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dc.rights.licenseCreative Commons Attribution License
dc.contributor.authorWitter, Sophie
dc.contributor.authorHerbst, Christopher H.
dc.contributor.authorSmitz, Marc
dc.contributor.authorBalde, Mamadou Dioulde
dc.contributor.authorMagazi, Ibrahim
dc.contributor.authorZaman, Rashid U.
dc.contributor.editorMayne, Elizabeth S.
dc.identifier.citationWitter, S., Herbst, C.H., Smitz, M., Balde, M.D., Magazi, I. and Zaman R.U. (2021) ‘How to attract and retain health workers in rural areas of a fragile state: Findings from a labour market survey in Guinea’, PLoS ONE, 16(12), article no. e0245569.
dc.descriptionFrom PLOS via Jisc Publications Router
dc.descriptionSophie Witter - ORCID: 0000-0002-7656-6188
dc.description.abstractMost countries face challenges attracting and retaining health staff in remote areas but this is especially acute in fragile and shock-prone contexts, like Guinea, where imbalances in staffing are high and financial and governance arrangements to address rural shortfalls are weak. The objective of this study was to understand how health staff could be better motivated to work and remain in rural, under-served areas in Guinea. In order to inform the policy dialogue on strengthening human resources for health, we conducted three nationally representative cross-sectional surveys, adapted from tools used in other fragile contexts. This article focuses on the health worker survey. We found that the locational job preferences of health workers in Guinea are particularly influenced by opportunities for training, working conditions, and housing. Most staff are satisfied with their work and with supervision, however, financial aspects and working conditions are considered least satisfactory, and worrying findings include the high proportion of staff favouring emigration, their high tolerance of informal user payments, as well as their limited exposure to rural areas during training. Based on our findings, we highlight measures which could improve rural recruitment and retention in Guinea and similar settings. These include offering upgrading and specialization in return for rural service; providing greater exposure to rural areas during training; increasing recruitment from rural areas; experimenting with fixed term contracts in rural areas; and improving working conditions in rural posts. The development of incentive packages should be accompanied by action to tackle wider issues, such as reforms to training and staff management.
dc.description.sponsorshipFunder: World Bank Group; funder-id:
dc.relation.ispartofPLoS ONE
dc.subjectResearch Article
dc.subjectEarth Sciences
dc.subjectMedicine And Health Sciences
dc.subjectPeople And Places
dc.subjectSocial Sciences
dc.titleHow to attract and retain health workers in rural areas of a fragile state: Findings from a labour market survey in Guinea
qmu.authorWitter, Sophie
qmu.centreInstitute for Global Health and Development

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