scholarly journals Job preferences for medical and nursing students to work in rural Guizhou Province, China: a discrete choice experiment

2020 ◽  
Author(s):  
Meiling Bao ◽  
Cunrui Huang
Keyword(s):  
Nursing Students ◽  
Discrete Choice ◽  
Rural Areas ◽  
Choice Experiment ◽  
Health Workers ◽  
Mixed Logit ◽  
Guizhou Province ◽  
Medical Order ◽  
Medical University ◽  
Education Opportunity

Abstract Background Maldistribution of health workers between urban and rural areas has been a critical difficulty in China. The shortage of health workers in disadvantaged areas reduces access to essential health services delivery, and adversely affects the population health. Policies on attracting health workers to locate in rural areas are needed to be explored. In order to identify the appropriate incentives, we conducted a discrete choice experiment to determine how specific job attributes might be valued by final year students in medical university in Guizhou Province, China. Methods Attributes of potential job were developed through literature review, in-depth semi-structured interviews and pretest. Salary, education opportunity, transportation, job location, workload, essential equipment, medical order, and identification ('bianzhi') were included. The questionnaire was formulated through a fractional factorial experiment design using %MktRuns macros of SAS 9.4. All medical and nursing students in the final year at Guizhou Medical University were invited to participate in the study. Mixed logit model was used to estimate stated preferences of attributes. Willingness to pay and uptake rates for a defined job were also calculated based on the mixed logit estimates. Results The final sample comprised 787 respondents, including 388 medical students and 399 nursing students. Attributes were statistically significant (with the exception of once every two years for education opportunity) and had expected signs. The results indicate that physical conflict between doctors and patients and identification ('bianzhi') were two of the most important non-monetary job characteristics for both medical and nursing students. And nursing students placed more value on identification ('bianzhi'). Policy simulation suggests that as for the individual incentive respondents were most sensitive to salary increasing. Incentive packages effects were stronger for students from rural background. Conclusions Strategies on medical order, identification ('bianzhi') and salary should be considered to attract final year medical and nursing students to work in rural areas. In addition, specific recruitment policy design tailored for subgroups should be taken into account.

scholarly journals Job preferences of medical and nursing students seeking employment in rural China: a discrete choice experiment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meiling Bao ◽  
Cunrui Huang
Keyword(s):  
Nursing Students ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Rural Areas ◽  
Choice Experiment ◽  
Health Workers ◽  
Rural China ◽  
Mixed Logit ◽  
Fractional Factorial ◽  
Guizhou Province

Abstract Background China has a shortage of health workers in rural areas, but little research exists on policies that attract qualified medical and nursing students to rural locations. We conducted a discrete choice experiment to determine how specific incentives would be valued by final–year students in a medical university in Guizhou Province, China. Methods Attributes of potential jobs were developed through the literature review, semi–structured interviews, and a pilot survey. Forty choice sets were developed using a fractional factorial design. A mixed logit model was used to estimate the relative strength of the attributes. Willingness to pay and uptake rates for a defined job were also calculated based on the mixed logit estimates. Results The final sample comprised 787 medical and nursing students. The statistically significant results indicated “Bianzhi” (the number of personnel allocated to each employer by the government) and physical conflicts between doctors and patients were two of the most important non-monetary job characteristics that incentivized both medical and nursing students. Policy simulation suggested that respondents were most sensitive to a salary increase, and the effect of incentive packages was stronger for students with a rural family background. Conclusions Strategies for patient–doctor relationships, Bianzhi and salary should be considered to attract final–year medical and nursing students to work in rural China. In addition, specific recruitment policy designs tailored for students with different majors and backgrounds should be taken into account.

scholarly journals Analysis of policy interventions to attract and retain nurse midwives in rural areas of Malawi: A discrete choice experiment

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253518
Author(s):  
Leslie Berman ◽  
Levison Nkhoma ◽  
Margaret Prust ◽  
Courtney McKay ◽  
Mihereteab Teshome ◽  
...  
Keyword(s):  
Health Worker ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Rural Areas ◽  
Choice Experiment ◽  
Health Workers ◽  
Scale Up ◽  
Unequal Distribution ◽  
Recruitment And Retention ◽  
Facility Level

Background Inadequate and unequal distribution of health workers are significant barriers to provision of health services in Malawi, and challenges retaining health workers in rural areas have limited scale-up initiatives. This study therefore aims to estimate cost-effectiveness of monetary and non-monetary strategies in attracting and retaining nurse midwife technicians (NMTs) to rural areas of Malawi. Methods The study uses a discrete choice experiment (DCE) methodology to investigate importance of job characteristics, probability of uptake, and intervention costs. Interviews and focus groups were conducted with NMTs and students to identify recruitment and retention motivating factors. Through policymaker consultations, qualitative findings were used to identify job attributes for the DCE questionnaire, administered to 472 respondents. A conditional logit regression model was developed to produce probability of choosing a job with different attributes and an uptake rate was calculated to estimate the percentage of health workers that would prefer jobs with specific intervention packages. Attributes were costed per health worker year. Results Qualitative results highlighted housing, facility quality, management, and workload as important factors in job selection. Respondents were 2.04 times as likely to choose a rural job if superior housing was provided compared to no housing (CI 1.71–2.44, p<0.01), and 1.70 times as likely to choose a rural job with advanced facility quality (CI 1.47–1.96, p<0.01). At base level 43.9% of respondents would choose a rural job. This increased to 61.5% if superior housing was provided, and 72.5% if all facility-level improvements were provided, compared to an urban job without these improvements. Facility-level interventions had the lowest cost per health worker year. Conclusions Our results indicate housing and facility-level improvements have the greatest impact on rural job choice, while also creating longer-term improvements to health workers’ living and working environments. These results provide practical evidence for policymakers to support development of workforce recruitment and retention strategies.

scholarly journals Job preferences of undergraduate pharmacy students in China: a discrete choice experiment

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ping Liu ◽  
Shimeng Liu ◽  
Tiantian Gong ◽  
Quan Li ◽  
Gang Chen ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Rural Areas ◽  
Choice Experiment ◽  
Job Characteristics ◽  
Pharmacy Students ◽  
Preference Heterogeneity ◽  
Short Supply ◽  
Job Preferences ◽  
Open Management

Abstract Background Pharmacists are a crucial part of the health workforce and play an important role in achieving universal health coverage. In China, pharmaceutical human resources are in short supply, and the distribution is unequal. This study aimed to identify the key job characteristics that influence the job preferences of undergraduate pharmacy students and to elicit the relative importance of different job characteristics to shed light on future policy interventions. Methods A discrete choice experiment was conducted to assess the job preferences of undergraduate pharmacy students from 6 provinces in mainland China. A face-to-face interview was used to collect data. Conditional logit and mixed logit models were used to analyse data, and the final model was chosen according to the model fit statistics. A series of policy simulations was also conducted. Results In total, 581 respondents completed the questionnaire, and 500 respondents who passed the internal consistency test were analysed. All attributes were statistically significant except for open management. Monthly income and work location were most important to respondents, followed by work unit (which refers to the nature of the workplace) and years to promotion. There was preference heterogeneity among respondents, e.g., male students preferred open management, and female students preferred jobs in public institutions. Furthermore, students with an urban background or from a single-child family placed higher value on a job in the city compared to their counterparts. Conclusion The heterogeneity of attributes showed the complexity of job preferences. Both monetary and nonmonetary job characteristics significantly influenced the job preferences of pharmacy students in China. A more effective policy intervention to attract graduates to work in rural areas should consider both incentives on the job itself and the background of pharmacy school graduates.

scholarly journals Experts’ preferences for sarcopenia outcomes: a discrete-choice experiment from a working group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) in collaboration with the European Union of Geriatric Medicine Society (EUGMS)

2021 ◽  
Author(s):  
Charlotte Beaudart ◽  
◽  
Jürgen M. Bauer ◽  
Francesco Landi ◽  
Olivier Bruyère ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Musculoskeletal Diseases ◽  
Geriatric Medicine ◽  
Mixed Logit ◽  
The European Union ◽  
Domestic Activities

Abstract Background and aims To assess experts’ preference for sarcopenia outcomes. Methods A discrete-choice experiment was conducted among 37 experts (medical doctors and researchers) from different countries around the world. In the survey, they were repetitively asked to choose which one of two hypothetical patients suffering from sarcopenia deserves the most a treatment. The two hypothetical patients differed in five pre-selected sarcopenia outcomes: quality of life, mobility, domestic activities, fatigue and falls. A mixed logit panel model was used to estimate the relative importance of each attribute. Results All sarcopenia outcomes were shown to be significant, and thus, important for experts. Overall, the most important sarcopenia outcome was falls (27%) followed by domestic activities and mobility (24%), quality of life (15%) and fatigue (10%). Discussion and conclusion Compared to patient’s preferences, experts considered falls as a more important outcome of sarcopenia, while the outcomes fatigue and difficulties in domestic activities were considered as less important.

scholarly journals Understanding Health Workers’ Job Preferences to Improve Rural Retention in Timor-Leste: Findings from a Discrete Choice Experiment

PLoS ONE ◽  
2016 ◽  
Vol 11 (11) ◽  
pp. e0165940 ◽  
Author(s):  
Marc-Francois Smitz ◽  
Sophie Witter ◽  
Christophe Lemiere ◽  
Patrick Hoang-Vu Eozenou ◽  
Tomas Lievens ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Health Workers ◽  
Job Preferences ◽  
Timor Leste ◽  
Rural Retention

scholarly journals Preferences of Medical Students for Rural Medical Internships in South Africa: A Discrete Choice Experiment

2020 ◽  
Author(s):  
Maria Jose ◽  
Amarech Obse ◽  
Mark Zuidgeest ◽  
Olufunke Alaba
Keyword(s):  
Medical Students ◽  
Rural Health ◽  
Health Facility ◽  
Discrete Choice ◽  
Rural Areas ◽  
Choice Experiment ◽  
Practical Experience ◽  
Medical Doctors ◽  
Hospital Safety ◽  
Main Effects

Abstract Background: Globally the proportion of medical doctors to population in rural areas in low- and middle-income countries remains insufficient to address their health care needs. Therefore, it is imperative to design strategies that attract medical doctors to rural areas to reduce health inequalities and achieve universal health coverage. Methods: This study assessed preferences of medical students for rural internships using a discrete choice experiment. Attributes of rural job were identified through literature and focus group discussions. A D-efficient design was generated with 15 choice sets, each with forced binary, unlabelled, rural hospital alternatives. An online survey was conducted, and data analysed using mixed logit models of main effects only and main effects plus interaction terms. Results: Majority of the respondents were females (130/66.33%) and had urban origin (176/89.80%). The main effects only model showed advanced practical experience, hospital safety, correctly fitting personal protective equipment, and availability of basic resources as the most important attributes influencing take up of rural internship, respectively. Respondents were willing to pay ZAR 2645.92 monthly (95%CI: 1345.90; 3945.94) to gain advanced practical experience (equivalent to 66.15% of current rural allowance). In contrast, increases in rural allowance and the provision of housing were the least important attributes. Based on the interaction model, female respondents and those intending general practise associated higher weight for hospital safety over advanced practical experience. Conclusion: In the context of limited budgets and resource constraints, policy makers and rural health facility managers are advised to prioritise meaningful internship practise environments that offer supervised learning environment, safety from physical and occupational hazards and the provision of basic resources for healthcare system-wide benefits to both staff and rural health facility users alike.

scholarly journals What do community health workers want? Findings of a discrete choice experiment among Accredited Social Health Activists (ASHAs) in India

2019 ◽  
Vol 4 (3) ◽  
pp. e001509 ◽  
Author(s):  
Marwa Abdel-All ◽  
Blake Angell ◽  
Stephen Jan ◽  
Martin Howell ◽  
Kirsten Howard ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Latent Class ◽  
Health Workers ◽  
Family Health ◽  
Health Check ◽  
Social Health ◽  
Significant Heterogeneity ◽  
Group 3

IntroductionA number of factors contribute to the performance and motivation of India’s Accredited Social Health Activists (ASHAs). This study aims to identify the key motivational factors (and their relative importance) that may help retain ASHAs in service.MethodsA discrete choice experiment (DCE) survey presented ASHAs with eight unlabelled choice sets, each describing two hypothetical jobs that varied based on five attributes, specifically salary, workload, travel allowance, supervision and other job benefits. Multinomial logit and latent class (LC) models were used to estimate stated preferences for the attributes.ResultWe invited 318 ASHAs from 53 primary health centres of Guntur, a district in south India. The DCE was completed by 299 ASHAs using Android tablets. ASHAs were found to exhibit a strong preference for jobs that incorporated training leading to promotion, a fixed salary and free family healthcare. ASHAs were willing to sacrifice 2530 Indian rupee (INR) from their monthly salary, for a job offering training leading to promotion opportunity and 879 INR for a free family health-check. However, there was significant heterogeneity in preferences across the respondents. The LC model identified three distinct groups (comprising 51%, 35% and 13% of our cohort, respectively). Group 1 and 2 preferences were dominated by the training and salary attributes with group 2 having higher preference for free family health-check while group 3 preferences were dominated by workload. Relative to group 3, ASHAs in groups 1 and 2 were more likely to have a higher level of education and less likely to be the main income earners for their families.ConclusionASHAs are motivated by both non-financial and financial factors and there is significant heterogeneity between workers. Policy decisions aimed at overcoming workforce attrition should target those areas that are most valued by ASHAs to maximise the value of investments into these workers.Trial registration numberCTRI/2018/03/012425.

Sign in / Sign up

Export Citation Format

Share Document