The Healthcare worker: Rural retention, retraining and professional development

Abstract

Zambia, like many sub-Saharan countries, has gross disparities between levels of care between urban and rural areas. The noticeable effect of this scenario on health care delivery in our rural areas is profoundly negative. A situation now prevails where about a third of our rural health centres are manned by unqualified health workers. 1 In this issue of the Journal, two feature articles address issues of great importance that play a pivotal role in our goal to provide quality health care. Munachonga and Siziya present a study that looks at factors associated with staffing of medical doctors and nurses in rural areas.2 The study reveals that marital status and a curriculum that prepares one for the rural setting are the predominant determinants. Single qualified staffs were 55% less likely to accept working in a rural area. This has greatly compromised the quality of health services delivered. The authors' objectives were limited to what they called factors that may have not been considered before. These factors are in effect individual factors that depend on personal characteristics, such as age, gender, or marital status.3 They are quite distinct but interrelated with international, national, local and work-related factors that have been addressed to some degree by Government.