Retention and job satisfaction Retention and job satisfaction of rural health workforce in of rural health workforce in

ThailandThailand

Nonglak PagaiyaNonglak PagaiyaHRH Research and Development OfficeHRH Research and Development Office

Health System Research InstituteHealth System Research Institute

The 2The 2ndnd AAAH Conference AAAH Conference12-14 October 2007, Beijing, CHINA12-14 October 2007, Beijing, CHINA

Questions to be answeredQuestions to be answered

– Retention of vital health professional Retention of vital health professional in rural: doctors, nurses, primary in rural: doctors, nurses, primary health workershealth workers

– Factors affecting their turn over from Factors affecting their turn over from ruralrural

– Retention in rural and factorsRetention in rural and factors

Doctors: Leave/ intention to leave rural/ Doctors: Leave/ intention to leave rural/ publicpublic

FactorsFactors 19921992 19921992 20032003 20032003

Close to family/ hometownClose to family/ hometown

RecognitionRecognition

WorkloadWorkload

Career advancementCareer advancement

Growth/ further educationGrowth/ further education

PaymentPayment

Policy/ administrationPolicy/ administration

SupervisorSupervisor

Work conditionWork condition

Doctors: Intention to stay at ruralDoctors: Intention to stay at rural

FactorsFactors SumamanSumaman

19921992

PutasePutase

19961996

NoreeNoree

20072007

Close to family/ hometownClose to family/ hometown

RecognitionRecognition

Work itselfWork itself

AchievementAchievement

Career advancementCareer advancement

Growth/ further educationGrowth/ further education

PaymentPayment

Policy/ administrationPolicy/ administration

Work conditionWork condition

Relationship with peersRelationship with peers

Nurses: Intention to stay at ruralNurses: Intention to stay at rural

FactorsFactors Health centreHealth centre

20032003

Com hospitalCom hospital

20022002

RecognitionRecognition

AutonomyAutonomy

Career advancementCareer advancement

Growth/ further educationGrowth/ further education

Relationship with peersRelationship with peers

Appropriate shift workAppropriate shift work

Survival in rural health centres of Primary health Survival in rural health centres of Primary health workers (PHW)workers (PHW)

Survival Function

D5

403020100

Cum

Surv

ival

1.0

.8

.6

.4

.2

0.0

YEAR

2541-2545

2536-2540

2531-2535

2526-2530

2521-2525

2516-2520

2511-2515

53

7

1

2

4

6

1968-72

1973-77

1978-82

1983-87

1988-92

1993-97

1998-02

Primary health workers: turn over by age Primary health workers: turn over by age groupgroup

ReasonsReasons 1-5 yr1-5 yr 6-25 yr6-25 yr >25 yr >25 yr

hometownhometown//familyfamily 38%38% 62%62% 100%100%

Managerial deploymentManagerial deployment 15%15% 15%15%

Growth/ experience Growth/ experience enhancementenhancement

11%11% 19%19%

Seek for career Seek for career advancementadvancement

24%24% 1%1%

- HRH

- financial

-supply/equipment

- management

Organization support

motivation

Work satisfaction

leaving

Individual

family / home town, sex, education

Motivation factors

- career advancement

Maintenance factors

- Payment

Factors associate with their turn overFactors associate with their turn over

- HRH

- materials

Organization support

motivation

Work satisfaction

Retention

External

Other job hardship areas

Motivation factors

- Recognition

- work itself

- autonomy/ responsibility

Maintenance factors

- Relationship with peers

- work condition

ind: income

Factors associated with intention to stayFactors associated with intention to stay

- HRH

- financial

- materials

Organization support

Motivation

Work satisfaction

Retention

Ind. /ext

Family/ other jobs/ hardship areas

Motivation factors)

-work achievement

- Recognition

- career advancement

- growth/ further education

Maintenance factors

- Pay

-Relationship with peer

- policy/ administration

- work condition