Rural pipeline and willingness to work in rural areas: Mixed method study on students in midwifery and obstetric nursing in Mali

The availability and retention of healthcare professionals in rural areas and remote areas is a challenge to the health sector worldwide. Attracting people who are most likely to be interested in rural practice can be conducive to the sustainable availability of health services in rural areas where health facilities are typically understaffed and existing professionals often underqualified. This article aims to contribute to the rural pipeline evidence, and reports on the findings of a study that investigated the career choices of midwifery and obstetric nurse students in Mali. The article enquires into the relationship between their intention to practice in rural areas and the different components of the rural pipeline. A mixed method study using a survey, semi-structured interviews, and document analysis was conducted from October to December 2017 on third-year midwifery and obstetric nurse students and school-managers. Descriptive statistics and bivariate analysis were performed for quantitative data, and content analysis was carried out for the qualitative data. Key findings suggest that students prefer urban locations for living and for work. The intention to work in rural areas seems to be influenced by the current living situation (currently living in a rural area) or having attended secondary school or professional training in rural areas.

全球范围内，农村与偏远地区医疗卫生人员的配备与留存始终是卫生领域面临的一大挑战。吸引对乡村执业最具意愿的人员，有助于改善农村地区卫生服务的可持续供给状况——这类地区普遍存在医疗机构人员配备不足、在岗从业人员资质欠佳的问题。本文旨在为乡村人才输送体系（rural pipeline）相关实证研究提供补充，并报告一项针对马里助产学与产科护理专业学生职业选择的研究成果。本文探讨了这些学生投身乡村执业的意愿，与乡村人才输送体系各构成要素之间的关联。本研究于2017年10月至12月期间开展，采用混合研究方法，面向三年级助产学与产科护理专业学生及院校管理者开展问卷调查、半结构化访谈与文件分析。针对定量数据，本研究采用描述性统计与双变量分析方法；针对定性数据，则开展了内容分析。核心研究结果显示，学生更倾向于在城市地区生活与工作；而投身乡村执业的意愿，则似乎受当前居住环境（即目前居住在乡村地区）或曾在乡村地区完成中等教育与职业培训的经历影响。