Influencing Factors of Medical Doctors’ Intentions to Work in the Rural Health Facilities in the Eastern Cape Province, South Africa

Abstract

Abstract Background Understanding of context-specific retention strategies for doctors will guide targeted interventions and policy framework for strengthening the district health system in South Africa. Several strategies have been examined, some more impactful than others, with resilience playing a role in retention of staff, but data is lacking in the Eastern Cape Province, South Africa. Aim To assess factors influencing the retention and resilience of doctors at district hospitals in the Eastern Cape. Setting District hospitals in Amathole and Buffalo City health district municipalities in the Eastern Cape. Methods In this cross-sectional survey, participants rated retention strategies as well as a validated resilience scale (the CD-RISC 25). Results A total of 74 doctors were surveyed; mostly ≤34 years (66%), Black Africans (69%), and ≤5 years of professional experience (59%). The majority had worked in their current facilities for ≤5 years (76%). Significant proportion of young (78%), single (59%), and Grade 1 medical officers (86%) intend to leave their current facilities. Improving hospital accommodation was significantly associated with the intention to stay longer at the rural district hospitals. While not statistically significant, factors affecting professional development and growth scored higher while those related to financial remuneration scored lowest. There were no associations between resilience and intention to stay. Conclusion Early career doctors prioritise career growth and development, while more experienced doctors rated improved living condition as the main determinants of retention in the rural health facilities. Future studies should recruit representative sample of doctors from the various municipalities and across provinces in the country. Contribution Improving hospital accommodation and enhancing career growth and development may increase retention of doctors in the rural district hospitals.