Nursing Students’ Intention to Work in Rural Areas after Graduation: A Mixed Approach Study

Authors

  • Selina Siwakoti Nepal Health Research Council
  • Nand Ram Gahatraj School of Health and Allied Sciences, Pokhara University
  • Niranjan Shrestha School of Health and Allied Sciences, Pokhara University

DOI:

https://doi.org/10.61814/jkahs.v6i2.767

Keywords:

Career intention, Job location preferences, Nursing students, Rural area

Abstract

Introduction: A key issue of Human Resources for Health and constraint to Universal Health Coverage is a disparity between the number of healthcare providers in urban and rural areas. The accessibility to health services has been found difficult in rural areas due to shortage of health workers. As final-year nursing students are the prospective human resource for health, this study aimed to assess the intention of nursing students to work in rural areas and identify the motivating and discouraging factors associated with their intention.

Methods: Cross-sectional research design with mixed methods was conducted among final-year bachelor-level nursing students of Pokhara, Nepal from December 2019 to July 2020. A census method using a self-administered questionnaire was used for the quantitative method and in-depth interviews were conducted for the qualitative method. For quantitative method, descriptive and inferential statistics were used while content analysis for the qualitative method was carried out.

Results: About one-third (33.3%) participants intended to work in rural areas. The motivating factors were an opportunity for career advancement (AOR: 3.8; 95% CI: 1.35-10.77), locating near to family (AOR: 3.58, 95% CI: 1.36-9.45),  high salary/incentives, and high healthcare needs in rural areas; whereas discouraging factors were separation from family and friends (AOR 4.10, 95% CI 1.34-12.52), less availability of recreational facilities (AOR 3.68, 95% CI 1.11-12.21), inadequate salary/incentives, lack of equipment and resources, low utilization of skills and knowledge and low self-perceived competency.

Conclusions: Only one-third of the participants had the intention to have the job placement in rural areas. The participants preferred to work staying with or nearby their family. The enrollment of students of rural origin/residence or background in a nursing program should be ensured. Various motivating factors like training, attractive incentives, infrastructures, and facilities should be offered to make rural jobs more attractive.

References

Wilson NW, Couper ID, De Vries E, Reid S, Fish T, Marais BJ. A critical review of interventions to redress the inequitable distribution of healthcare professionals to rural and remote areas. Rural and remote health. 2009 Jun 1;9(2):1-21. [DOI] [Google Scholar] [Full Text] [PubMed]

Humphreys J, Jones J, Jones M, Hugo G, Bamford E, Taylor D. A critical review of rural medical workforce retention in Australia. Australian Health Review. 2001;24(4):91-102. [Google Scholar] [DOI] [Full Text] [PubMed]

Munikar S, Thapa K. Determinants and Aspirants of Nurse Migration from Nepal: A Cross-Sectional Study from Kathmandu. Medical Journal of Shree Birendra Hospital. 2019;18(2):22-28. [DOI] [Google Scholar]

Ailuogwemhe J, Rajbhandari R, Iliaki E, Villar M, Dieterich M. Tackling Shortages of Health Care Workers in Rural Nepal:'Train to Retain'. Harvard School of Public Health, Student Project, ID. 2005;262. [Full Text]

Dussault G, Franceschini MC. Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce. Hum Resour Health. 2006;4(1):12. [DOI] [Google Scholar] [PubMed] [Full Text]

International Labour Organization. Migration of Health Workers from Nepal. 2017. [Full Text]

DoHS. Annual Report: Department of Health Services 2074/75 (2017/18). Kathmandu, Nepal: Department of Health Services2074/75 2076. [Full Text]

Isaac V, Walters L, McLachlan CS. Association between self-efficacy, career interest and rural career intent in Australian medical students with rural clinical school experience. BMJ open. 2015;5(12). [DOI] [Google Scholar] [PubMed] [Full Text]

Silvestri DM, Blevins M, Afzal AR, Andrews B, Derbew M, Kaur S, et al. Medical and nursing students' intentions to work abroad or in rural areas: a cross-sectional survey in Asia and Africa. Bull World Health Organ. 2014; 92:750-759. [DOI] [Google Scholar] [PubMed]

Huntington I, Shrestha S, Reich NG, Hagopian A. Career intentions of medical students in the setting of Nepal’s rapidly expanding private medical education system. Health Policy Plan. 2011;27(5):417-428. [DOI] [Google Scholar] [PubMed]

De Vries E, Reid S. Do South African rural origin medical students return to rural practice. S Afr Med J. 2003;93(10):789-793. PMID: 14652974. [PubMed] [Full Text]

Sidibé CS, Touré O, Jacqueline EWB, Dieleman M. Rural pipeline and willingness to work in rural areas: Mixed method study on students in midwifery and obstetric nursing in Mali. PloS one. 2019;14(9): e0222266. [PubMed] [Google Scholar] [Full Text]

Firdaus A, Efendi F, Hadisuyatmana S, Aurizki GE, Abdullah KL. Factors influencing the intention of Indonesian nursing students to work in rural areas. Family Medicine and Community Health. 2019;7(3): e000144. [Google Scholar] [PubMed] [Full Text]

Dalton L, Routley G, Peek K. Rural placements in Tasmania: do experiential placements and background influence undergraduate health science student's attitudes toward rural practice? Rural & Remote Health. 2008;8(3). [Google Scholar] [PubMed] [Full Text]

Daniels ZM, VanLeit BJ, Skipper BJ, Sanders ML, Rhyne RL. Factors in recruiting and retaining health professionals for rural practice. The Journal of Rural Health. 2007;23(1):62-71[DOI] [Google Scholar] [PubMed] [Full Text]

Achiso B. Intention of medical student to work in rural setting and associated factors among the public Universities undergraduate medical students of Ethiopia (Masters thesis): Addis Ababa Universty; 2018. [Full Text]

Syahmar I, Putera I, Istatik Y, Furqon MA, Findyartini A. Indonesian medical students' preferences associated with the intention toward rural practice. Rural and Remote Health. 2015;15(4). [Google Scholar] [PubMed] [Full Text]

Shankar PR, Thapa TP. Student perception about working in rural Nepal after graduation: a study among first-and second-year medical students. Human Resources for Health. 2012;10(1):27. [DOI] [PubMed] [Google Scholar] [Full Text]

Published

2023-08-31

How to Cite

1.
Siwakoti S, Gahatraj NR, Shrestha N. Nursing Students’ Intention to Work in Rural Areas after Graduation: A Mixed Approach Study. Journal of Karnali Academy of Health Sciences [Internet]. 2023Aug.31 [cited 2024May14];6(2). Available from: https://jkahs.org.np/jkahs/index.php/jkahs/article/view/767