Candidate attributes included in pilot study and reason for inclusion
Attribute | Reason for inclusion | Propositions |
Relationship between the doctor and the local community | Qualitative work highlighted that the doctors felt that having a good relationship with the community was the key determinant of how manageable the demands placed on them were. Further, many noted that if there was a good relationship, it would be unlikely that there would be security issues. | Doctors expected to prefer facilities that enabled a strong relationship with powerful individuals within the community. |
Safety at workplace | Security was found to be a concern to the doctors both at workplace and living place. Many facilities did not have appropriate or functional security measures while many interviewees told of situations where they had either been verbally or physically abused while in the workplace. | Doctors expected to prefer facilities with effective security measures. |
Workload | Many doctors reported that due to high numbers of patients, staff shortages and social pressures from the local community, they found their workload unmanageable and outside of their control. | Doctors expected to prefer facilities with better workload management practices. |
Monitoring absenteeism | Doctors reported that monitoring mechanisms were often either non-functional or inconvenient to use (eg, having to sign in at central locations away from the facility). | Doctors expected to prefer facilities with either minimal or efficient monitoring systems. |
Policies to address absenteeism | Doctors reported that policies to control absenteeism were often not enforced and findings from the literature suggest that there is limited evidence of successful interventions to overcome absenteeism. | Doctors expected to prefer facilities that reward good attendance. Punitive measures were expected to be disliked by most doctors although some noted that appropriate enforcement would reduce absenteeism and thus their personal workload. |
Incentive for working in rural facility | Incentive payments are used in the Bangladesh health system to encourage doctors to work in the Hills districts and would thus be familiar to doctors and allow for a numerical assessment of the importance of attributes. | Doctors expected to prefer higher incentive payments. |