title: Willingness to work in rural areas and the role of intrinsic versus extrinsic professional motivations - a survey of medical students in Ghana.
abstract: BACKGROUND
  Retaining health workers in rural areas is challenging for a number of reasons, ranging from personal preferences to difficult work conditions and low remuneration. This paper assesses the influence of intrinsic and extrinsic motivation on willingness to accept postings to deprived areas among medical students in Ghana.
  
  
  METHODS
  A computer-based survey involving 302 fourth year medical students was conducted from May-August 2009. Logistic regression was used to assess the association between students' willingness to accept rural postings and their professional motivations, rural exposure and family parental professional and educational status (PPES).
  
  
  RESULTS
  Over 85% of students were born in urban areas and 57% came from affluent backgrounds. Nearly two-thirds of students reported strong intrinsic motivation to study medicine. After controlling for demographic characteristics and rural exposure, motivational factors did not influence willingness to practice in rural areas. High family PPES was consistently associated with lower willingness to work in rural areas.
  
  
  CONCLUSIONS
  Although most Ghanaian medical students are motivated to study medicine by the desire to help others, this does not translate into willingness to work in rural areas. Efforts should be made to build on intrinsic motivation during medical training and in designing rural postings, as well as favour lower PPES students for admission.
authors.affiliation: Department of Community Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. agyeibaffour@yahoo.co.uk
authors.forename: Peter
authors.initials: P
authors.lastname: Agyei-Baffour
authors.forename: S Rani
authors.initials: SR
authors.lastname: Kotha
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Johnson
authors.forename: Mawuli
authors.initials: M
authors.lastname: Gyakobo
authors.forename: Kwesi
authors.initials: K
authors.lastname: Asabir
authors.forename: Janet
authors.initials: J
authors.lastname: Kwansah
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Nakua
authors.forename: Mawuli
authors.initials: M
authors.lastname: Dzodzomenyo
authors.forename: Rachel C
authors.initials: RC
authors.lastname: Snow
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Kruk
mesh_terms: D002755:Choice Behavior; D003625:Data Collection; D005260:Female; D005869:Ghana; D006801:Humans; D016015:Logistic Models; D008297:Male; D009042:Motivation; D011365:Professional Practice Location; D019035:Rural Health Services; D013337:Students, Medical; D055815:Young Adult