Why Would I Go There? Motivating Workers to Take and Keep Jobs in Rural Areas

Given the complexity of the social, professional, and economic factors that influence motivation, how do institutions make rural job postings more attractive? While many recognize that salary is an important factor, other characteristics of a job—such as better living or working conditions, supportive supervision, opportunities for continuing professional development, career advancement, networking, and even public recognition—can improve a worker’s sense of purpose and productivity. Identifying and offering the right incentive package to workers can result in a win-win situation, with benefits for both the worker and the community served. To address this issue of job attraction and retention in the health sector, CapacityPlus has helped ministries of health and NGOs answer these questions by using a rapid discrete choice experiment, a rigorous survey method that identifies the trade-offs that workers would be willing to make between specific job characteristics. Garnering statistical evidence of what motivates workers provides policy-makers with the needed information to develop more cost-effective job incentive strategies. This article originally appeared in the December 2012 issue of Monthly Developments Magazine (

User Guide with Case Studies: How to Conduct a Discrete Choice Experiment for Health Workforce Recruitment and Retention in Remote and Rural Areas

Understanding why health workers want or don’t want to take posts and remain in remote and rural areas is a prerequisite to formulating appropriate policy responses to the shortage of health workers in these areas. Building on the World Health Organization (WHO) Guidelines on Increasing Access to Health Workers in Remote and Rural Areas through Improved Retention, this user guide proposes an innovative methodology, the discrete choice experiment (DCE), to measure the strength of health workers’ preferences and trade-offs related to different job characteristics that can influence their decision to take up rural postings. The user guide offers step-by-step advice on the application of DCE to identify policy interventions appropriate to a particular country context. The guide is the product of close collaboration among three agencies—the World Bank, the WHO, and USAID/CapacityPlus—and represents their shared commitment to supporting policy-relevant research on critical topics related to human resources for health.

Rapid Retention Survey Toolkit: Designing Evidence-Based Incentives for Health Workers

Rapid Retention Survey ToolkitThe Rapid Retention Survey Toolkit is designed to help countries determine what would motivate health workers to accept and remain in rural posts. It builds on the World Health Organization global policy recommendations for rural retention and is based on the discrete choice experiment (DCE), a powerful research method that identifies the trade-offs professionals are willing to make between specific job characteristics and determines their preferences for various incentive packages, including the probability of accepting a post in a rural facility. Employing a simplified version of the DCE methodology, the toolkit guides HR managers through the survey process to quickly assess health students’ and health workers’ motivational preferences to accept a position and continue working in underserved facilities. The results can be used to create evidence-based incentive packages that are appropriate within a country’s health labor market. Read more »


¿Qué motivará a los trabajadores de salud a permanecer en las zonas rurales?

Motiver les prestataires de soins pour mieux desservir les populations rurales en République démocratique populaire du Laos

Les docteurs Chanthakhath Papassarang, Phouthone Vangkonevilay et Outavong Phathammavong expliquent comment évaluer les préférences des agents de santé afin de déterminer les mesures d’incitation les plus efficaces pour faciliter la prestation de services en milieu rural.

Motivating Health Workers to Serve in Rural Lao PDR

Dr. Chanthakhath Papassarang, Dr. Phouthone Vangkonevilay, and Dr. Outavong Phathammavong describe an effort to assess health workers’ preferences in order to determine the most effective incentives for rural service. Also available in French.

La rétention du personnel

Comment motiver les prestataires de soins pour qu’ils restent dans les zones rurales ?

Retención del personal de salud: metodología rápida para desarrollar paquetes de incentivos basados en la evidencia

Spanish translation of an overview of the Rapid Discrete Choice Experiment (DCE) Tool, intended to allow human resources managers to determine health workers’ motivational preferences.


What will motivate health workers to stay in rural areas? This brief presents an overview of the issue of retention along with suggested actions, key considerations, and resources. Also available in French and Spanish.

Retaining Health Workers: A Toolkit to Develop Evidence-Based Incentive Packages

An overview of the Rapid Retention Survey Toolkit: Designing Evidence-Based Incentives for Health Workers, intended to allow human resources managers to determine health workers’ motivational preferences.

Syndicate content