Factors influencing recruitment and retention of professional nurses, doctors and allied health professionals in rural hospitals in KwaZulu Natal

Abstract

Introduction: In South Africa fewer health professionals (HPs) work in rural areas compared to urban areas, despite rural communities having greater health needs. This study explores factors influencing recruitment and retention of three categories of HPs in KwaZulu-Natal and has implications about how to retain them in rural areas.

Methods: A cross-sectional, descriptive survey was conducted in 8 hospitals, 5 rural and 3 urban, in one district in KZN in 2011. Data were collected on single day in each hospital and all HPs on duty were requested to participate. We compared responses from rural and urban based HP as well as professional nurses (PNs), doctors, and allied HPs.

Results: 417 questionnaires were completed: 150 from HPs in rural and 267 from HPs in urban hospitals. Perceptions of living/working in rural areas is negative and the quality of health care provided in rural areas is perceived as poor by all categories of HP. Rural-basedHPs were more likely to report living apart from spouse/partner (72.1% vs 37.0%, p < 0.001)and children (76.7% vs 36.9%, p < 0.001), and living in hospital accommodation (50.8% vs 28.9%; p < 0.001).

Conclusions: Decisions made by HP about where to work are complex, multifactorial and should be tailored to each category of health professional.