Location and vocation: Why some government doctors stay on in rural Chhattisgarh, India

Kabir Sheikh, Babita Rajkumari, Kamlesh Jain, Krishna Rao, Pratibha Patanwar, Garima Gupta, K. R. Antony, T. Sundararaman

Research output: Contribution to journalArticlepeer-review

Abstract

We conducted a qualitative research study in Chhattisgarh State, India, to explore why some qualified medical practitioners decide to stay on in government rural service. The fieldwork consisted of in-depth interviews with 37 practitioners who had an established record of rural service, and data were analyzed using the 'framework' approach for applied policy research. Study participants cited complexes of reasons for staying on, including geographical and ethnic (tribal) affinities, rural upbringing, availability of schools, personal values of service, professional interests, co-location with spouses, and relations with co-workers. Extrinsic (environmental) and intrinsic (personal) factors both play a part in determining the decisions of doctors to stay on, and are interdependent. Some doctors were influenced to remain by the close relationships they had developed with local communities and their acclimatisation over time to rural life. The policy imperative of rural workforce adequacy may be served less by choosing one retention strategy over another than by developing multi-dimensional solutions focused simultaneously on identifying and incentivising rural practitioners with appropriate characteristics, and on creating external conditions for their improved performance and welfare. Further, in a low-income setting such as India, questions of rural workforce adequacy cannot be addressed in isolation, but need to be tackled as part of broad agenda of social development that include strengthening public service systems and empowering communities.

Original languageEnglish (US)
Pages (from-to)192-199
Number of pages8
JournalInternational health
Volume4
Issue number3
DOIs
StatePublished - Sep 2012
Externally publishedYes

Keywords

  • Doctors
  • Health workforce
  • India
  • Qualitative
  • Retention
  • Rural

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health

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