Zheng Jingmin, Li Jie, Jiang Xingxing, Zhang Bin
Department of Social Medicine, School of Public Health, Chongqing Medical University, Chongqing, 400016, China.
Front Med. 2015 Jun;9(2):239-50. doi: 10.1007/s11684-015-0392-0. Epub 2015 Apr 18.
Township hospitals, the main provider of rural primary healthcare in China, are severely understaffed. International studies on factors influencing rural working are increasing; however, studies on factors affecting the recruitment and retention of health workers in Chinese township hospitals are limited. The current study aims to understand the motivation of health workers and arrive at a systematic framework of pluralistic factors that would help support health workers in terms of receiving posts and remaining in posts in township hospitals. A three-stage integrated quantitative and qualitative methodology was employed. First, a survey on 120 directors of township hospitals was conducted to learn the latest status of health workers in township hospitals and distinguish existing problems. Second, after sending these problems back to the directors, an open-ended pen-and-paper survey was conducted to ask the directors to identify the factors influencing the attraction and retention of health workers in township hospitals. Third, four focus groups were conducted to gauge the underlying reasons. Five problems from the questionnaire survey were recognized, and numbers of thematic factors were identified at the individual, professional, and treatment environment from the pen-and-paper survey and focus group. Similar to other studies, this framing of both non-financial and financial elements affected the attraction and retention of health workers in township hospitals, thereby filling the gap in a Chinese context. Although several factors had been recognized earlier, our findings further highlighted the importance of these factors. Meanwhile, the factors identified in this study were barely explored in literature. This paper identifies and develops multi-faceted factors to call for a bundled package of multidimensional incentives if decision-makers get interested. The evidence-based findings in our study can be used to provide China-specific policy recommendations on how to recruit and retain health workers in rural areas of China.
乡镇卫生院是中国农村基层医疗卫生服务的主要提供者，人员严重短缺。关于影响农村工作因素的国际研究日益增多；然而，关于影响中国乡镇卫生院卫生工作者招聘和留用因素的研究却很有限。本研究旨在了解卫生工作者的动机，并得出一个多元因素的系统框架，以帮助支持卫生工作者在乡镇卫生院就职和留任。采用了三阶段定量与定性相结合的综合方法。首先，对120名乡镇卫生院院长进行了调查，以了解乡镇卫生院卫生工作者的最新状况，并找出存在的问题。其次，将这些问题反馈给院长后，进行了一次开放式纸笔调查，要求院长们确定影响乡镇卫生院卫生工作者吸引和留用的因素。第三，开展了四个焦点小组讨论，以探究潜在原因。从问卷调查中识别出五个问题，并从纸笔调查和焦点小组讨论中，在个人、职业和治疗环境方面确定了若干主题因素。与其他研究类似，这种对非财务和财务因素的构建影响了乡镇卫生院卫生工作者的吸引和留用，从而填补了中国背景下的空白。尽管一些因素 earlier 已经被认识到，但我们的研究结果进一步凸显了这些因素的重要性。同时，本研究确定的因素在文献中几乎未被探讨。本文识别并提出了多方面的因素，呼吁决策者如有兴趣可提供一揽子多维激励措施。我们研究中的循证结果可用于为中国农村地区如何招聘和留住卫生工作者提供针对中国国情的政策建议。 （注：原文中“earlier”一词在这里语义不太明确，可能是有拼写错误，推测可能是“earlier”，翻译时根据语境做了适当处理。）
