How to make rural jobs more attractive to health workers. Findings from a discrete choice experiment in Tanzania

• Published in: Health economics Vol. 20; no. 2; pp. 196 - 211
• Main Author: Kolstad, Julie Riise
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01-02-2011; Wiley Periodicals Inc
• Subjects: Career Choice; Discrete choice; discrete choice experiments; Family; Female; Health economics; Health services; Health Services Accessibility; Hierarchies; human resources for health; Humans; Male; Medical personnel; Medically Underserved Area; Motivation; Professional Practice Location; Recruitment; Rural areas; Rural communities; Rural Health Services - economics; Rural Health Services - manpower; rural-urban imbalances; Salaries and Fringe Benefits; Sex Factors; Studies; Tanzania; Wages; Tanzania
• ISSN: 1057-9230; 1099-1050
• DOI: 10.1002/hec.1581

The geographical imbalance of the health workforce in Tanzania represents a serious problem when it comes to delivering crucial health services to a large share of the population. This study provides new quantitative information about how to make jobs in rural areas more attractive to newly educated clinical officers (COs). A unique data set stemming from a discrete choice experiment with CO finalists in Tanzania is applied. The results show that offering continuing education after a certain period of service is one of the most powerful recruitment instruments the authorities have available. Increased salaries and hardship allowances will also substantially increase recruitment in rural areas. Offers of decent housing and good infrastructure, including the provision of equipment, will increase recruitment to rural remote areas but not as much as higher wages and offers of education. Women are less responsive to pecuniary incentives and are more concerned with factors that directly allow them to do a good job, while those with parents living in a remote rural area are generally less responsive to the proposed policies. When the willingness to help other people is a strong motivating force, policies that improve the conditions for helping people appear particularly effective. Copyright © 2010 John Wiley & Sons, Ltd.