The Push and Pull Factors in the Retention of Health Workers in a District in Ghana

Abstract

Aim: To assess the push and pull factors associated with the retention of health workers in a district in Ghana. Study Design: This study was an analytical cross-sectional study using quantitative methods in the collection of data. Place and Duration of Study: Komenda-Edina-Eguafo-Abirem District of the Central Region of Ghana in October 2022. Methodology: A structured self-administered questionnaire was used to obtain data from 282 health workers who were consecutively selected from various health facilities in the study. The data collected was cleaned and analyzed using the statistical software STATA version 15. Descriptive statistics were presented in tables and graphs. A Chi-square test and multiple logistic regression analysis were used to assess the association between dependent and independent variables. The significance of association was set at P<0.05 at a 95% confidence interval. Results: Overall, 22.0% of the health workers intended to stay at their current organization. Logistic regression analysis predicted that age more than 35 years (AOR: 3.4, CI: 1.025 -11.283, P = .046) and sex - females (AOR: 0.56, CI: 0.016 - 0.223, P = .001) were significantly associated with retention. Institutional factors like lack of supervision of work (AOR: 0.508, CI: 0.176 – 1.472, P = .021), lack of in-service training (AOR:0.045, CI: 0.010 - 0.193, P = .001), inadequate management support (AOR: 0.288, CI: 0.109 – 0.764, P = .012), and poor career progression (AOR: 0.472, CI: 0.019 - 1.873, P = .028) significantly reduced the likelihood of staying. Community factors like the absence of family (AOR: 0.138, CI: 0.051 – 0.376, P = .001) and the absence of alternative jobs (AOR: 0.051, CI: 0.006 – 0.459, P = .008) also negatively predicted retention. Conclusion: Only a small proportion of health workers in the district intended to stay. Factors related to retention were predominantly organizational like career progression, management support, and incentives.