Who is absent and why? Factors affecting doctor absenteeism in Bangladesh

Vista sencilla de ítem
dc.creatorIslam, Mir Raihanul
dc.creatorAngell, Blake
dc.creatorNaher, Nahitun
dc.creatorIslam, Bushra Zarin
dc.creatorKhan, Mushtaq Husain
dc.creatorMcKee, Martin
dc.creatorHutchinson, Eleanor
dc.creatorBalabanova, Dina
dc.creatorAhmed, Syed Masud
dc.date2024-04-04
dc.date2024-04-09T14:23:44Z
dc.date2024-04-09T14:23:44Z
dc.date.accessioned2026-06-27T15:27:05Z
dc.descriptionAbsenteeism by doctors in public healthcare facilities in rural Bangladesh is a form of chronic rule-breaking and is recognised as a critical problem by the government. We explored the factors underlying this phenomenon from doctors’ perspectives. We conducted a facility-based cross-sectional survey in four government hospitals in Dhaka, Bangladesh. Junior doctors with experience in rural postings were interviewed to collect data on socio-demographic characteristics, work and living experience at the rural facilities, and associations with professional and social networks. Multiple logistic regression was used to determine the factors associated with rural retention. Of 308 respondents, 74% reported having served each term of their rural postings without interruptions. The main reasons for absenteeism reported by those who interrupted rural postings were formal training opportunities (65%), family commitments (41%), and a miscellaneous group of others (17%). Almost half of the respondents reported unmanageable workloads. Most (96%) faced challenges in their last rural posting, such as physically unsafe environments (70%), verbally abusive behaviour by patients/caregivers (67%) and absenteeism by colleagues that impacted them (48%). Respondents who did not serve their entire rural posting were less likely to report an unmanageable workload than respondents who did (AOR 0.39, 95% CI 0.22–0.70). Respondents with connections to influential people in the local community had a 2.4 times higher chance of serving in rural facilities without interruption than others (AOR 2.40, 95% CI 1.26–4.57). Our findings demonstrate that absenteeism is not universal and depends upon doctors’ socio-political networks. Policy interventions rarely target unsupportive or threatening behaviour by caregivers and community members, a pivotal disincentive to doctors’ willingness to work in underserved rural areas. Policy responses must promote opportunities for doctors with weak networks who are willing to attend work with appropriate support.
dc.identifierhttps://hdl.handle.net/10568/140781
dc.identifier.urihttp://hdl.handle.net/123456789/104768
dc.languageen
dc.publisherPublic Library of Science
dc.rightsOpen Access
dc.sourceIslam, Mir Raihanul; Angell, Blake; Naher, Nahitun; Islam, Bushra Zarin; Khan, Mushtaq Husain; McKee, Martin; Hutchinson, Eleanor; Balabanova, Dina; and Ahmed, Syed Masud. 2024. Who is absent and why? Factors affecting doctor absenteeism in Bangladesh. PLOS Global Public Health 4(4): e0003040. https://doi.org/10.1371/journal.pgph.0003040
dc.subjectphysicians
dc.subjectpublic health
dc.subjectrules
dc.subjectrural communities
dc.titleWho is absent and why? Factors affecting doctor absenteeism in Bangladesh
dc.typeJournal Article

Archivos

Colecciones

Instituto Internacional de Investigación sobre Políticas Alimentarias (IFPRI)