Baytopp Tamryn J, Lomas-Marais Vanessa, Motsohi Ts'epo
Department of Family Medicine and Primary Care, Faculty of Health Science, Stellenbosch University, Cape Town.
S Afr Fam Pract (2004). 2025 Jul 15;67(1):e1-e9. doi: 10.4102/safp.v67i1.6125.
Staff shortages in rural areas have led to unequal healthcare access in South Africa. The compulsory community service programme aims to address this disparity; but to be effective, it must encourage doctors to remain in rural facilities beyond their service periods. Identifying factors that influence their decisions to stay is crucial for developing strategies to improve rural doctor retention. The aim is to describe the important factors influencing Western Cape community service doctors' choice of whether they will seek employment in public rural practice.
An observational cross-sectional study with correlational analysis was conducted using an internet-based questionnaire. This study was conducted on community service doctors who were employed in the Western Cape in 2022.
Eighty-six doctors participated, with 8% intending to work in rural practice in 2023 and 21% considering it in the future. Significant factors associated with rural practice intentions included rural upbringing (6.5 times more likely), rural internship placement (7.7 times more likely) and rural community service (3.5 times more likely). Key influences were personal safety, job satisfaction and mental health.
The proportion of doctors considering rural practice remains low. Policy revisions should focus on preferentially enrolling medical students with rural backgrounds and placing community service doctors in rural areas, alongside efforts to create safe, satisfying work environments that support mental health.Contribution: This study enhances the understanding of retaining healthcare professionals in underserved rural areas, addressing primary healthcare challenges in the African context.
农村地区的人员短缺导致南非的医疗服务获取不平等。义务社区服务计划旨在解决这一差距；但要想有效，就必须鼓励医生在服务期结束后继续留在农村医疗机构。确定影响他们留下来的因素对于制定提高农村医生留用率的策略至关重要。目的是描述影响西开普省社区服务医生选择是否会在农村公共医疗机构就业的重要因素。
采用基于互联网的问卷进行了一项带有相关性分析的观察性横断面研究。该研究针对的是2022年在西开普省就业的社区服务医生。
86名医生参与了研究，其中8%的人打算在2023年从事农村医疗工作，21%的人考虑在未来从事农村医疗工作。与农村医疗工作意向相关的重要因素包括在农村长大（可能性高6.5倍）、在农村进行实习（可能性高7.7倍）以及参与农村社区服务（可能性高3.5倍）。关键影响因素是个人安全、工作满意度和心理健康。
考虑从事农村医疗工作的医生比例仍然较低。政策修订应侧重于优先招收有农村背景的医学生，并将社区服务医生安排到农村地区，同时努力营造支持心理健康的安全、令人满意的工作环境。贡献：本研究增进了对在服务不足的农村地区留住医疗专业人员的理解，解决了非洲背景下的初级医疗保健挑战。
