INTEGRATION AND RETENTION OF CLINICIANS WORKING IN HOSPITALS OF PESHAWAR: A QUALITATIVE STUDY

Background: Health policy makers in low income countries are considering policy strategies to retain home and overseas-trained health professionals. Little evidence is available so as to how the hospitals would retain the skilled health professionals integrating them into the existing system. The aim of this study was to explore the retention and integration experiences of skilled health professionals working as assistants/associates in tertiary care hospitals. Methods: A qualitative study was conducted from July 2021 to January 2022. A semi-structured interview was undertaken. Thematic analysis was used to code and analyze the data. The study was framed within a theoretical model of role development. Results: At time point one Eighteen clinicians working as assistant and associate professors participated in interviews, and sixteen at time point two, across three tertiary care hospitals of Peshawar. Themes identified in the process of retention and integration were four in number as experienced by participants: inspirations and opportunities, seeking professional identity, recognition and integration, and motivation. Proper supervision of the doctors has a pivotal role in creating opportunities through recognition of training and system adjustment, facilitating the development of role models, contributing an effective match between the skills of the participant along with their interests, and organizational needs of the surgical team. Whether or not they had a niche role influenced the decision of participants to remain or leave. Conclusion: Retention of skilled health professionals requires integration. The approach that maximizes the value of the medical and surgical team and leads to their retention by optimizing their roles requires resources and time.