human resource on health: gender dimension

Human Resource on Health: Human Resource on Health: Gender DimensionGender Dimension

Churnrurtai Kanchanachitra, Suwit Wibulpolprasert, Churnrurtai Kanchanachitra, Suwit Wibulpolprasert, Thaksaphol ThammarangsriThaksaphol Thammarangsri

ObjectivesObjectivesTTo investigate the differences o investigate the differences between gender, between gender,

mobility from mobility from – rural to urban areasrural to urban areas– public to the private sectorpublic to the private sector– training opportunities training opportunities – careercareer development development

Data collected fromData collected from cohorts cohorts (1973, 1978, 1983, (1973, 1978, 1983, 1988, 1993) 1988, 1993) from a cohort retrospective survefrom a cohort retrospective survey of doctor mobility conducted by y of doctor mobility conducted by SuwitSuwit et al i et al in n 19981998

Sampling Sampling PPopulation opulation

CohortCohort MaleMale FemaleFemale

NumberNumber %% NumberNumber %%

19731973 134134 68.468.4 6262 31.631.6

19781978 130130 73.973.9 4646 26.126.1

19831983 139139 76.076.0 4343 23.523.5

19881988 130130 77.477.4 3838 22.622.6

19931993 100100 59.959.9 6565 38.938.9

Income level and working hoursIncome level and working hours

Income Level Income Level (percent)(percent)

100 80 60 40 20 0 20 40 60 80 100

1973

1978

1983

1988

1993

Female Male

<20,00020,000-40,000

40,001-60,000

60,001-80,000

>80,000

Working hour by Working hour by ffull-time equivalent ull-time equivalent (40(40hour = hour = 11 FTE) FTE)

100 80 60 40 20 0 20 40 60 80 100

1973

1978

1983

1988

1993

Female Male

0.5-0.99 1.0-1.49<0.49 1.5-1.99

2.0-2.49 2.5-2.99 3.0+

Average working hour per weekAverage working hour per week

49.1753.2

56.261.54 63.66

48.21 50 51.3648.61

58.49

0

10

20

30

40

50

60

70

1973 1978 1983 1988 1993

Male

Female

Percentage of income from private sector as Percentage of income from private sector as compared to total incomecompared to total income

100 80 60 40 20 0 20 40 60 80 100

1973

1978

1983

1988

1993

Female Male

1-24% 25-49%Private only

50-74% 75-99% Public only

Type of specialist training by sex Type of specialist training by sex and year graduatedand year graduated

100 80 60 40 20 0 20 40 60 80 100

1973

1978

1983

1988

1993

Female Male

Surgery Obs-gynMedicine Pediatric

Orthopedic Radiologist Others

Average number of years from Average number of years from graduation to specialist traininggraduation to specialist training

6.07

5.24 5.365.76

4.4

6.62

4.97 5.065.5

4.44

0

1

2

3

4

5

6

7

1973 1978 1983 1988 1993

Male

Female

Percentage of doctors moving from Percentage of doctors moving from district to urban areadistrict to urban area

44.850

70.5

62.3

4545.2

69.665.1

71.1

55.4

0

10

20

30

40

50

60

70

80

1973 1978 1983 1988 1993

Male

Female

Average number of years working Average number of years working in district hospital before movingin district hospital before moving

6

3.9 4 3.8

2.6

6.1

3.7 3.8 3.6

2.5

0

1

2

3

4

5

6

7

1973 1978 1983 1988 1993

Male

Female

0.2

.4.6

.81

Kap

lan-

Mei

erS

urvi

val F

unct

ion

0 5 10 15 20 25years after graduation

male_1973 male_1978male_1983 male_1988

male_1993

Stay in District Hospital

Survival function of male doctors in district hospital

0.2

.4.6

.81

Kap

lan-

Mei

erS

urvi

val F

unct

ion

0 5 10 15 20 25years after graduation

female_1973 female_1978female_1983 female_1988

female_1993

Stay in District Hospital

Survival function of female doctors in district hospital

Percentage of doctors moving from Percentage of doctors moving from public to privatepublic to private

17.9

12.314.4

12.3

4

12.9

21.7

11.613.2

4.6

0

5

10

15

20

25

1973 1978 1983 1988 1993

Male

Female

Average number of years working in Average number of years working in public sector before moving to privatepublic sector before moving to private

6.1

9.18.4

4.93.8

9.6

7.6

6.25.4

3.3

0

2

4

6

8

10

12

1973 1978 1983 1988 1993

Male

Female

0.2

.4.6

.81

Kap

lan-

Mei

erS

urvi

val F

unct

ion

0 5 10 15 20 25years after graduation

male_1973 male_1978male_1983 male_1988

male_1993

Stay in Public Sector

Survival function of male doctors in public sector

0.2

.4.6

.81

Kap

lan-

Mei

erS

urvi

val F

unct

ion

0 5 10 15 20 25years after graduation

female_1973 female_1978female_1983 female_1988

female_1993

Stay in Public Sector

Survival function of female doctors in public sector

Factors related to rFactors related to relocation from elocation from ddistrict istrict hospitalshospitals to urban areas orto urban areas or to to Bangkok Bangkok (LPM)(LPM)

MaleMale -0.106***-0.106***

19781978 0.124**0.124**

19831983 0.268***0.268***

19881988 0.232***0.232***

19931993 0.0440.044

Khon KaenKhon Kaen -0.227***-0.227***

ChiangmaiChiangmai -0.132**-0.132**

SrinakarinwirotSrinakarinwirot 0.419*0.419*

SongklaSongkla -0.152*-0.152*

Time (years) worked inTime (years) worked in ddistrict istrict hospitalshospitals before before moving moving to urban areas orto urban areas or to to Bangkok Bangkok (LPM)(LPM)

MaleMale 0.2940.294

19781978 -1.665***-1.665***

19831983 -1.567***-1.567***

19881988 -1.677***-1.677***

19931993 -3.169***-3.169***

% of public% of public 0.010**0.010**

SummarySummary

• Older cohorts work longer in rural areas than the Older cohorts work longer in rural areas than the younger cohorts younger cohorts

• Women stay shorter and are more likely to move Women stay shorter and are more likely to move to urban areasto urban areas

• Majority of doctors moved out after 3 yearsMajority of doctors moved out after 3 years• If they can survive after 5 years, it is less likely If they can survive after 5 years, it is less likely

to move outto move out• Graduated from Universities outside Bangkok Graduated from Universities outside Bangkok

are more likely to stay in rural areasare more likely to stay in rural areas