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Factors influencing attraction and retention of frontline health workers in remote and rural areas in Nigeria: a discrete choice experiment

Journal of Public Health Policy volume 43, pages 347–359 (2022)Cite this article

Abstract

The policy thrust in Nigeria is to ensure qualified, skilled, and adequate health workforce to achieve universal health coverage. We designed a discrete choice experiment to determine the combinations of incentives that may increase the attraction and retention of frontline health workers. We conducted the study in Bauchi State amongst 145 students and health workers. Health workers are 14.6 and 14.4 times more likely to take up a rural posting or continue to stay in their present rural posts if there was basic housing and improvement of the quality of the facilities respectively. The preference for rural job location increased 6.17 times when good schools for children's education were provided. Ensuring availability of basic housing, improving the quality of health facilities, and ensuring good schools for children’s educations are essential factors that may support attraction and retention of health workers. These strategies will support health care services in rural areas and achieving universal health coverage.

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Acknowledgements

The authors wish to express their profound gratitude to the respondents in Bauchi State.

Funding

Funding support was provided by the Government of Canada through Global Affairs Canada through the Enhancing the Ability of Frontline Health Workers to Improve Health in Nigeria Project –A-035024/1.

Author information

Authors and Affiliations

  1. Health Systems Strengthening Cluster, World Health Organization Country Office in Nigeria, Abuja, Nigeria

    Sunny C. Okoroafor

  2. Global Affairs Canada, High Commission of Canada, Abuja, Nigeria

    Martin K. Osubor

  3. School of Public Health, University of Texas Health Science Center, Houston, USA

    Chukwuemeka Nwachukwu

Authors
  1. Sunny C. Okoroafor
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  2. Martin K. Osubor
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  3. Chukwuemeka Nwachukwu
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Contributions

All authors meet the ICMJE authorship criteria—SCO and MKO conceived the study. SCO designed the protocol. SCO and CN designed the tools and conducted data collection and analysis. SCO and CN drafted the initial manuscript. SCO, CN and MKO reviewed and approved the final manuscript.

Corresponding author

Correspondence to Sunny C. Okoroafor.

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Conflict of interest

The authors declare no conflict of interest.

Ethical approval

Research ethical clearance for this study was obtained from the National Health Research Ethics Committee (NHREC Approval Number NHREC/01/01/2007–12/07/2018) of the Federal Ministry of Health and approval for data collection was obtained from the Bauchi State Ministry of Health.

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Cite this article

Okoroafor, S.C., Osubor, M.K. & Nwachukwu, C. Factors influencing attraction and retention of frontline health workers in remote and rural areas in Nigeria: a discrete choice experiment. J Public Health Pol 43, 347–359 (2022). https://doi.org/10.1057/s41271-022-00351-z

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  • DOI: https://doi.org/10.1057/s41271-022-00351-z

Keywords

  • Community health workers
  • Discrete choice experiment (DCE)
  • Nigeria
  • Rural and remote areas
  • Attraction and retention strategies