Factors affecting job choice among physician anesthesia providers in Uganda: a survey of income composition, discrete choice experiment, and implications for the decision to work rurall
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Human resources for health
Abstract
One of the biggest barriers to accessing safe surgical and anesthetic care is lack of trained providers.
Uganda has one of the largest deficits in anesthesia providers in the world, and though they are increasing in number,
they remain concentrated in the capital city. Salary is an oft-cited barrier to rural job choice, yet the size and sources
of anesthesia provider incomes are unclear, and so the potential income loss from taking a rural job is unknown. Additionally,
while salary augmentation is a common policy proposal to increase rural job uptake, the relative importance
of non-monetary job factors in job choice is also unknown.
Methods: A survey on income sources and magnitude, and a Discrete Choice Experiment examining the relative
importance of monetary and non-monetary factors in job choice, was administered to 37 and 47 physician anesthesiologists
in Uganda, between May–June 2019.
Results: No providers worked only at government jobs. Providers earned most of their total income from a nongovernment
job (50% of income, 23% of working hours), but worked more hours at their government job (36% of
income, and 44% of working hours). Providers felt the most important job attributes were the quality of the facility
and scope of practice they could provide, and the presence of a colleague (33% and 32% overall relative importance).
These were more important than salary and living conditions (14% and 12% importance).
Conclusions: No providers accepted the salary from a government job alone, which was always augmented by
other work. However, few providers worked only nongovernment jobs. Non-monetary incentives are powerful
influencers of job preference, and may be leveraged as policy options to attract providers. Salary continues to be an
important driver of job choice, and jobs with fewer income generating opportunities (e.g. private work in rural areas)
are likely to need salary augmentation to attract providers.
Description
Keywords
Anesthesia, Rural, Surgery, Discrete choice experiment, Salary, Income, Incentive
Citation
Law, Tyler J., et al. "Factors affecting job choice among physician anesthesia providers in Uganda: a survey of income composition, discrete choice experiment, and implications for the decision to work rurally." Human resources for health 19.1 (2021): 1-10. https://doi.org/10.1186/s12960-021-00634-8