Rural job preferences of graduate class medical students in Ethiopia—a discrete choice experiment (DCE)

Engidaw, Mamo; Alemu, Melaku; Muche, Getasew Amare; Yitayal, Mezgebu

doi:10.1186/s12909-023-04133-3

Cited by 7 publications

(1 citation statement)

References 45 publications

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“…Financial bonuses in the form of increased salary or hardship allowances are the most commonly practiced incentive to improve health workers productivity or job satisfaction. Various studies that employed a discrete choice experiment have found that improving salary has a positive effect on health workers willingness to work in remote and rural locations (Efendi et al, 2016a;Engidaw et al, 2023;Jaskiewicz, 2012;Kolstad, 2011). The magnitude of effects however, varies between countries, and whether the study sample are students or practicing health workers.…”

Section: Introductionmentioning

confidence: 99%

Addressing Concerns of Access and Distribution of Health Workforce: A Discrete Choice Experiment to Develop Rural Attraction and Retention Strategies in Southwestern Ethiopia.

Hilo

2024

Preprint

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Background: There exists a shortage of healthcare workers in Ethiopia, with an uneven distribution between urban and remote areas. To formulate effective policy intervention aimed at attracting and retaining health workers in remote regions, this study examines the stated preferences of health workers when selecting health jobs. Methods: A Discrete Choice Experiment was conducted with health workers in the Aari and South Omo Zone of the South Ethiopia region from September to November 2022 to gather insights into their job preferences. After conducting literature review, focus group discussions and in-depth interviews salary, education, housing, location, timeliness of payment, medicine and equipment, management culture, and infrastructure attributes included in the study. To assess the relative importance of these job attributes and account for heterogeneity in preferences and scales, I used a mixed logit model with full correlation between utility coefficients. I conducted willingness to pay analysis using delta method and probability of job uptake for single incentive and combination of incentives based on results from the mixed logit model. Results: All eight attributes were statistically significant with the expected signs and demonstrated the existence of preference heterogeneity. Education, salary, and housing were of most concern to health workers when deciding their future workplace. Health workers are willing to trade a significant portion of their salary for improvements in other aspects of the job. Sub-group analysis showed that health workers with no rural background were willing to pay more to work at the zone center than health workers who lived in rural area for more than a year. The probability to work in rural area increases by 61% if education is offered to health workers after one year of service. Cost-effectiveness analysis revealed that raising salary is the most cost-effective incentive to attract and retain health workers. However, packages of incentives are always preferred over single incentive. Conclusion: Health workers express willingness to relocate to or continue serving in rural and remote areas, contingent upon improved working conditions Both monetary and non-monetary policy interventions should be considered by policymakers to attract and retain health workers to distant locations of southwestern Ethiopia.

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Section: Introductionmentioning

confidence: 99%

Addressing Concerns of Access and Distribution of Health Workforce: A Discrete Choice Experiment to Develop Rural Attraction and Retention Strategies in Southwestern Ethiopia.

Hilo

2024

Preprint

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Stated preferences of adolescents and young adults for sexual and reproductive health services in Africa: a systematic review protocol

Alemu,

Norman,

Dantas

et al. 2024

BMJ Open

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BackgroundAdolescence and young adulthood are critical life stages with varied healthcare needs. Adolescents and young adults (AYAs) are often confronted with challenges in their sexual and reproductive health (SRH) and rights. Uptake of SRH services among AYAs groups remains limited, especially in resource-limited settings. This could be partly attributed to the existing services not catering for the preferences of AYAs. However, there is no systematic evaluation of research to explore the preferences of AYAs for SRH services in Africa. Therefore, the objective of this systematic review is to assess AYAs’s preferences for SRH in Africa.Methods and analysisThe systematic review will follow the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. Stated preference studies in the area of SRH services conducted among AYAs will be included. We will search MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, Global Health and Google Scholar databases. Two independent researchers will screen the articles, and any disagreement will be handled through discussion with the broader research team. The quality of the included papers will be assessed and reported. The preferences for attributes, the most important and least important attributes and preference heterogeneity will be reported. In addition, the preference research gap across African regions and SRH services among AYAs will be reported.Ethics and disseminationEthical approval is not required for this protocol. The systematic review findings will be published in a peer-reviewed journal and presented at conferences.PROSPERO registration numberCRD42023386944.

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The impacts of altruism levels on the job preferences of medical students: a cross-sectional study in China

Zhang

Lin

et al. 2023

BMC Med Educ

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Background Rational allocation of human resources for health is crucial for ensuring public welfare and equitable access to health services. Understanding medical students’ job preferences could help develop effective strategies for the recruitment and retention of the health workforce. Most studies explore the relationship between extrinsic incentives and job choices through discrete choice experiments (DCEs). Little attention has been paid to the influence of intrinsic altruism on job choice. This study aimed to explore the heterogeneous preferences of medical students with different levels of altruism regarding extrinsic job attributes. Methods We conducted an online survey with 925 medical students from six hospitals in Beijing from July to September 2021. The survey combined job-choice scenarios through DCEs and a simulation of a laboratory experiment on medical decision-making behavior. Behavioral data were used to quantify altruism levels by estimating altruistic parameters based on a utility function. We fit mixed logit models to estimate the effects of altruism on job preference. Results All attribute levels had the expected effect on job preferences, among which monthly income (importance weight was 30.46%, 95% CI 29.25%-31.67%) and work location (importance weight was 22.39%, 95% CI 21.14%–23.64%) were the most salient factors. The mean altruistic parameter was 0.84 (s.d. 0.19), indicating that medical students’ altruism was generally high. The subgroup analysis showed that individuals with higher altruism levels had a greater preference for non-financial incentives such as an excellent work environment, sufficient training and career development opportunities, and a light workload. The change in the rate of the uptake of a rural position by individuals with lower levels of altruism is sensitive to changes in financial incentives. Conclusions Medical students’ altruism was generally high, and those with higher altruism paid more attention to non-financial incentives. This suggests that policymakers and hospital managers should further focus on nonfinancial incentives to better motivate altruistic physicians, in addition to appropriate economic incentive when designing recruitment and retention interventions. Medical school administrations could attach importance to the promotion of altruistic values in medical education.

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Rural job preferences of graduate class medical students in Ethiopia—a discrete choice experiment (DCE)

Cited by 7 publications

References 45 publications

Addressing Concerns of Access and Distribution of Health Workforce: A Discrete Choice Experiment to Develop Rural Attraction and Retention Strategies in Southwestern Ethiopia.

Addressing Concerns of Access and Distribution of Health Workforce: A Discrete Choice Experiment to Develop Rural Attraction and Retention Strategies in Southwestern Ethiopia.

Stated preferences of adolescents and young adults for sexual and reproductive health services in Africa: a systematic review protocol

The impacts of altruism levels on the job preferences of medical students: a cross-sectional study in China

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