Preferences for working in rural health facilities among trainee health workers in South Ethiopia Region using a discrete choice experiment
Abstract
The shortage of health workers in rural Ethiopia limits access to essential services and contributes to poor health outcomes, yet little evidence exists on which job incentives most effectively attract new graduates to underserved areas. This study aimed to identify the job preferences of graduating health science students and estimate the relative importance and cost-effectiveness of alternative incentive packages. We hypothesized that both financial and non-financial incentives would significantly influence willingness to accept rural postings. A discrete choice experiment was conducted among final-year students at Arba Minch Health Science College in South Ethiopia. Participants evaluated hypothetical rural job postings defined by eight attributes: salary, education opportunities, housing, location, timely payment, availability of medicine and equipment, management support, and infrastructure. Mixed logit models with full correlation between utility coefficients were used to estimate preferences. We also calculated predicted probabilities of job uptake and assessed the cost-effectiveness of alternative incentive combinations. Students showed a strong preference for opportunities to upgrade their education after one year of service (β = 1.174, p < 0.001). Advanced housing (β = 0.263, p < 0.001) and on-time salary payment (β = 0.167, p < 0.05) were also significantly preferred. Although increasing salary alone was the most cost-effective strategy, combining financial and non-financial incentives produced larger increases in predicted job uptake. These findings suggest that targeted incentive packages can substantially improve rural workforce recruitment and provide evidence to guide policy decisions in resource-constrained settings.
Start Time
15-4-2026 3:30 PM
End Time
15-4-2026 4:30 PM
Room Number
304
Presentation Type
Oral Presentation
Presentation Subtype
Grad/Comp Orals
Presentation Category
Health
Student Type
Graduate
Preferences for working in rural health facilities among trainee health workers in South Ethiopia Region using a discrete choice experiment
304
The shortage of health workers in rural Ethiopia limits access to essential services and contributes to poor health outcomes, yet little evidence exists on which job incentives most effectively attract new graduates to underserved areas. This study aimed to identify the job preferences of graduating health science students and estimate the relative importance and cost-effectiveness of alternative incentive packages. We hypothesized that both financial and non-financial incentives would significantly influence willingness to accept rural postings. A discrete choice experiment was conducted among final-year students at Arba Minch Health Science College in South Ethiopia. Participants evaluated hypothetical rural job postings defined by eight attributes: salary, education opportunities, housing, location, timely payment, availability of medicine and equipment, management support, and infrastructure. Mixed logit models with full correlation between utility coefficients were used to estimate preferences. We also calculated predicted probabilities of job uptake and assessed the cost-effectiveness of alternative incentive combinations. Students showed a strong preference for opportunities to upgrade their education after one year of service (β = 1.174, p < 0.001). Advanced housing (β = 0.263, p < 0.001) and on-time salary payment (β = 0.167, p < 0.05) were also significantly preferred. Although increasing salary alone was the most cost-effective strategy, combining financial and non-financial incentives produced larger increases in predicted job uptake. These findings suggest that targeted incentive packages can substantially improve rural workforce recruitment and provide evidence to guide policy decisions in resource-constrained settings.
