What rural doctors want: a qualitative study in Chhattisgarh state.

The importance of addressing concerns of rural health worker welfare in order to improve their performance and retention is widely acknowledged; yet there is little empirical research on the needs of rural health professionals. We report findings from a qualitative research study in rural Chhattisgarh, involving indepth interviews with 37 practitioners and data analysis using the "framework" approach. Participants' expressions of their needs encompassed a range of reforms and improvements, including better salaries and job security, more rational posting and promotion procedures, and facility improvements. Opportunities for need-based skills training and better housing also emerged as key needs, as did better schools, assurance of personal security, and recognition and appreciation of their services by the administration. Increased investment in rural infrastructure and training, graded packages of benefits for rural doctors, and governance reforms to improve the internal accountability of government health services emerge as recommendations from the study.

Location and vocation: why some government doctors stay on in rural Chhattisgarh, India.

We conducted a qualitative research study in Chhattisgarh State, India, to explore why some qualified medical practitioners decide to stay on in government rural service. The fieldwork consisted of in-depth interviews with 37 practitioners who had an established record of rural service, and data were analyzed using the 'framework' approach for applied policy research. Study participants cited complexes of reasons for staying on, including geographical and ethnic (tribal) affinities, rural upbringing, availability of schools, personal values of service, professional interests, co-location with spouses, and relations with co-workers. Extrinsic (environmental) and intrinsic (personal) factors both play a part in determining the decisions of doctors to stay on, and are interdependent. Some doctors were influenced to remain by the close relationships they had developed with local communities and their acclimatisation over time to rural life. The policy imperative of rural workforce adequacy may be served less by choosing one retention strategy over another than by developing multi-dimensional solutions focused simultaneously on identifying and incentivising rural practitioners with appropriate characteristics, and on creating external conditions for their improved performance and welfare. Further, in a low-income setting such as India, questions of rural workforce adequacy cannot be addressed in isolation, but need to be tackled as part of broad agenda of social development that include strengthening public service systems and empowering communities.

What rural doctors want: a qualitative study in Chhattisgarh state

The importance of addressing concerns of rural health worker welfare in order to improve their performance and retention is widely acknowledged; yet there is little empirical research on the needs of rural health professionals. We report findings from a qualitative research study in rural Chhattisgarh, involving indepth interviews with 37 practitioners and data analysis using the “framework” approach. Participants’ expressions of their needs encompassed a range of reforms and improvements, including better salaries and job security, more rational posting and promotion procedures, and facility improvements. Opportunities for need-based skills training and better housing also emerged as key needs, as did better schools, assurance of personal security, and recognition and appreciation of their services by the administration. Increased investment in rural infrastructure and training, graded packages of benefits for rural doctors, and governance reforms to improve the internal accountability of government health services emerge as recommendations from the study.