Public service motivation, public sector preference and employment of Kenyan medical doctor interns: a cross-sectional and prospective study.
Employment
Labour market
Public sector
Public service motivation
Journal
Human resources for health
ISSN: 1478-4491
Titre abrégé: Hum Resour Health
Pays: England
ID NLM: 101170535
Informations de publication
Date de publication:
02 Sep 2024
02 Sep 2024
Historique:
received:
19
03
2024
accepted:
22
08
2024
medline:
3
9
2024
pubmed:
3
9
2024
entrez:
2
9
2024
Statut:
epublish
Résumé
Kenya grapples with a paradox; severe public sector workforce shortages co-exist with rising unemployment among healthcare professionals. Medical schools have increased trainee outputs, but only 45% of newly qualified/registered doctors were absorbed by the public sector during 2015-2018. In such a context, we explore what influences doctors' career choices at labour market entry, specifically understanding the role of public service motivation (PSM). We conducted a cross-sectional and prospective study of interns and recently graduated doctors to examine PSM, their intention to work in the public sector and their final employment sector and status. We surveyed them on their PSM and job intentions and conducted a prospective follow-up survey of the interns, around one year later, to understand their employment status. We recruited 356 baseline participants and followed up 76 out of 129 eligible interns. The overall PSM score was high among all participants (rated 4.50/5.00) irrespective of sector preferences. 48% (171/356) of the participants preferred to work in the public sector immediately after internship, alongside 16% (57/356) preferring direct entry into specialist training-commonly in the public sector. Only 13% (46/356) and 7% (25/365) preferred to work in the private or faith-based sector. Despite the high proportion of interns preferring public sector jobs, only 17% (13/76) were employed in the public sector at follow-up and 13% (10/76) were unemployed, due to lack of job availability. High PSM scores irrespective of sector preferences suggest that doctors are generally committed to serving the 'public good'. Many intended to work in the public sector but were unable to due to lack of job opportunities. Policymakers have an opportunity to tackle workforce gaps in the public sector as young doctors continue to express a preference for such work. To do this they should prioritise creating adequate and sustainable job opportunities.
Sections du résumé
BACKGROUND
BACKGROUND
Kenya grapples with a paradox; severe public sector workforce shortages co-exist with rising unemployment among healthcare professionals. Medical schools have increased trainee outputs, but only 45% of newly qualified/registered doctors were absorbed by the public sector during 2015-2018. In such a context, we explore what influences doctors' career choices at labour market entry, specifically understanding the role of public service motivation (PSM).
METHODS
METHODS
We conducted a cross-sectional and prospective study of interns and recently graduated doctors to examine PSM, their intention to work in the public sector and their final employment sector and status. We surveyed them on their PSM and job intentions and conducted a prospective follow-up survey of the interns, around one year later, to understand their employment status.
FINDINGS
RESULTS
We recruited 356 baseline participants and followed up 76 out of 129 eligible interns. The overall PSM score was high among all participants (rated 4.50/5.00) irrespective of sector preferences. 48% (171/356) of the participants preferred to work in the public sector immediately after internship, alongside 16% (57/356) preferring direct entry into specialist training-commonly in the public sector. Only 13% (46/356) and 7% (25/365) preferred to work in the private or faith-based sector. Despite the high proportion of interns preferring public sector jobs, only 17% (13/76) were employed in the public sector at follow-up and 13% (10/76) were unemployed, due to lack of job availability.
CONCLUSION
CONCLUSIONS
High PSM scores irrespective of sector preferences suggest that doctors are generally committed to serving the 'public good'. Many intended to work in the public sector but were unable to due to lack of job opportunities. Policymakers have an opportunity to tackle workforce gaps in the public sector as young doctors continue to express a preference for such work. To do this they should prioritise creating adequate and sustainable job opportunities.
Identifiants
pubmed: 39223496
doi: 10.1186/s12960-024-00945-6
pii: 10.1186/s12960-024-00945-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
61Subventions
Organisme : Africa-Oxford travel grant
ID : AfOx-209
Organisme : National Institute for Health and Care Research
ID : NIHR130812
Organisme : National Institute for Health and Care Research
ID : Applied Research Collaboration Oxford and Thames Valley at Oxford Health NHS Foundation Trust
Organisme : National Institute for Health and Care Research
ID : NIHR130812
Organisme : Economic and Social Research Council
ID : ES/T008415/1
Organisme : European Union
ID : ECS_00000043
Organisme : Wellcome Trust
ID : 207522
Pays : United Kingdom
Informations de copyright
© 2024. The Author(s).
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