IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0266159.html
   My bibliography  Save this article

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

Author

Listed:
  • Ogonna N O Nwankwo
  • Chukwuebuka I Ugwu
  • Grace I Nwankwo
  • Michael A Akpoke
  • Collins Anyigor
  • Uzoma Obi-Nwankwo
  • Sunday Andrew Jr.
  • Kelechukwu Nwogu
  • Neil Spicer

Abstract

Introduction: 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. Methods: 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. Results: 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. Conclusions: 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.

Suggested Citation

  • Ogonna N O Nwankwo & Chukwuebuka I Ugwu & Grace I Nwankwo & Michael A Akpoke & Collins Anyigor & Uzoma Obi-Nwankwo & Sunday Andrew Jr. & Kelechukwu Nwogu & Neil Spicer, 2022. "A qualitative inquiry of rural-urban inequalities in the distribution and retention of healthcare workers in southern Nigeria," PLOS ONE, Public Library of Science, vol. 17(3), pages 1-17, March.
    • Handle: RePEc:plo:pone00:0266159
    DOI: 10.1371/journal.pone.0266159
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266159
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0266159&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0266159?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Krishna D Rao & Mandy Ryan & Zubin Shroff & Marko Vujicic & Sudha Ramani & Peter Berman, 2013. "Rural Clinician Scarcity and Job Preferences of Doctors and Nurses in India: A Discrete Choice Experiment," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-9, December.
    2. Seye Abimbola & Titilope Olanipekun & Marta Schaaf & Joel Negin & Stephen Jan & Alexandra L. C. Martiniuk, 2017. "Where there is no policy: governing the posting and transfer of primary health care workers in Nigeria," International Journal of Health Planning and Management, Wiley Blackwell, vol. 32(4), pages 492-508, October.
    3. J Jaime Miranda & Francisco Diez-Canseco & Claudia Lema & Andrés G Lescano & Mylene Lagarde & Duane Blaauw & Luis Huicho, 2012. "Stated Preferences of Doctors for Choosing a Job in Rural Areas of Peru: A Discrete Choice Experiment," PLOS ONE, Public Library of Science, vol. 7(12), pages 1-9, December.
    4. Marc-Francois Smitz & Sophie Witter & Christophe Lemiere & Patrick Hoang-Vu Eozenou & Tomas Lievens & Rashid U Zaman & Kay Engelhardt & Xiaohui Hou, 2016. "Understanding Health Workers’ Job Preferences to Improve Rural Retention in Timor-Leste: Findings from a Discrete Choice Experiment," PLOS ONE, Public Library of Science, vol. 11(11), pages 1-14, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Oche Joseph Otorkpa & Chinenye Otorkpa & Onifade Adefunmilola Adebola & Stephen Emmanuel & Ahamed Adamu & Ololade Esther Olaniyan & Saizonou Jacques & Okolo Oseni & Abdirizak Mohamud Yusuf & Maman Ibr, 2024. "Von der Politik zur Praxis: Eine Überprüfung der Gesundheitspolitik in Afrika [From Policy to Practice: A Review of Africa’s Public Health Policy]," Post-Print hal-04587843, HAL.
    2. Helen. C. Nnadi & Onyinyechi. G. Ossai & Victor C. Nwokocha, 2024. "Urbanization factors and the vagaries of the rural health care industry in Nigeria: an analysis of the accessibility of healthcare services by older adults in the Nsukka Local Government Area," Palgrave Communications, Palgrave Macmillan, vol. 11(1), pages 1-9, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Krishna D Rao & Mandy Ryan & Zubin Shroff & Marko Vujicic & Sudha Ramani & Peter Berman, 2013. "Rural Clinician Scarcity and Job Preferences of Doctors and Nurses in India: A Discrete Choice Experiment," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-9, December.
    2. Nikita Arora & Matthew Quaife & Kara Hanson & Mylene Lagarde & Dorka Woldesenbet & Abiy Seifu & Romain Crastes dit Sourd, 2022. "Discrete choice analysis of health worker job preferences in Ethiopia: Separating attribute non‐attendance from taste heterogeneity," Health Economics, John Wiley & Sons, Ltd., vol. 31(5), pages 806-819, May.
    3. Dunsch, Felipe Alexander & Velenyi, Edit, 2019. "Job Preferences of Frontline Health Workers in Ghana - A Discrete Choice Experiment," SocArXiv bqx5k, Center for Open Science.
    4. Mohammadreza Amiresmaeili & Majid Heidari Jamebozorgi & Azam Heidari Jamebozorgi, 2022. "Identifying factors affecting dentists retention in deprived areas in Iran," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(3), pages 1340-1350, May.
    5. Emmanuel Ebuka Elebesunu & Gabriel Ilerioluwa Oke & Yusuff Adebayo Adebisi & Ifeanyi McWilliams Nsofor, 2021. "COVID‐19 calls for health systems strengthening in Africa: A case of Nigeria," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(6), pages 2035-2043, November.
    6. Leslie Berman & Levison Nkhoma & Margaret Prust & Courtney McKay & Mihereteab Teshome & Dumisani Banda & Dalitso Kabambe & Andrews Gunda, 2021. "Analysis of policy interventions to attract and retain nurse midwives in rural areas of Malawi: A discrete choice experiment," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-17, June.
    7. Sophie Witter & Christopher H Herbst & Marc Smitz & Mamadou Dioulde Balde & Ibrahim Magazi & Rashid U Zaman, 2021. "How to attract and retain health workers in rural areas of a fragile state: Findings from a labour market survey in Guinea," PLOS ONE, Public Library of Science, vol. 16(12), pages 1-20, December.
    8. Na-na Wang & Liang-guo Luo & Ya-ru Pan & Xue-mei Ni, 2019. "Use of discrete choice experiments to facilitate design of effective environmentally friendly agricultural policies," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 21(4), pages 1543-1559, August.
    9. Alessandro Stievano & Douglas Olsen & Ymelda Tolentino Diaz & Laura Sabatino & Gennaro Rocco, 2017. "Indian nurses in Italy: a qualitative study of their professional and social integration," Journal of Clinical Nursing, John Wiley & Sons, vol. 26(23-24), pages 4234-4245, December.
    10. Gareth H Rees & Felipe Peralta Quispe & Cris Scotter, 2021. "The implications of COVID‐19 for health workforce planning and policy: the case of Peru," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(S1), pages 190-197, May.
    11. Weituschat, Chiara Sophia & Pascucci, Stefano & Materia, Valentina Cristiana & Caracciolo, Francesco, 2023. "Can contract farming support sustainable intensification in agri-food value chains?," Ecological Economics, Elsevier, vol. 211(C).
    12. Mandeville, Kate L. & Ulaya, Godwin & Lagarde, Mylène & Muula, Adamson S. & Dzowela, Titha & Hanson, Kara, 2016. "The use of specialty training to retain doctors in Malawi: A discrete choice experiment," Social Science & Medicine, Elsevier, vol. 169(C), pages 109-118.
    13. Vikas Soekhai & Esther W. Bekker-Grob & Alan R. Ellis & Caroline M. Vass, 2019. "Discrete Choice Experiments in Health Economics: Past, Present and Future," PharmacoEconomics, Springer, vol. 37(2), pages 201-226, February.
    14. Boniface Ayanbekongshie Ushie & Ekerette Emmanuel Udoh & Anthony Idowu Ajayi, 2019. "Examining inequalities in access to delivery by caesarean section in Nigeria," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-16, August.
    15. Landry, Craig & Syphers, Steven & Keeler, Andrew, 2022. "Preferences for Post-storm Coastal Adaptation," 2022 Annual Meeting, July 31-August 2, Anaheim, California 322385, Agricultural and Applied Economics Association.
    16. Arora, Nikita & Quaife, Matthew & Hanson, Kara & Lagarde, Mylène & Woldesenbet, Dorka & Seifu, Abiy & Crastes dit Sourd, Romain, 2022. "Discrete choice analysis of health worker job preferences in Ethiopia: separating attribute non-attendance from taste heterogeneity," LSE Research Online Documents on Economics 113529, London School of Economics and Political Science, LSE Library.
    17. Hisaya Oda & Yuko Tsujita & Sebastian Irudaya Rajan, 2018. "An Analysis of Factors Influencing the International Migration of Indian Nurses," Journal of International Migration and Integration, Springer, vol. 19(3), pages 607-624, August.
    18. Shimeng Liu & Shunping Li & Yujia Li & Haipeng Wang & Jingjing Zhao & Gang Chen, 2019. "Job preferences for healthcare administration students in China: A discrete choice experiment," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-19, January.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0266159. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.