How does additional education affect willingness to work in rural remote areas?

The main objective of this paper is to evaluate the effect of offering educational opportunities as a strategy to recruit health workers to rural areas. Tanzania, like the rest of sub-Saharan Africa, has a very small and unequally distributed health workforce. It has been suggested that rural remote jobs can be made more attractive to health workers with basic clinical skills by offering them the opportunity to upgrade their skills after a certain period of service. A data set capturing stated job preferences among freshly educated Tanzanian health workers with basic and more advanced clinical education is applied in order to investigate how additional education as an incentive mechanism affects willingness to work in rural areas. In order to control for selection effects into the additional education scheme, the two cadres are matched on propensity scores. It turns out that those health workers with advanced clinical education would have been more likely to prefer a job in a rural remote area had they not received the advanced clinical education. This effect (the ATT) is significant and substantial with several different specifications. The result is robust with regards to omitted variables and goes a long way in suggesting that a policy aimed at recruiting health personnel with basic clinical education to rural remote areas by offering jobs that include possibilities of upgrading after a certain period of service may be a temporary measure only.