Factors associated with retention of health workers in remote public health centers in Northern Uganda: a cross-sectional study

Abstract

Health worker retention in remote and hard-to-reach areas remains a threat in most low- and middleincome countries, and this negatively impacts health service delivery. The health workforce inequity is catastrophic for countries like Uganda that still has a low health worker to patient ratio, and remote areas like Lira District that is still recovering from a long-term civil war. This study explores factors associated with retention of health workers in remote public health centers in Lira district in Northern Uganda. A descriptive cross-sectional study with quantitative methods of data collection was used among health workers namely; doctors, clinical ofcers, nurses, midwives, pharmacists and, laboratory technicians. The study utilized a structured questionnaire with closed ended questions to obtain quantitative information. Most of the respondents were females (62.90%), married (84.62%), with certifcate level (55.74%), and nurses as qualifcation (36.60%) as well as attached to Health Center 3 level (61.28%). Signifcant individual factors associated with retention included having a certifcate as highest level of education, staying with family, and working at facility for 6 or more years. The health system factors were good physical state of facility, equipment availability, availability of sundries, feeling comfortable with rotations, receiving adequate support from staf, feeling valued and respected by colleagues at workplace and access to incentives while career factors were job satisfaction, job motivation, promotion, and further training on scholarship. The study established that indeed several individual and social demographics, health system and careerrelated factors are signifcantly associated with retention of Health workers in the rural public health facilities and these are critical policy recommendations for establishing retention guidelines in a national human resources for health manual.