectives of the study was to test the effects of potential policies to attract nurses to rural areas, we wanted to be able to have job characteristics that were different for rural and urban positions.
Policy options identified as successful in promoting rural recruitment or retention from lit reviews or HR policy docs KII used to identify feasible local strategies FGDs used with nurses to make sure attributes and levels were relevant
Focused on RN students in their final year of which we have two types: pre-service students who have no work experience and are 1 st time college students Distance learners who are ENs seeking to upgrade to RNs and have upto 10 years worth of work experience
Focusing on the ORs for rural jobs so urban ORs are not represented here All job attributes were found to significantly influence the utility associated with a job, except type of facility, housing and management style in the DL All coefficients estimated were in the expected direction.. That is the better the working conditions, the greater the utility associated with the job, either in a rural or urban area.
The base case is a rural posting in a hospital, with a salary of USD 228, a single room provided, a 3 year contract, no guaranteed further training, personal management style and a guaranteed promotion after 4 years. Each bar represents what effect of the improved attribute has on the uptake of a rural post.
