Abstract:
A major challenge to the achievement of Millennium Development Goals is the shortage of health workers in the remote areas, especially in the developing countries where preventable disease burden is high. The aim of the study was to determine perceived factors contributing to non-stay of professional health workers in rural areas of Enugu state and strategies to retain them. The study was a descriptive, cross-sectional, questionnaire-based study carried out in randomly selected health districts of Enugu state. A total of 236 consenting professional health staff with at least two years working experience were randomly selected. A validated researcher developed questionnaire was used to obtain information from the respondents. Data were analysed using descriptive statistics and facilitated by the Statistical Package for the Social Sciences (SPSS version 17.0). Findings revealed that there were 70.8% females and 29.2% males in the study. Age distribution showed a mean age of 33.8 with a standard deviation of 8.23. Family tie was the most significant personal factor identified as contributing to non-stay of health workers (P<0.0005). Among the institutional factors affecting non-stay of health workers in rural areas, poor organizational policy and inadequate reward/ recognition were considered very strong reasons for non-stay (P<0.005). None of the community factors had a significant relationship with the staff decision to stay or not stay in the rural areas. Suggested strategies identified by respondents to retain health workers in rural areas included paying more to professionals working in rural areas (92.79%), provision of adequate security in the health centres (88.56%) and provision of rural allowance (92.79%). It is therefore recommended that the observed factors should assist stakeholders and government of Enugu State in formulating effective strategies that would improve retention of health workers in the rural areas. Postings to the rural areas should be rotational and preferably staff family locations should be considered. In addition, adequate remuneration and motivation for staff working in the rural areas should be considered as ways of improving shortage of professional health workers in the remote areas.
