1. Retention and job satisfaction of rural health workforce in Thailand Nonglak Pagaiya HRH Research and Development Office Health System Research Institute The 2 nd AAAH Conference 12-14 October 2007, Beijing, CHINA

2. Questions to be answered –Retention of vital health professional in rural: doctors, nurses, primary health workers –Factors affecting their turn over from rural –Retention in rural and factors

3. Doctors: Leave/ intention to leave rural/ public Factors1992199220032003 Close to family/ hometown Recognition Workload Career advancement Growth/ further education Payment Policy/ administration Supervisor Work condition

4. Doctors: Intention to stay at rural FactorsSumaman1992Putase1996Noree2007 Close to family/ hometown Recognition Work itself Achievement Career advancement Growth/ further education Payment Policy/ administration Work condition Relationship with peers

5. Nurses: Intention to stay at rural Factors Health centre 2003 Com hospital 2002 Recognition Autonomy Career advancement Growth/ further education Relationship with peers Appropriate shift work

6. Survival in rural health centres of Primary health workers (PHW) 5 3 7 1 2 4 6 1968-72 1973-77 1978-82 1983-87 1988-92 1993-97 1998-02

7. Primary health workers: turn over by age group Reasons 1-5 yr 6-25 yr >25 yr hometown/family 38%62%100% Managerial deployment 15%15% Growth/ experience enhancement 11%19% Seek for career advancement 24%1%

8. - HRH - financial -supply/equipment - management Organization support motivation Work satisfaction leaving Individual family / home town, sex, education Motivation factors - career advancement Maintenance factors - Payment Factors associate with their turn over

9. - HRH - materials Organization support motivation Work satisfaction Retention External Other job hardship areas Motivation factors - Recognitio n - work itself - autonomy/ responsibil ity Maintenance factors - Relationship with peers - work condition ind: income Factors associated with intention to stay

10. - HRH - financial - materials Organization support Motivation Work satisfaction Retention Ind. /ext Family/ other jobs/ hardship areas Motivation factors) -work achievement - Recognition - career advancement - growth/ further education Maintenance factors - Pay -Relationship with peer - policy/ administration - work condition