Willingness of house surgeons to serve in rural primary health centres of maharashtra, india: a cross sectional study

Introduction: The shortage of health professionals in rural areas is a global problem. The urban and rural maldistribution of doctors results in severe problems regarding access to and performance of health care services. Retaining doctors in rural areas is a challenging task for a number of reasons, ranging from personal preferences to difficult work conditions and low remuneration. The objective of the study was to understand the factors influencing medical and dental house surgeons choice to work in rural PHC’s as a basis for designing policies to redress geographic imbalances in health professional’s distribution. Method: A total of 385 dental and medical house surgeons provided a unique contingent valuation data in a cross sectional survey conducted in 4 medical and 4 dental colleges in Maharashtra, using a questionnaire concerning their preferences, related incentives to work in various rural and remote primary health centres of Maharashtra state, India. Results: The response rate obtained for the study was 89 %, (n= 344), with only 24% of house surgeons expressing their willingness to serve in rural/remote primary health centres. Most of them stressed for increase in salary, better accommodation and infrastructure of the hospitals as the factors for increasing their retention in remote rural areas. Conclusion: Although most Indian students are motivated to study medicine and dentistry by the desire to help others, this does not translate into willingness to work in rural areas. Efforts from the government to build intrinsic motivation during medical and dental training to serve in these deprived areas should be in focus with addition to improved working and living conditions and better remuneration.