Labour market preferences, attitudes and expectations of prospective health workers in Guinea

Herbst, Christopher H. and Hollingsworth, Bruce and Mateus, Ceu (2020) Labour market preferences, attitudes and expectations of prospective health workers in Guinea. PhD thesis, Lancaster University.

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Abstract

Background: This study identifies the stated attitudes, expectations, and locational job preferences (and factors influencing these preferences), of final year medical and nursing students in Guinea, West Africa. Such evidence can help design interventions that influence the supply side behaviour of graduates, and thus improve the availability and distribution of health workers in Guinea. Methods: The study uses a nationally representative cross-sectional survey design to sample 193 and 192 final year nursing and medical students, respectively, from across medical and nursing schools in Guinea. Percentage analysis and statistical tests were applied to explore differences in attitudes, expectations and locational preferences of medical and nursing students. Binary logistic regression was applied to identify predictors of the stated locational outcome variables (i.e. Conakry/outside Conakry, rural/urban, public/private, and national/abroad preferences of the health students). Results: The stated attitudes and expectations, in terms of working in the health labour market, differ for medical and nursing students in Guinea. For example, whereas both medical and nursing students expect to find good working conditions once posted, significantly more medical than nursing students expect to be posted into a job within 6 months of graduating, earn more from informal income generation activities, and find it acceptable to earn extra income during working hours and work less hours than stated in their contract. In terms of locational preferences, overall there is a strong short-term preference to work outside of Conakry, in urban locations, in the private sector, and to migrate abroad. The extent of these preferences varies between medical and nursing students, some of which change in the medium term, and are explained by a number of stated monetary and non-monetary factors, and statistically associated with and number of predictor variables that mostly vary between medical and nursing students. Conclusions: The study confirms the existing heterogeneity of attitudes, expectations and locational labor market preferences of medical and nursing students. There is a need for different education and labor market interventions, to mitigate unmet expectations and potentially disruptive attitudes, and to increase job uptake particularly in rural areas and to reduce migration abroad. The design of such interventions should take into account the different monetary and non- monetary, education and profile related factors that are influencing the supply side preference of medical and nursing students in Guinea.