Rural Origin and Exposure Drives Ghanaian Midwives Reported Future Practice

Jody R. Lori, Laura Livingston, Megan Eagle, Sarah Rominski, Emmanuel Kweku Nakua, Peter Agyei-Baffour

Abstract

A primary cause of Ghana’s higher than global average maternal mortality rate is limited access to maternal care in rural areas. To date, few studies have examined how rural background/training of midwives impacts their future willingness to work in remote areas. The purpose of this paper is to describe the relationship between Ghanaian student midwife place of origin and rural training on their willingness to choose a future rural practice location. A cross-sectional computer-based survey was completed by 238 final year Ghanaian midwifery students from two public midwifery training schools located in urban Ghana between October and December 2009.  The relationship between rural exposure and willingness to work in rural Ghana was analyzed using independent t-test, chi-square, and bivariate logistic regression.  Participants who experienced a rural rotation (OR: 1.51, 95% CI: 0.71, 3.22) and those born in a rural area (OR: 2.24, 95% CI: 0.74, 6.75) resulted in greater odds ratio to choose rural practice following graduation. This study indicates an association between midwifery students’ place of origin and training and their willingness to practice in a rural area after graduation. (Afr J Reprod Health 2014; 18[3]: 95-100)

 

Keywords: Midwifery, Ghana, human resources for health, maldistribution, rural practice, rural incentives  

Résumé

La principale cause du taux  de la mortalité maternelle au Ghana qui est plus élevé que la moyenne mondiale  est l'accès limité aux soins de santé maternelle dans les régions rurales. À ce jour, peu d'études ont examiné comment le milieu rural / la formation des sages-femmes affectent  sur leur volonté éventuelle de travailler dans les zones rurales éloignées. Le but de cet article est de décrire la relation entre le milieu d’origine de l’étudiante sage-femme ghanéenne  et  la formation en milieu rural sur leur volonté de choisir un emplacement futur de la pratique rurale. Une enquête transversale basée sur l’ordinateur  a été menée auprès des  238 étudiants de dernière année dans deux écoles publiques de formation des sages-femmes ghanéennes  situées au Ghana urbain entre octobre et décembre 2009. La relation entre l'exposition rurale et la volonté de travailler en milieu rural au Ghana a été analysée à l'aide d’un du t –test indépendant, chi-carré et la régression logistique à deux variables. Les participants qui ont subi une rotation rurale  (OR: 1,51, IC 95%: 0,71, 3,22) et ceux qui sont nés dans une région rurale (OR: 2,24, IC 95%: 0,74, 6,75) ont abouti à un plus grand odds ratio de choisir la pratique rurale obtention de leur diplôme. Cette étude indique une association entre la place d’origine et la formation des élèves sages-femmes et leur volonté d’exercer leur profession dans une région rurale après leur formation. (Afr J Reprod Health 2014; 18[3]: 95-100)

 

Mots-clés: sages-femmes,  Ghana,  ressources humaines pour la santé, mauvaise répartition,  pratique rurale,  incitations rurale

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