Understanding the 'four directions of travel': qualitative research into the factors affecting recruitment and retention of doctors in rural Vietnam

<p>Abstract</p> <p>Background</p> <p>Motivation and retention of health workers, particularly in rural areas, is a question of considerable interest to policy-makers internationally. Many countries, including Vietnam, are debating the right mix of interventions to motiv...

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Main Authors: Witter Sophie, Thi Thu Ha Bui, Shengalia Bakhuti, Vujicic Marko
Format: Article
Language:English
Published: BMC 2011-08-01
Series:Human Resources for Health
Online Access:http://www.human-resources-health.com/content/9/1/20
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author Witter Sophie
Thi Thu Ha Bui
Shengalia Bakhuti
Vujicic Marko
author_facet Witter Sophie
Thi Thu Ha Bui
Shengalia Bakhuti
Vujicic Marko
author_sort Witter Sophie
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Motivation and retention of health workers, particularly in rural areas, is a question of considerable interest to policy-makers internationally. Many countries, including Vietnam, are debating the right mix of interventions to motivate doctors in particular to work in remote areas. The objective of this study was to understand the dynamics of the health labour market in Vietnam, and what might encourage doctors to accept posts and remain in-post in rural areas.</p> <p>Methods</p> <p>This study forms part of a labour market survey which was conducted in Vietnam in November 2009 to February 2010. The study had three stages. This article describes the findings of the first stage - the qualitative research and literature review, which fed into the design of a structured survey (second stage) and contingent valuation (third stage). For the qualitative research, three tools were used - key informant interviews at national and provincial level (6 respondents); in-depth interviews of doctors at district and commune levels (11 respondents); and focus group discussions with medical students (15 participants).</p> <p>Results</p> <p>The study reports on the perception of the problem by national level stakeholders; the motivation for joining the profession by doctors; their views on the different factors affecting their willingness to work in rural areas (including different income streams, working conditions, workload, equipment, support and supervision, relationships with colleagues, career development, training, and living conditions). It presents findings on their overall satisfaction, their ranking of different attributes, and willingness to accept different kinds of work. Finally, it discusses recent and possible policy interventions to address the distribution problem.</p> <p>Conclusions</p> <p>Four typical 'directions of travel' are identified for Vietnamese doctors - from lower to higher levels of the system, from rural to urban areas, from preventive to curative health and from public to private practice. Substantial differences in income from formal and informal sources all reinforce these preferences. While non-financial attributes are also important for Vietnamese doctors, the scale of the difference of opportunities presents a considerable policy challenge. Significant salary increases for doctors in hard-to-staff areas are likely to have some impact. However, addressing the differentials is likely to require broader market reforms and regulatory measures.</p>
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spelling doaj.art-7ab0b085bc064d0fb3d763e839351d422022-12-22T03:17:06ZengBMCHuman Resources for Health1478-44912011-08-01912010.1186/1478-4491-9-20Understanding the 'four directions of travel': qualitative research into the factors affecting recruitment and retention of doctors in rural VietnamWitter SophieThi Thu Ha BuiShengalia BakhutiVujicic Marko<p>Abstract</p> <p>Background</p> <p>Motivation and retention of health workers, particularly in rural areas, is a question of considerable interest to policy-makers internationally. Many countries, including Vietnam, are debating the right mix of interventions to motivate doctors in particular to work in remote areas. The objective of this study was to understand the dynamics of the health labour market in Vietnam, and what might encourage doctors to accept posts and remain in-post in rural areas.</p> <p>Methods</p> <p>This study forms part of a labour market survey which was conducted in Vietnam in November 2009 to February 2010. The study had three stages. This article describes the findings of the first stage - the qualitative research and literature review, which fed into the design of a structured survey (second stage) and contingent valuation (third stage). For the qualitative research, three tools were used - key informant interviews at national and provincial level (6 respondents); in-depth interviews of doctors at district and commune levels (11 respondents); and focus group discussions with medical students (15 participants).</p> <p>Results</p> <p>The study reports on the perception of the problem by national level stakeholders; the motivation for joining the profession by doctors; their views on the different factors affecting their willingness to work in rural areas (including different income streams, working conditions, workload, equipment, support and supervision, relationships with colleagues, career development, training, and living conditions). It presents findings on their overall satisfaction, their ranking of different attributes, and willingness to accept different kinds of work. Finally, it discusses recent and possible policy interventions to address the distribution problem.</p> <p>Conclusions</p> <p>Four typical 'directions of travel' are identified for Vietnamese doctors - from lower to higher levels of the system, from rural to urban areas, from preventive to curative health and from public to private practice. Substantial differences in income from formal and informal sources all reinforce these preferences. While non-financial attributes are also important for Vietnamese doctors, the scale of the difference of opportunities presents a considerable policy challenge. Significant salary increases for doctors in hard-to-staff areas are likely to have some impact. However, addressing the differentials is likely to require broader market reforms and regulatory measures.</p>http://www.human-resources-health.com/content/9/1/20
spellingShingle Witter Sophie
Thi Thu Ha Bui
Shengalia Bakhuti
Vujicic Marko
Understanding the 'four directions of travel': qualitative research into the factors affecting recruitment and retention of doctors in rural Vietnam
Human Resources for Health
title Understanding the 'four directions of travel': qualitative research into the factors affecting recruitment and retention of doctors in rural Vietnam
title_full Understanding the 'four directions of travel': qualitative research into the factors affecting recruitment and retention of doctors in rural Vietnam
title_fullStr Understanding the 'four directions of travel': qualitative research into the factors affecting recruitment and retention of doctors in rural Vietnam
title_full_unstemmed Understanding the 'four directions of travel': qualitative research into the factors affecting recruitment and retention of doctors in rural Vietnam
title_short Understanding the 'four directions of travel': qualitative research into the factors affecting recruitment and retention of doctors in rural Vietnam
title_sort understanding the four directions of travel qualitative research into the factors affecting recruitment and retention of doctors in rural vietnam
url http://www.human-resources-health.com/content/9/1/20
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