Recruitment and Distribution of Public Sector Health Workers and Determinants of Variation in Their Distribution in Enugu State, Nigeria

Aims: The aim of study was to assess the recruitment and distribution of public sector health workers and the determinants of variation in their distribution in Enugu state, Nigeria.

Study Design: A cross sectional comparative study design.

Place and Duration of Study: Public health facilities in Enugu state, Nigeria between April and May 2015.

Methodology: A three stage sampling technique was used to select 376 public health workers in urban and rural areas of the state. The respondents were interviewed using a self administered questionnaire. Data entry and analysis was done using Statistical Package for Social Sciences version 20. Chi square test of statistical significance was used in the analysis and level of significance was determined by a p value of <0.05.

Results: Of the 376 health workers that participated in the study, 293 were from urban while 83 were from rural health facilities. All the health workers in the two study groups were aware of methods of recruitment into the public sector health service and the radio was the major source of information. Majority of the health workers, (urban, 84.3% and rural, 96.4%) were also aware that there were more health workers in the urban when compared to the rural. Lack of social amenities in the rural area was perceived by the health workers as the main reason for the imbalance in the distribution of health workers in urban and rural areas. Also, majority of the health workers, (urban, 75.4% and rural, 95.2%) were of the opinion that indigenous health workers should be trained to work in rural areas and that training centers for health workers should be located in the rural area, (urban, 77.8% and rural, 91.6%).

Conclusion: There was a similarity in the recruitment but a great imbalance in the distribution of the public sector health workers between the urban and rural areas of Enugu state. Efforts should be made towards attracting and retaining health workers in rural areas. Measures like use of incentives, training of indigenous health workers and location of training centers for health workers in rural areas could be adopted.