Factors influencing Ghanaian midwifery students' willingness to work in rural areas: a computerized survey.
Factors influencing Ghanaian midwifery students' willingness to work in rural areas: a computerized survey.
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DOI：
10.1016/j.ijnurstu.2012.02.006
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发表时间：
2012-07
影响因子：
8.1
通讯作者：
Gyakobo M
中科院分区：
文献类型：
--
作者：
Lori JR;Rominski S;Richardson J;Agyei-Baffour P;Kweku NE;Gyakobo M
加纳农村和偏远地区缺乏助产士是一个全国性的问题，因为该国正努力实现千年发展目标所确定的到2015年降低孕产妇和儿童死亡率的具体目标。了解影响加纳助产专业三年级学生在农村地区工作意愿的因素。加纳最大的两所助产学校。三年级助产专业学生（n = 238）即将毕业并进入劳动力市场。基于与助产专业学生的焦点小组讨论，我们改进了一个计算机化的调查，以评估学生毕业后对农村工作的偏好。然后，我们对加纳的助产专业学生进行了这项调查。我们使用皮尔逊卡方检验比较了那些可能和不可能在农村地区工作的学生选择工作地点的主要原因。Logistic回归模型用于计算比值比。获得额外教育的机会是助产专业学生决定最终工作地点的最重要因素（72%）。临床设施质量差（26%）、儿童教育质量差（19%）和缺乏社会设施（17%）是在农村社区工作的主要障碍。对于愿意在农村地区工作的学生助产士来说，最主要的原因包括为人类服务（74%）和增加获得临床经验的机会（62%）。在农村社区工作的经验越多，愿意在农村地区工作的几率就越大。出生在农村（OR：1.95，95%CI：0.736，5.16），5岁以后在农村生活1年以上（OR：1.52，CI：0.857，2.70）。一个例外是助产专业的学生，他们在培训期间在农村地区从事六周或更长时间的保健工作。这些学生被发现有0.83低赔率愿意在农村地区工作（95% CI：0.449，1.55）。通过更好地了解农村保健工作者的激励因素，可以制定具体的政策干预措施，改善助产士的分布，从而减少孕产妇和婴儿死亡率的负担。
Lack of midwives in rural and remote areas of Ghana is a national concern as the country attempts to reach targets set by Millennium Development Goals to reduce maternal and child mortality by 2015. To understand factors influencing third-year Ghanaian midwifery students’ willingness to work in rural areas. Two of the largest midwifery schools in Ghana. Third-year midwifery students (n = 238) about to graduate and enter the workforce. Based on focus group discussions with midwifery students, we refined a computerized survey to assess students’ preferences for rural posting after graduation. We then administered this survey to midwifery students in Ghana. We used Pearson’s chi-squared to compare the top reasons for choosing job location between those students likely and not likely to work in a rural area. Logistic regression models were used to calculate the odds ratios. An opportunity to gain additional education was the most important factor for the midwifery students in deciding where they would eventually work (72%). Poor quality of clinical facilities (26%), poor quality of education for children (19%), and lack of social amenities (17%) were major deterrents to working in rural communities. For student midwives willing to work in rural areas the top reasons cited included to serve humanity (74%), and increased opportunities to gain clinical experience (62%). More experiences overall with rural communities resulted in greater odds of being willing to work in a rural area. Being born in a rural area (OR: 1.95, 95% CI: 0.736, 5.16) and living in a rural area after age 5 for one-year or more (OR: 1.52, CI: 0.857, 2.70). An exception to this was midwifery students who performed health work for six weeks or more in a rural area during training. These students were found to have 0.83 lower odds of willingness to work in a rural area (95% CI: 0.449, 1.55). By better understanding the motivating factors for rural healthcare workers, specific policy interventions can be established to improve the distribution of midwives thereby decreasing the burden of maternal and infant mortality.