title: Understanding Health Workers' Job Preferences to Improve Rural Retention in Timor-Leste: Findings from a Discrete Choice Experiment.
abstract: BACKGROUND
  Timor-Leste built its health workforce up from extremely low levels after its war of independence, with the assistance of Cuban training, but faces challenges as the first cohorts of doctors will shortly be freed from their contracts with government. Retaining doctors, nurses and midwives in remote areas requires a good understanding of health worker preferences.
  
  
  METHODS
  The article reports on a discrete choice experiment (DCE) carried out amongst 441 health workers, including 173 doctors, 150 nurses and 118 midwives. Qualitative methods were conducted during the design phase. The attributes which emerged were wages, skills upgrading/specialisation, location, working conditions, transportation and housing.
  
  
  RESULTS
  One of the main findings of the study is the relative lack of importance of wages for doctors, which could be linked to high intrinsic motivation, perceptions of having an already highly paid job (relative to local conditions), and/or being in a relatively early stage of their career for most respondents. Professional development provides the highest satisfaction with jobs, followed by the working conditions. Doctors with less experience, males and the unmarried are more flexible about location. For nurses and midwives, skill upgrading emerged as the most cost effective method.
  
  
  CONCLUSIONS
  The study is the first of its kind conducted in Timor-Leste. It provides policy-relevant information to balance financial and non-financial incentives for different cadres and profiles of staff. It also augments a thin literature on the preferences of working doctors (as opposed to medical students) in low and middle income countries and provides insights into the ability to instil motivation to work in rural areas, which may be influenced by rural recruitment and Cuban-style training, with its emphasis on community service.
authors.affiliation: Oxford Policy Management, Oxford, United Kingdom.
authors.forename: Marc-Francois
authors.initials: MF
authors.lastname: Smitz
authors.affiliation: Oxford Policy Management, Oxford, United Kingdom.|Queen Margaret University, Edinburgh, United Kingdom.
authors.forename: Sophie
authors.initials: S
authors.lastname: Witter
authors.affiliation: World Bank, Washington DC, United States of America.
authors.forename: Christophe
authors.initials: C
authors.lastname: Lemiere
authors.affiliation: World Bank, Washington DC, United States of America.
authors.forename: Patrick Hoang-Vu
authors.initials: PH
authors.lastname: Eozenou
authors.affiliation: Oxford Policy Management, Oxford, United Kingdom.
authors.forename: Tomas
authors.initials: T
authors.lastname: Lievens
authors.affiliation: Oxford Policy Management, Oxford, United Kingdom.
authors.forename: Rashid U
authors.initials: RU
authors.lastname: Zaman
authors.affiliation: Oxford Policy Management, Oxford, United Kingdom.
authors.forename: Kay
authors.initials: K
authors.lastname: Engelhardt
authors.affiliation: World Bank, Washington DC, United States of America.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Hou
mesh_terms: D002321:Career Choice; D002755:Choice Behavior; D005260:Female; D006282:Health Personnel / Q000191:economics / Q000523:psychology*; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008880:Midwifery / Q000191:economics; D009042:Motivation; D009726:Nurses / Q000191:economics / Q000523:psychology; D010820:Physicians / Q000191:economics / Q000523:psychology; D012424:Rural Population; D012456:Salaries and Fringe Benefits; D013337:Students, Medical