human resource on health: gender dimension
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Human Resource on Health: Gender Dimension. Churnrurtai Kanchanachitra, Suwit Wibulpolprasert, Thaksaphol Thammarangsri. Objectives. T o investigate the differences between gender, mobility from rural to urban areas public to the private sector training opportunities career development - PowerPoint PPT PresentationTRANSCRIPT
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Human Resource on Health: Human Resource on Health: Gender DimensionGender Dimension
Churnrurtai Kanchanachitra, Suwit Wibulpolprasert, Churnrurtai Kanchanachitra, Suwit Wibulpolprasert, Thaksaphol ThammarangsriThaksaphol Thammarangsri
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ObjectivesObjectivesTTo investigate the differences o investigate the differences between gender, between gender,
mobility from mobility from – rural to urban areasrural to urban areas– public to the private sectorpublic to the private sector– training opportunities training opportunities – careercareer development development
Data collected fromData collected from cohorts cohorts (1973, 1978, 1983, (1973, 1978, 1983, 1988, 1993) 1988, 1993) from a cohort retrospective survefrom a cohort retrospective survey of doctor mobility conducted by y of doctor mobility conducted by SuwitSuwit et al i et al in n 19981998
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Sampling Sampling PPopulation opulation
CohortCohort MaleMale FemaleFemale
NumberNumber %% NumberNumber %%
19731973 134134 68.468.4 6262 31.631.6
19781978 130130 73.973.9 4646 26.126.1
19831983 139139 76.076.0 4343 23.523.5
19881988 130130 77.477.4 3838 22.622.6
19931993 100100 59.959.9 6565 38.938.9
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Income level and working hoursIncome level and working hours
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Income Level Income Level (percent)(percent)
100 80 60 40 20 0 20 40 60 80 100
1973
1978
1983
1988
1993
Female Male
<20,00020,000-40,000
40,001-60,000
60,001-80,000
>80,000
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Working hour by Working hour by ffull-time equivalent ull-time equivalent (40(40hour = hour = 11 FTE) FTE)
100 80 60 40 20 0 20 40 60 80 100
1973
1978
1983
1988
1993
Female Male
0.5-0.99 1.0-1.49<0.49 1.5-1.99
2.0-2.49 2.5-2.99 3.0+
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Average working hour per weekAverage working hour per week
49.1753.2
56.261.54 63.66
48.21 50 51.3648.61
58.49
0
10
20
30
40
50
60
70
1973 1978 1983 1988 1993
Male
Female
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Percentage of income from private sector as Percentage of income from private sector as compared to total incomecompared to total income
100 80 60 40 20 0 20 40 60 80 100
1973
1978
1983
1988
1993
Female Male
1-24% 25-49%Private only
50-74% 75-99% Public only
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Type of specialist training by sex Type of specialist training by sex and year graduatedand year graduated
100 80 60 40 20 0 20 40 60 80 100
1973
1978
1983
1988
1993
Female Male
Surgery Obs-gynMedicine Pediatric
Orthopedic Radiologist Others
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Average number of years from Average number of years from graduation to specialist traininggraduation to specialist training
6.07
5.24 5.365.76
4.4
6.62
4.97 5.065.5
4.44
0
1
2
3
4
5
6
7
1973 1978 1983 1988 1993
Male
Female
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Percentage of doctors moving from Percentage of doctors moving from district to urban areadistrict to urban area
44.850
70.5
62.3
4545.2
69.665.1
71.1
55.4
0
10
20
30
40
50
60
70
80
1973 1978 1983 1988 1993
Male
Female
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Average number of years working Average number of years working in district hospital before movingin district hospital before moving
6
3.9 4 3.8
2.6
6.1
3.7 3.8 3.6
2.5
0
1
2
3
4
5
6
7
1973 1978 1983 1988 1993
Male
Female
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0.2
.4.6
.81
Kap
lan-
Mei
erS
urvi
val F
unct
ion
0 5 10 15 20 25years after graduation
male_1973 male_1978male_1983 male_1988
male_1993
Stay in District Hospital
Survival function of male doctors in district hospital
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0.2
.4.6
.81
Kap
lan-
Mei
erS
urvi
val F
unct
ion
0 5 10 15 20 25years after graduation
female_1973 female_1978female_1983 female_1988
female_1993
Stay in District Hospital
Survival function of female doctors in district hospital
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Percentage of doctors moving from Percentage of doctors moving from public to privatepublic to private
17.9
12.314.4
12.3
4
12.9
21.7
11.613.2
4.6
0
5
10
15
20
25
1973 1978 1983 1988 1993
Male
Female
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Average number of years working in Average number of years working in public sector before moving to privatepublic sector before moving to private
6.1
9.18.4
4.93.8
9.6
7.6
6.25.4
3.3
0
2
4
6
8
10
12
1973 1978 1983 1988 1993
Male
Female
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0.2
.4.6
.81
Kap
lan-
Mei
erS
urvi
val F
unct
ion
0 5 10 15 20 25years after graduation
male_1973 male_1978male_1983 male_1988
male_1993
Stay in Public Sector
Survival function of male doctors in public sector
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0.2
.4.6
.81
Kap
lan-
Mei
erS
urvi
val F
unct
ion
0 5 10 15 20 25years after graduation
female_1973 female_1978female_1983 female_1988
female_1993
Stay in Public Sector
Survival function of female doctors in public sector
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Factors related to rFactors related to relocation from elocation from ddistrict istrict hospitalshospitals to urban areas orto urban areas or to to Bangkok Bangkok (LPM)(LPM)
MaleMale -0.106***-0.106***
19781978 0.124**0.124**
19831983 0.268***0.268***
19881988 0.232***0.232***
19931993 0.0440.044
Khon KaenKhon Kaen -0.227***-0.227***
ChiangmaiChiangmai -0.132**-0.132**
SrinakarinwirotSrinakarinwirot 0.419*0.419*
SongklaSongkla -0.152*-0.152*
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Time (years) worked inTime (years) worked in ddistrict istrict hospitalshospitals before before moving moving to urban areas orto urban areas or to to Bangkok Bangkok (LPM)(LPM)
MaleMale 0.2940.294
19781978 -1.665***-1.665***
19831983 -1.567***-1.567***
19881988 -1.677***-1.677***
19931993 -3.169***-3.169***
% of public% of public 0.010**0.010**
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SummarySummary
• Older cohorts work longer in rural areas than the Older cohorts work longer in rural areas than the younger cohorts younger cohorts
• Women stay shorter and are more likely to move Women stay shorter and are more likely to move to urban areasto urban areas
• Majority of doctors moved out after 3 yearsMajority of doctors moved out after 3 years• If they can survive after 5 years, it is less likely If they can survive after 5 years, it is less likely
to move outto move out• Graduated from Universities outside Bangkok Graduated from Universities outside Bangkok
are more likely to stay in rural areasare more likely to stay in rural areas