Rural posting experience, requests for transfer, and perspectives about critical factors for staff retention among primary health care workers in urban Kano, Nigeria

Abstract

Background: Inadequate skilled manpower at rural posts is a serious impediment toward equitable and universal access to healthcare in Nigeria.

Objective: To examine the experiences of primary health care (PHC) workers on rural assignments, requests for transfer, and perspectives about critical factors for retention of healthcare workers at rural posts.

Materials and Methods: Using descriptive cross‑sectional design, 262 PHC workers in Kano were studied. Data were collected using semi‑structured questionnaires and analyzed on Statistical Package for Social Sciences version 22. Pearson’s Chi‑square and Fisher’s exact tests were used to test for significant association between categorical variables. P ≤ 0.05 was considered significant.

Results: The mean age of the workers was 36.0 ± 9 years. Majority were females (55.4%) and married (64.2%) with mean working experience of 13.0 ± 8.0 years. Only 29 (11.2%) had rural posting experience. Mean duration of posting was 4.0 ± 2.0 years; 19 (65.5%) sought re‑deployment for lack of social amenities and good schools for children 19 (100.0%) and poor work environment 17 (89.5%). Common positive rural experiences mentioned were less work pressure 26 (89.7%), cordial relationship with colleagues and community members 24 (82.8%), and willingness of the community to partake in health activities 24 (82.8%). Common negative experiences reported include lack of social amenities 27 (93.1), lack of equipment and supplies in facilities 26 (89.7%), and stagnation 22 (75.9%). The workers’ perspectives about critical factors for retention at rural posts include good facility infrastructure and functional equipment 240 (92.3%), good housing 237 (91.2%), potable water and electricity supply 238 (91.5%), good schools for staff’s children 38 (91.5%), and good access of road to town 239 (91.9%).

Conclusion and Recommendation: While steering gear at upgrading basic infrastructures in rural areas, government should in the interim, ensure attractive working and living conditions at rural posts.

Keywords: Nigeria, primary health care, request for transfer, rural posting, staff retention