Why do people become health workers? Analysis from life histories in 4 post-conflict and post-crisis countries

摘要

While there is a growing body of literature on how to attract and retain\udhealth workers once they are trained, there is much less published on\udwhat motivates people to train as health professions in the first place\udin low‐ and middle‐income countries and what difference this makes\udto later retention. In this article, we examine patterns in expressed\udmotivation to join the profession across different cadres, based on\ud103 life history interviews conducted in northern Uganda, Sierra\udLeone, Cambodia, and Zimbabwe. A rich mix of reported motivations\udfor joining the profession was revealed, including strong influence of\ud“personal calling,” exhortations of family and friends, early experiences,\udand chance factors. Desire for social status and high respect for health\udprofessionals were also significant. Economic factors are also important—\udnot just perceptions of future salaries and job security but also\udmore immediate ones, such as low cost or free training. These allowed\udlow‐income participants to access the health professions, to which\udthey had shown considerably loyalty. The lessons learned from these\udcohorts, which had remained in service through periods of conflict\udand crisis, can influence recruitment and training policies in similar\udcontexts to ensure a resilient health workforce.