Dae Emhu (No Way): A Survey of Student Midwives Willingness to Practice in Rural Areas in Ghana

Background: Midwives are the foundation for maternal child health worldwide. In Ghana the majority of the population lives in rural areas while the vast majority of health care workers reside in urban areas. We undertook this study to elucidate factors that young midwives-in-training find important when deciding whether or not to practice in rural areas. Methods: Computer-based surveys were conducted with 238 final year midwifery students at the two largest midwifery training colleges in Ghana. Students reported their willingness to work in a deprived area according to a five category Likert scale. Data were collected via Sawtooth Software and analyzed via PASW 18. Results: The most important drivers impacting their decision to not work in a rural area were: 1) poor quality of clinical facilities; 2) poor quality of education for children; and 3) lack of social amenities in rural deprived areas. The ability to return to a university to pursue a degree was consistently cited as one of the most important factors in choosing a future work location. Discussion: Until more midwives are attracted to work in rural, remote areas health inequities will continue and the targeted reduction for maternal mortality will remain elusive. Young midwives in this study were not interested in practicing in rural areas. Based on our findings a small number of young midwives may be motivated to live and practice in rural areas for a distinct amount of time (2 years) if they would then be guaranteed a position in a degree program.