Who Wants to Work in a Rural Health Post? The Role of Intrinsic Motivation, Rural Background and Faith-Based Institutions in Rwanda and Ethiopia
AbstractMost developing countries face shortages of health workers in rural areas. This has profound consequences for health service delivery, and ultimately for health outcomes. To design policies that rectify these geographic imbalances it is vital to understand what factors determine health workers' choice to work in rural areas. But empirical analysis of health worker preferences has remained limited due to the lack of data. Using unique contingent valuation data from a cohort survey of 412 nursing and medical students in Rwanda, this paper examines the determinants of future health workers' willingness to work in rural areas, as measured by rural reservation wages, using regression analysis. These data are also combined with those from an identical survey in Ethiopia to enable a two-country analysis. We find that health workers with higher intrinsic motivation – measured as the importance attached to helping the poor – as well as those who have grown up in a rural area, and Adventists who participate in a local bonding scheme are all significantly more willing to work in a rural area. The main Rwanda result for intrinsic motivation is strikingly similar to that obtained for Ethiopia and Rwanda together. These results suggest that in addition to economic incentives, intrinsic motivation and rural origin play an important role in health workers' decisions to work in a rural area, and that faith-based institutions matter.
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Bibliographic InfoPaper provided by Institute for the Study of Labor (IZA) in its series IZA Discussion Papers with number 4831.
Length: 22 pages
Date of creation: Mar 2010
Date of revision:
Publication status: published in: Bulletin of the World Health Organization, 2010, 88, 342-349.
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Other versions of this item:
- Pieter Serneels & Jose G. Montalvo & Gunilla Pettersson & Tomas Lievens & Jean Damascene Butera & Aklilu Kidanu, 2010. "Who Wants to Work in a Rural Health Post? The Role of Intrinsic Motivation, Rural Background and Faith-Based Institutions in Rwanda and Ethiopia," CSAE Working Paper Series 2010-10, Centre for the Study of African Economies, University of Oxford.
- Pieter Serneels, 2010. "Who Wants to Work in a Rural Health Post? The Role of Intrinsic Motivation, Rural Background and Faith-Based Institutions in Rwanda and Ethiopia," Economics Series Working Papers CSAE WPS/2010-10, University of Oxford, Department of Economics.
- J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply
- I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
This paper has been announced in the following NEP Reports:
- NEP-AFR-2010-04-04 (Africa)
- NEP-ALL-2010-04-04 (All new papers)
- NEP-DEV-2010-04-04 (Development)
- NEP-HEA-2010-04-04 (Health Economics)
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- Serneels, Pieter & Lindelow, Magnus & Garcia-Montalvo, Jose & Barr, Abigail, 2005. "For public service or money : understanding geographical imbalances in the health workforce," Policy Research Working Paper Series 3686, The World Bank.
- Anderson, Malcolm & Rosenberg, Mark W., 1990. "Ontario's underserviced area program revisited: An indirect analysis," Social Science & Medicine, Elsevier, vol. 30(1), pages 35-44, January.
- Michael A. Shields, 2004. "Addressing nurse shortages: what can policy makers learn from the econometric evidence on nurse labour supply?," Economic Journal, Royal Economic Society, Royal Economic Society, vol. 114(499), pages F464-F498, November.
- Paul R. Portney, 1994. "The Contingent Valuation Debate: Why Economists Should Care," Journal of Economic Perspectives, American Economic Association, vol. 8(4), pages 3-17, Fall.
- Peter A. Diamond & Jerry A. Hausman, 1994. "Contingent Valuation: Is Some Number Better than No Number?," Journal of Economic Perspectives, American Economic Association, vol. 8(4), pages 45-64, Fall.
- Timothy Besley & Maitreesh Ghatak, 2005.
"Competition and Incentives with Motivated Agents,"
American Economic Review,
American Economic Association, vol. 95(3), pages 616-636, June.
- Besley, Timothy J. & Ghatak, Maitreesh, 2004. "Competition and Incentives with Motivated Agents," CEPR Discussion Papers 4641, C.E.P.R. Discussion Papers.
- Tim Besley & Maitreesh Ghatak, 2005. "Competition and incentives with motivated agents," LSE Research Online Documents on Economics 928, London School of Economics and Political Science, LSE Library.
- Timothy Besley & Maitreesh Ghatak, 2003. "Competition and incentives with motivated agents," LSE Research Online Documents on Economics 2202, London School of Economics and Political Science, LSE Library.
- Sonja Fagernäs & Panu Pelkonen, 2011.
"Whether to Hire Local Contract Teachers? Trade-off Between Skills and Preferences in India,"
SERC Discussion Papers
0083, Spatial Economics Research Centre, LSE.
- Sonja Fagernäs & Panu Pelkonen, 2011. "Whether to Hire Local Contract Teachers? Trade-off Between Skills and Preferences in India," Working Paper Series 1811, Department of Economics, University of Sussex.
- Vujicic, Marko & Shengelia, Bakhuti & Alfano, Marco & Thu, Ha Bui, 2011. "Physician shortages in rural Vietnam: Using a labor market approach to inform policy," Social Science & Medicine, Elsevier, vol. 73(7), pages 970-977.
- Berhanu Feysia & Christopher H. Herbst & Wuleta Lemma & Agnes Soucat, 2012. "The Health Workforce in Ethiopia : Addressing the Remaining Challenges," World Bank Publications, The World Bank, number 2226.
- Sonja Fagernäs & Panu Pelkonen, 2012.
"Preferences and skills of Indian public sector teachers,"
IZA Journal of Labor & Development,
Springer, vol. 1(1), pages 1-31, December.
- Fagernäs, Sonja & Pelkonen, Panu, 2012. "Preferences and Skills of Indian Public Sector Teachers," IZA Discussion Papers 6563, Institute for the Study of Labor (IZA).
- Olivier, Jill & Wodon, Quentin, 2012. "Satisfaction with faith-inspired health care services in Africa: review and evidence from household surveys," MPRA Paper 45374, University Library of Munich, Germany.
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