A qualitative inquiry of rural-urban inequalities in the distribution and retention of healthcare workers in southern Nigeria.

<h4>Introduction</h4>Globally, the population in rural communities are disproportionately cared for by only 25% and 38% of the total physicians and nursing staff, respectively; hence, the poor health outcomes in these communities. This condition is worse in Nigeria by the critical shorta...

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Main Authors: Ogonna N O Nwankwo, Chukwuebuka I Ugwu, Grace I Nwankwo, Michael A Akpoke, Collins Anyigor, Uzoma Obi-Nwankwo, Sunday Andrew, Kelechukwu Nwogu, Neil Spicer
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0266159
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author Ogonna N O Nwankwo
Chukwuebuka I Ugwu
Grace I Nwankwo
Michael A Akpoke
Collins Anyigor
Uzoma Obi-Nwankwo
Sunday Andrew
Kelechukwu Nwogu
Neil Spicer
author_facet Ogonna N O Nwankwo
Chukwuebuka I Ugwu
Grace I Nwankwo
Michael A Akpoke
Collins Anyigor
Uzoma Obi-Nwankwo
Sunday Andrew
Kelechukwu Nwogu
Neil Spicer
author_sort Ogonna N O Nwankwo
collection DOAJ
description <h4>Introduction</h4>Globally, the population in rural communities are disproportionately cared for by only 25% and 38% of the total physicians and nursing staff, respectively; hence, the poor health outcomes in these communities. This condition is worse in Nigeria by the critical shortage of skilled healthcare workforce. This study aimed to explore factors responsible for the uneven distribution of healthcare workers (physicians and nurses) to rural areas of Ebonyi State, Nigeria.<h4>Methods</h4>Qualitative data were obtained using semi-structured in-depth interviews and focus group discussions from purposively selected physicians, nurses, and policymakers in the state. Data was analysed for themes related to factors influencing the mal-distribution of healthcare workers (physicians and nurses) to rural areas. The qualitative analysis involved the use of both inductive and deductive reasoning in an iterative manner.<h4>Results</h4>This study showed that there were diverse reasons for the uneven distribution of skilled healthcare workers in Ebonyi State. This was broadly classified into three themes; socio-cultural, healthcare system, and personal healthcare workers' intrinsic factors. The socio-cultural factors include symbolic capital and stigma while healthcare system and governance issues include poor human resources for health policy and planning, work resources and environment, decentralization, salary differences, skewed distribution of tertiary health facilities to urban area and political interference. The intrinsic healthcare workers' factors include career progression and prospect, negative effect on family life, personal characteristics and background, isolation, personal perceptions and beliefs.<h4>Conclusions</h4>There may be a need to implement both non-financial and financial actions to encourage more urban to rural migration of healthcare workers (physicians and nurses) and to provide incentives for the retention of rural-based health workers.
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spelling doaj.art-a09114256f594a349a18d7817032bd132022-12-22T02:54:07ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01173e026615910.1371/journal.pone.0266159A qualitative inquiry of rural-urban inequalities in the distribution and retention of healthcare workers in southern Nigeria.Ogonna N O NwankwoChukwuebuka I UgwuGrace I NwankwoMichael A AkpokeCollins AnyigorUzoma Obi-NwankwoSunday AndrewKelechukwu NwoguNeil Spicer<h4>Introduction</h4>Globally, the population in rural communities are disproportionately cared for by only 25% and 38% of the total physicians and nursing staff, respectively; hence, the poor health outcomes in these communities. This condition is worse in Nigeria by the critical shortage of skilled healthcare workforce. This study aimed to explore factors responsible for the uneven distribution of healthcare workers (physicians and nurses) to rural areas of Ebonyi State, Nigeria.<h4>Methods</h4>Qualitative data were obtained using semi-structured in-depth interviews and focus group discussions from purposively selected physicians, nurses, and policymakers in the state. Data was analysed for themes related to factors influencing the mal-distribution of healthcare workers (physicians and nurses) to rural areas. The qualitative analysis involved the use of both inductive and deductive reasoning in an iterative manner.<h4>Results</h4>This study showed that there were diverse reasons for the uneven distribution of skilled healthcare workers in Ebonyi State. This was broadly classified into three themes; socio-cultural, healthcare system, and personal healthcare workers' intrinsic factors. The socio-cultural factors include symbolic capital and stigma while healthcare system and governance issues include poor human resources for health policy and planning, work resources and environment, decentralization, salary differences, skewed distribution of tertiary health facilities to urban area and political interference. The intrinsic healthcare workers' factors include career progression and prospect, negative effect on family life, personal characteristics and background, isolation, personal perceptions and beliefs.<h4>Conclusions</h4>There may be a need to implement both non-financial and financial actions to encourage more urban to rural migration of healthcare workers (physicians and nurses) and to provide incentives for the retention of rural-based health workers.https://doi.org/10.1371/journal.pone.0266159
spellingShingle Ogonna N O Nwankwo
Chukwuebuka I Ugwu
Grace I Nwankwo
Michael A Akpoke
Collins Anyigor
Uzoma Obi-Nwankwo
Sunday Andrew
Kelechukwu Nwogu
Neil Spicer
A qualitative inquiry of rural-urban inequalities in the distribution and retention of healthcare workers in southern Nigeria.
PLoS ONE
title A qualitative inquiry of rural-urban inequalities in the distribution and retention of healthcare workers in southern Nigeria.
title_full A qualitative inquiry of rural-urban inequalities in the distribution and retention of healthcare workers in southern Nigeria.
title_fullStr A qualitative inquiry of rural-urban inequalities in the distribution and retention of healthcare workers in southern Nigeria.
title_full_unstemmed A qualitative inquiry of rural-urban inequalities in the distribution and retention of healthcare workers in southern Nigeria.
title_short A qualitative inquiry of rural-urban inequalities in the distribution and retention of healthcare workers in southern Nigeria.
title_sort qualitative inquiry of rural urban inequalities in the distribution and retention of healthcare workers in southern nigeria
url https://doi.org/10.1371/journal.pone.0266159
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