Health worker attrition at a rural district hospital in Rwanda: a need for improved placement and retention strategies

Abstract

INTRODUCTION: the shortage and maldistribution of health care workers in sub-Saharan Africa is a major concern for rural health facilities. Rural areas have 63% of sub-Saharan Africa population but only 37% of its doctors. Although attrition of health care workers is implicated in the human resources for health crisis in the rural settings, few studies report attrition rates and risk factors for attrition in rural district hospitals in sub-Saharan Africa. METHODS: we assessed attrition of health care workers at a Kirehe District Hospital in rural Rwanda. We included all hospital staff employed as of January 1, 2013 in this retrospective cohort study. We report the proportion of staff that left during 2013, and used logistic regression to assess individual characteristics associated with attrition.

Keywords

• human resources for health
• health workforce
• retention
• compulsory service
• turnover
• africa