abstract: 'Background One of the biggest barriers to accessing safe surgical and

  anesthetic care is lack of trained providers. Uganda has one of the

  largest deficits in anesthesia providers in the world, and though they

  are increasing in number, they remain concentrated in the capital city.

  Salary is an oft-cited barrier to rural job choice, yet the size and

  sources of anesthesia provider incomes are unclear, and so the potential

  income loss from taking a rural job is unknown. Additionally, while

  salary augmentation is a common policy proposal to increase rural job

  uptake, the relative importance of non-monetary job factors in job

  choice is also unknown. Methods A survey on income sources and

  magnitude, and a Discrete Choice Experiment examining the relative

  importance of monetary and non-monetary factors in job choice, was

  administered to 37 and 47 physician anesthesiologists in Uganda, between

  May-June 2019. Results No providers worked only at government jobs.

  Providers earned most of their total income from a non-government job

  (50\% of income, 23\% of working hours), but worked more hours at their

  government job (36\% of income, and 44\% of working hours). Providers

  felt the most important job attributes were the quality of the facility

  and scope of practice they could provide, and the presence of a

  colleague (33\% and 32\% overall relative importance). These were more

  important than salary and living conditions (14\% and 12\% importance).

  Conclusions No providers accepted the salary from a government job

  alone, which was always augmented by other work. However, few providers

  worked only nongovernment jobs. Non-monetary incentives are powerful

  influencers of job preference, and may be leveraged as policy options to

  attract providers. Salary continues to be an important driver of job

  choice, and jobs with fewer income generating opportunities (e.g.

  private work in rural areas) are likely to need salary augmentation to

  attract providers.'
affiliation: 'Law, TJ (Corresponding Author), Univ Calif San Francisco, Dept Anesthesia
  \& Perioperat Care, Div Global Hlth Equ, 1001 Potrero Ave,Bldg 5,Ward 3C, San Francisco,
  CA 94110 USA.

  Law, Tyler J.; Lipnick, Michael S., Univ Calif San Francisco, Dept Anesthesia \&
  Perioperat Care, Div Global Hlth Equ, 1001 Potrero Ave,Bldg 5,Ward 3C, San Francisco,
  CA 94110 USA.

  Subhedar, Shivani, Univ Calif San Francisco, Inst Global Hlth Sci, San Francisco,
  CA 94132 USA.

  Bulamba, Fred; Hewitt-Smith, Adam, Busitema Univ, Fac Hlth Sci, Dept Anesthesia
  \& Crit Care, Tororo, Uganda.

  O''Hara, Nathan N., Univ Maryland, Sch Med, Dept Orthopaed, Baltimore, MD 21201
  USA.

  Nabukenya, Mary T.; Sendagire, Cornelius; Tumukunde, Janat, Makerere Univ, Coll
  Hlth Sci, Dept Anaesthesia, Kampala, Uganda.'
article-number: '93'
author: Law, Tyler J. and Subhedar, Shivani and Bulamba, Fred and O'Hara, Nathan N.
  and Nabukenya, Mary T. and Sendagire, Cornelius and Hewitt-Smith, Adam and Lipnick,
  Michael S. and Tumukunde, Janat
author-email: tyler.law@ucsf.edu
author_list:
- family: Law
  given: Tyler J.
- family: Subhedar
  given: Shivani
- family: Bulamba
  given: Fred
- family: O'Hara
  given: Nathan N.
- family: Nabukenya
  given: Mary T.
- family: Sendagire
  given: Cornelius
- family: Hewitt-Smith
  given: Adam
- family: Lipnick
  given: Michael S.
- family: Tumukunde
  given: Janat
da: '2023-09-28'
doi: 10.1186/s12960-021-00634-8
eissn: 1478-4491
files: []
journal: HUMAN RESOURCES FOR HEALTH
keywords: 'Anesthesia; Rural; Uganda; Surgery; Discrete choice experiment; Salary;

  Income; Incentive'
keywords-plus: 'HEALTH-WORKERS; SURGICAL CARE; RETENTION; WORKFORCE; INCENTIVES;

  MIGRATION; DOCTORS; REMOTE'
language: English
month: JUL 28
number: '1'
number-of-cited-references: '41'
orcid-numbers: 'Law, Tyler/0000-0002-6141-4026

  Subhedar, Shivani/0000-0001-9606-6490'
papis_id: 503ad7e49e4351a340e5ac5f1a98273b
ref: Law2021factorsaffecting
researcherid-numbers: 'Law, Tyler/AFN-4323-2022

  '
times-cited: '4'
title: 'Factors affecting job choice among physician anesthesia providers in Uganda:
  a survey of income composition, discrete choice experiment, and implications for
  the decision to work rurally'
type: article
unique-id: WOS:000678583800001
usage-count-last-180-days: '5'
usage-count-since-2013: '13'
volume: '19'
web-of-science-categories: Health Policy \& Services; Industrial Relations \& Labor
year: '2021'