Factors associated with staffing of Medical Doctors and Nurses in Rural Areas

Abstract

Objective: To determine the factors associated with staffing of doctors and nurses in rural Health Institutions in Zambia.Design: This was a cross-sectional study using a structured self-administered closed and open-ended questionnaire.Setting: The study was undertaken at the University Of Zambia School of Medicine, University Teaching Hospital, Ndola Central Hospital, Kitwe Central Hospital, Kasama General Hospital and Chinsali District Hospital.Subjects: A total of 230 consenting practicing doctors and nurses, and final year medical and nursing students were interviewed.Sampling method: A convenient sample was used for the provinces and districts. Since we had only three main Registered Nursing Schools and one medical school at the time, all these were selected for the study. Due to the low numbers of doctors, nurses and students found in the study settings, all those found at the stations at the time of interviews were enrolled in the study.Main outcome measure: The main outcome measure was the willingness of medical personnel to work in the rural areas for at least five years continuously.Results After adjusting for confounding factors, the study revealed that for practicing Doctors and Nurses, age and marital status were the only factors significantly associated with the outcome. At each birthday respondents were 1.08 (95%CI; 1.001, 1.156; p=0.046) times more likely to be willing to work in rural areas for more than five years. Respondents who were married were 55% (OR=0.45, 95%CI; 0.205, 0.973; p=0.043) less likely to be willing to work in the rural areas for more than five years compared to those who were single. For student Doctors and Nurses, curricula and age were the only factors significantly associated with the outcome (length of stay longer than five years in a rural area). Students were 23% (OR=1.23, 95%CI; 1.04, 1.44; p= 0.013) times more likely to be willing to work in rural areas. Students who were of the conviction that the curricula prepared them adequately to work in rural areas were 6.56 (95%CI; 1.80,23.83; p=0.004) more likely to be willing to work in rural areas for more than five years compared to those who were of the conviction that the curricula did not prepare them to work in the rural areas.