Diversity in Career Preferences of Future Health Workers in Rwanda : Where, Why, and for How Much?

The Government of Rwanda has identified human resources for health as one of its Policy priorities. This study aims to contribute to building a better understanding of health worker choice and behavior, and to improve evidence based policies. The work was undertaken by The Ministry of Health in a collaborative effort with the World Bank, building on the results of qualitative pre research, and is the first wave of a cohort survey with medical and nursing students. In comparison with other African countries, migration of health workers abroad may be less of a problem for Rwanda. The study finds that 80 percent of nursing and medical students report to have no intention to migrate abroad in the coming five years. Using a contingent valuation method to measure the reservation wage to migrate, we find that at the current public sector starting salary more than half the students will choose a job in Kigali instead of going abroad. But there is considerable heterogeneity in the willingness to work abroad. For example, students who are married or engaged are less likely to move abroad. Younger medical students require a higher average salary to stay in Rwanda compared to older students. Although Rwanda has a relatively low HIV prevalence compared to other African countries, there are problems with attitudes to HIV/AIDS, although the attitudes differ greatly between students, with medical students consistently more positive than nurses. Medical students score higher than nurses on medical knowledge related to HIV/AIDS, have higher levels of self reported knowledge on AIDS, and are also more familiar with HIV. Health students are generally averse to taking up work in high HIV prevalence areas but preferences vary widely, as is reflected in the wide span of reservation wages to accept a job in a high HIV prevalence area. Students are less willing to work in high HIV prevalence areas than to take up rural service.