Career Shift Toward Medicine Among Health Workers in Zambia
Abstract
This study explores the increasing trend of career shifts toward medicine among sponsored health workers in Zambia. The introduction highlights systemic disparities in remuneration, professional recognition, and career progression that drive health workers to abandon their original professions.
A mixed-methods approach was adopted, involving quantitative analysis of salary correlations and chi-square tests, as well as qualitative insights from participants. Results showed a strong positive correlation (r = 0.94) between profession type and salary level, confirming that higher earnings are associated with the medical field. Regression analysis further supported this trend with an R² value of 0.89, indicating salary as a strong predictor of career shifts. A chi-square test of independence was performed to examine whether gender influenced motivations for shifting careers. The test yielded a statistic of χ² = 0.00 and a p-value of 1.000, confirming no statistically significant association between gender and motivation.
These findings indicate that financial incentives especially higher salaries are a universal motivator for both male and female health workers. The study concludes by emphasizing the need for balanced workforce policies that address these disparities to preserve equity and diversity in Zambia’s health system.
Downloads
References
Agyepong, I. A., Lehmann, U., Rakotosalama, H., Mpembeni, R., Haile-Mariam, D., Nzala, S., ... & Soucat, A. (2012). The path to longer and healthier lives for all Africans by 2030: The Lancet Commission on the future of health in sub-Saharan Africa. The Lancet, 385(9983), 2080–2090. https://doi.org/10.1016/S0140-6736(15)62060-1
Bossert, T., Beauvais, J., & Bowser, D. (2000). Decentralization of the health system in Zambia. Major Applied Research, 6. Retrieved from https://content.sph.harvard.edu/wwwhsph/sites/1989/2020/01/Zambia_DecentralizationOftheHealthSystemInZambia.pdf
Buchan, J., & Campbell, J. (2013). Challenges posed by the global crisis in the health workforce. BMJ, 347, f6201. https://doi.org/10.1136/bmj.f6201
Chankova, S., Muchiri, S., & Kombe, G. (2009). Health workforce attrition in the public sector in Kenya: A look at the reasons. Human Resources for Health, 7(58). https://doi.org/10.1186/1478-4491-7-58
Chipeta, B., Musonda, P., & Banda, K. (2018). Determinants of health worker motivation in Zambia. Lusaka: Ministry of Health.
Chipeta, J., Bakuwa, R., & Masiye, F. (2018). African Health Sciences, 18(2), 223–231.
Chipeta, J., Zulu, J. M., & Jacobs, C. N. (2018). Motivation and job satisfaction among health workers in Zambia: A comparative study. BMC Health Services Research, 18(1), 93. https://doi.org/10.1186/s12913-018-2882-2
Clemens, M. A., & Pettersson, G. (2008). New data on African health professionals abroad. Human Resources for Health, 6, 1. https://doi.org/10.1186/1478-4491-6-1
Creswell, J. W., & Plano Clark, V. L. (2017). Designing and conducting mixed methods research (3rd ed.). SAGE Publications.
Dieleman, M., & Harnmeijer, J. W. (2006). Improving health worker performance: In search of promising practices. World Health Organization.
Dieleman, M., Cuong, P. V., Anh, L. V., & Martineau, T. (2003). Identifying factors for job motivation of rural health workers in North Vietnam. Human Resources for Health, 1(1), 10.
Dovlo, D. (2003). The brain drain and retention of health professionals in Africa. In A case study prepared for a regional training conference on Improving Tertiary education in Sub-Saharan Africa: Things That Work (pp. 23-25).
Dussault, G., & Franceschini, M. C. (2006). Not enough there, too many here: Understanding geographical imbalances in the distribution of the health workforce. Human Resources for Health, 4(12). https://doi.org/10.1186/1478-4491-4-12
Ferrinho, P., Siziya, S., Goma, F., & Dussault, G. (2011). The human resource for health situation in Zambia: deficit and maldistribution. Human resources for health, 9(1), 30. Retrieved from https://link.springer.com/article/10.1186/1478-4491-9-30.
Goma, F. Y., Michelo, C., & Chirwa, G. (2021). Medical career aspirations in Zambia: An examination of institutional and social influences. Zambia Medical Journal, 48(3), 117–124.
Gow, J., George, G., Mwamba, S., Ingombe, L., & Mutinta, G. (2012). Health worker satisfaction and motivation: an empirical study of incomes, allowances and working conditions in Zambia. International Journal of Business and Management, 7(10), 37-48. Retrieved from https://research.usq.edu.au/item/q167y/health-worker-satisfaction-and-motivation-an-empirical-study-of-incomes-allowances-and-working-conditions-in-zambia.
Gutinyu, J., & Chang, Y. (2023). Public service motivation, job satisfaction, and turnover intention: evidence from the Ministry of Health, Zambia. International Review of Public Administration, 28(3), 357-376. Retrieved from https://www.tandfonline.com/doi/full/10.1080/12294659.2023.2256101?casa_token=bxQypbsgxZIAAAAA%3AtfXHnHn7kX4LYFaQKqfC2mOyLjtETv3U7bUVvdfIvTE5k18c_Ypoz3MsJYjUQ1Ybp_u8p8pzDfXm2kT.
Katemba, L. K. (2021). An evaluation of motivation of public health workers for effective work performance: a case study of university teaching hospital (Doctoral dissertation, The University of Zambia). Retrieved from https://dspace.unza.zm/handle/123456789/7339.
Likwa, R. (2015). Building capacity for public health and population policy-making: perspectives from Zambia. International Development Planning Review, 37(1), 61-76.
Lehmann, U., Dieleman, M., & Martineau, T. (2008). Staffing remote rural areas in middle- and low-income countries: A literature review of attraction and retention. BMC Health Services Research, 8, 19. https://doi.org/10.1186/1472-6963-8-19
Manda, K., Silumbwe, A., Mupeta Kombe, M., & Hangoma, P. (2023). Motivation and retention of primary healthcare workers in rural health facilities: An exploratory qualitative study of Chipata and Chadiza Districts, Zambia. Global Public Health, 18(1), 2222310. Retrieved from https://www.tandfonline.com/doi/full/10.1080/17441692.2023.2222310.
Mills, E. J., Kanters, S., Hagopian, A., Bansback, N., Nachega, J., Alberton, M., ... & Ford, N. (2011). The financial cost of doctors emigrating from sub-Saharan Africa: human capital analysis. Bmj, 343.
Mulenga, C., Lungu, M., & Mbewe, D. (2022). Career mobility and workforce planning in Zambia's public health sector. African Health Sciences, 22(1), 34–46.
Mulenga, D., Musonda, P., & Mweemba, C. (2022). Public service delivery and health workforce shifts: An investigation into professional transitions in Zambia. African Journal of Health Policy and Management, 14(2), 53–62.
Mulenga, M., Tembo, F., & Phiri, L. (2022). Career redirection and workforce implications in Zambia’s health sector. Zambian Journal of Public Health, 6(2), 45–58.
Mutale, W., Ayles, H., Bond, V., Mwanamwenge, M. T., & Balabanova, D. (2013). Measuring health workers’ motivation in rural health facilities: baseline results from three study districts in Zambia. Human resources for health, 11(1), 8. Retrieved from https://link.springer.com/article/10.1186/1478-4491-11-8.
Munthali, A., Chirwa, M. L., & Maseko, F. C. (2017). Understanding career mobility among health professionals in Malawi. Malawi Medical Journal, 29(4), 336–342. https://doi.org/10.4314/mmj.v29i4.8
Mwisongo, A., & Nabyonga-Orem, J. (2016). Global health initiatives in Africa: Governance, priorities, harmonisation and alignment. BMC Health Services Research, 16(212). https://doi.org/10.1186/s12913-016-1478-3
Omaswa, F., & Boufford, J. I. (2010). Strengthening health systems in developing countries. New York: The Rockefeller Foundation.
Phiri, J., & Ataguba, J. E. (2014). Inequalities in public health care delivery in Zambia. International journal for equity in health, 13(1), 24. Retrieved from https://link.springer.com/article/10.1186/1475-9276-13-24.
Rudasingwa, M., De Allegri, M., Mphuka, C., Chansa, C., Yeboah, E., Bonnet, E., ... & Chitah, B. M. (2022). Universal health coverage and the poor: to what extent are health financing policies making a difference? Evidence from a benefit incidence analysis in Zambia. BMC Public Health, 22(1), 1546. Retrieved from https://link.springer.com/article/10.1186/s12889-022-13923-1.
Serneels, P., Montalvo, J. G., Pettersson, G., Lievens, T., Butera, J. D., & Kidanu, A. (2010). Who wants to work in a rural health post? The role of intrinsic motivation, rural background, and faith-based institutions in Ethiopia and Rwanda. Bulletin of the World Health Organization, 88(5), 342–349. https://doi.org/10.2471/BLT.09.072728
Topp, S. M., Sharma, A., Moonga, C. N., Chileshe, C., Magwende, G., & Henostroza, G. (2018). Evaluation of a health system strengthening initiative in the Zambian prison system. BMJ Global Health, 3(1), e000614.
Vledder, M., & Campbell, K. (2011). The human resources for health crisis in Zambia: an outcome of health worker entry, exit, and performance within the national health labor market (No. 214). World Bank Publications. Retrieved from https://books.google.co.zm/books?hl=en&lr=&id=CkxKwh-sj2EC&oi=fnd&pg=PR3&dq=Zambian+ministry+of+health.
World Health Organization. (2016). Global strategy on human resources for health: Workforce 2030. https://www.who.int/hrh/resources/globstrathrh-2030/en/.
World Health Organization. (2016). Working for health and growth: Investing in the health workforce. WHO Commission Report
World Health Organization. (2020). State of the world’s nursing 2020: Investing in education, jobs and leadership. Geneva: WHO. https://www.who.int/publications/i/item/9789240003279
Zinnen, V., Paul, E., Mwisongo, A., Nyato, D., & Robert, A. (2012). Motivation of human resources for health: a case study at rural district level in Tanzania. The International journal of health planning and management, 27(4), 327-347. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1002/hpm.2117.
Zulu, J., & Mbewe, P. (2020). The silent drift: Internal migration of Zambian health workers from nursing to medicine. Zambia Journal of Health Sciences, 12(1), 45–56.
Zulu, N. (2019). ADDRESSING HEALTH DISARITIES IN ZAMBIA. Retrieved from https://cbie.ca/wp-content/uploads/2020/01/ADDRESSING-HEALTH-DISARITIES-IN-ZAMBIA-converted-1.pdf.
This work is licensed under a Creative Commons Attribution 4.0 International License.
