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Job Preferences of Nurses and Midwives for Taking Up a Rural Job in Peru: A Discrete Choice Experiment

Author

Listed:
  • Luis Huicho
  • J Jaime Miranda
  • Francisco Diez-Canseco
  • Claudia Lema
  • Andrés G Lescano
  • Mylene Lagarde
  • Duane Blaauw

Abstract

Background: Robust evidence on interventions to improve the shortage of health workers in rural areas is needed. We assessed stated factors that would attract short-term contract nurses and midwives to work in a rural area of Peru. Methods and Findings: A discrete choice experiment (DCE) was conducted to evaluate the job preferences of nurses and midwives currently working on a short-term contract in the public sector in Ayacucho, Peru. Job attributes, and their levels, were based on literature review, qualitative interviews and focus groups of local health personnel and policy makers. A labelled design with two choices, rural community or Ayacucho city, was used. Job attributes were tailored to these settings. Multiple conditional logistic regressions were used to assess the determinants of job preferences. Then we used the best-fitting estimated model to predict the impact of potential policy incentives on the probability of choosing a rural job or a job in Ayacucho city. We studied 205 nurses and midwives. The odds of choosing an urban post was 14.74 times than that of choosing a rural one. Salary increase, health center-type of facility and scholarship for specialization were preferred attributes for choosing a rural job. Increased number of years before securing a permanent contract acted as a disincentive for both rural and urban jobs. Policy simulations showed that the most effective attraction package to uptake a rural job included a 75% increase in salary plus scholarship for a specialization, which would increase the proportion of health workers taking a rural job from 36.4% up to 60%. Conclusions: Urban jobs were more strongly preferred than rural ones. However, combined financial and non-financial incentives could almost double rural job uptake by nurses and midwifes. These packages may provide meaningful attraction strategies to rural areas and should be considered by policy makers for implementation.

Suggested Citation

  • Luis Huicho & J Jaime Miranda & Francisco Diez-Canseco & Claudia Lema & Andrés G Lescano & Mylene Lagarde & Duane Blaauw, 2012. "Job Preferences of Nurses and Midwives for Taking Up a Rural Job in Peru: A Discrete Choice Experiment," PLOS ONE, Public Library of Science, vol. 7(12), pages 1-9, December.
    • Handle: RePEc:plo:pone00:0050315
    DOI: 10.1371/journal.pone.0050315
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    References listed on IDEAS

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    1. Pedersen, Duncan & Tremblay, Jacques & Errázuriz, Consuelo & Gamarra, Jeffrey, 2008. "The sequelae of political violence: Assessing trauma, suffering and dislocation in the Peruvian highlands," Social Science & Medicine, Elsevier, vol. 67(2), pages 205-217, July.
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    1. Yang, Jui-Chen & Johnson, F. Reed & Kilambi, Vikram & Mohamed, Ateesha F., 2015. "Sample size and utility-difference precision in discrete-choice experiments: A meta-simulation approach," Journal of choice modelling, Elsevier, vol. 16(C), pages 50-57.
    2. Priscylia Maria Sandehang & Rr Tutik Sri Hariyati, 2017. "Mapping a Career Ladder as an Initial Step in the Retention of Nurses," International Journal of Health and Medical Sciences, Mohammad A. H. Khan, vol. 3(2), pages 43-49.
    3. Dunsch, Felipe Alexander & Velenyi, Edit, 2019. "Job Preferences of Frontline Health Workers in Ghana - A Discrete Choice Experiment," SocArXiv bqx5k, Center for Open Science.
    4. Denise Doiron & Hong Il Yoo, 2020. "Stated preferences over job characteristics: A panel study," Canadian Journal of Economics/Revue canadienne d'économique, John Wiley & Sons, vol. 53(1), pages 43-82, February.
    5. Martin Kroczek & Jochen Späth, 2022. "The attractiveness of jobs in the German care sector: results of a factorial survey," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(9), pages 1547-1562, December.
    6. Qian Zhao & Miles M Yang & Yu-Ying Huang & Wenlin Chen, 2018. "How to make hand hygiene interventions more attractive to nurses: A discrete choice experiment," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-11, August.
    7. Shimeng Liu & Shunping Li & Yujia Li & Haipeng Wang & Jingjing Zhao & Gang Chen, 2019. "Job preferences for healthcare administration students in China: A discrete choice experiment," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-19, January.
    8. Alex Filby & Fran McConville & Anayda Portela, 2016. "What Prevents Quality Midwifery Care? A Systematic Mapping of Barriers in Low and Middle Income Countries from the Provider Perspective," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-20, May.

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