In Liberia, the maldistribution ofhealth workers is particularly pronounced as 14 years ofcivil war exacerbated the concentration of experiencedhealth workers in urban areas. The government has identifiedthis challenge as a priority area for policy intervention.The objective of this study was to explore the drivers ofhealth workforce choice including job location. It presentsthe results from preparatory qualitative research that fedinto the design of a discrete choice experiment (DCE). Thequalitative study interviewed 26 registered nurses,midwives, and physician assistants about their currentworking conditions, their job location preference, andpriority areas for change in working conditions. Contentanalysis was used to analyze the data. The study shed lighton health worker job preferences and their workingconditions, and identified six job attributes that healthworkers consider to be important when choosing a job. Thesewere pay, transport, availability of medical materials andinfrastructure, housing, workload, and further trainingopportunities. These attributes were chosen because theyreflect the frequency to which they were cited during theinterviews and the extent to which they were amenable topolicy intervention. Associated attribute levels were chosenfor each attribute to reflect current work conditions andthe levels of change that will be necessary to triggerchanges in job choice. The relative weight of each of theseattributes in location choice has been quantitativelydetermined through the follow-up DCE. Although the main aimof this study was to feed into the DCE design, itincidentally throws light on a wider variety of issues withregard to health worker career choice, motivation, and performance.
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