Physician distribution and attrition in the public health sector of Ethiopia

Figures & data

Figure 1 Reasons for attritions for physicians who left their appointments in percent, September 2009 to July 2015.

Table 1 Distribution of actively working physicians in the public health facilities of Ethiopia, September 2009 to July 2015

Variables	Characteristics	Actively working
		Frequency	Percent
Gender	Male	1,407	80.5
	Female	340	19.5
Date of birth	After 1985	889	50.9
	1975–1985	493	28.2
	Before 1975	216	12.4
	Missing	149	8.5
Service years	<3	997	57.07
	3–6	334	19.12
	7–10	167	9.56
	11–14	54	3.09
	≥15	161	9.22
Educational level	General practitionars	1,471	84.2
	Specialists/subspecialists	276	15.8
Settings	Referral hospital	474	27.13
	General hospital	979	56.04
	District hospital	275	15.74
	Health offices	19	1.09
Total of each variable		1,747	100.0
Position during the studya	On duty	1,220	81.4
	On training	279	19.6
	Total	1,499	100

Note:

a Excluding Southern Nations Nationalities and Peoples Region and Tigray.

Table 2 Physician distributions in various regions using the main categories (GPs, residents, and specialists/subspecialists) in Ethiopia, September 2009 to July 2015

Setting	GPs		Residents/fellows		Specialists/subspecialists		Total
	Frequency	Percent	Frequency	Percent	Frequency	Percent	Frequency	Percent
Regional locations
Oromia	477	68.5	139	19.9	80	11.5	696	39.8
Amhara	286	67.8	77	18.2	59	13.9	422	24.1
Addis Ababa	185	56.1	57	17.3	88	26.7	330	18.9
SNNPR	151	–	–	–	22	14.6	173	9.9
Tigray	64	–	–	–	11	14.6	75	4.3
Dire Dawa	18	–	–	–	11	37.9	29	1.7
Harari	15	–	2	–	5	22.5	22	1.3
Total	1,196	68.5	–	–	276	15.8	1,747	100

Note: – indicates information was unavailable.

Abbreviations: GP, general practitioner; SNNPR, Southern Nations Nationalities and Peoples Region.

Table 3 Characteristics of physicians who moved out of their duty stations (n=536), September 2009 to July 2015

Variables	Characteristics	Frequency	Percent
Gender	Male	411	76.68
	Female	125	23.32
Date of birth	After 1985	206	38.43
	1975–1985	187	34.89
	Prior 1975	86	16.04
	Missing	57	10.63
Service years	<3	330	61.57
	3–6	91	16.98
	7–10	32	5.97
	11–14	20	3.73
	≥15	43	8.02
	Missing	20	3.73
Educational level	General practitioners	413	77.05
	Specialist/subspecialist	123	22.95
Setting	Referral hospital	103	19.22
	General Hospital	289	53.92
	District hospital	92	17.16
	Missing	52	9.70

Figure 2 Comparisons between specialists who were actively working (during the study) and those who moved out of their duty stations across the regions in percent, September 2009 to July 2015.

Abbreviation: AACAHB, Addis Ababa City Administration Health Bureau.

Table 4 Characteristics of repeated turnover events between September 2009 and July 2015

Variables	Characteristics	Frequency	Percent
Gender	Male	99	75.57
	Female	32	24.43
Educational level	GPs	111	84.73
	Specialists	20	15.27
Duration of stay in years	Mean	3.4 (95% CI: 2.66, 4.10)
Fist destination
Settings	Clinical	93	70.99
	Academic	37	29.01
Educational levels	GPs	98	74.81
	Specialists	31	25.19
Place moved (n = 93)	To same region	54	58.06
	To different regions	39	41.94
From different regions (n=39)	To Addis Ababa	32	82.05
	Another region	7	17.95
Duration of stay in years	Mean	1.33 (95% CI: 1.12, 1.55)
Second destination (n = 31)
Settings	Clinical	8
	Academic	3
	Unknown	20
Place moved	To same region	3
	To different regions	5
From different regions (n = 5)	To Addis Ababa	2
	Out of Addis	3
	Ababa
Duration of stay in years	Mean	1.01 (95% CI: 0.20, 1.20)

Abbreviations: GP, general practitioner; CI, confidence interval.

Table 5 Factors associated with physician turnover: using Poisson regression model between September 2009 and July 2015

Variable	Category	IRR	SE	P-value	95% CI
					Lower	Upper
Gender	Male (reference)
	Female	1.44	0.17	0.002	1.14	1.81
Date of birth	After 1985 (reference)
	1975–1985	0.63	0.07	0.000	0.51	0.79
	Before 1975	0.24	0.04	0.000	0.17	0.34
Educational level	Specialist/subspecialist (reference)
	GPs	1.31	0.19	0.062	0.99	1.75
Settings	Referral hospital (reference)
	General hospital	1.39	0.18	0.008	1.08	1.78
	District hospital	2.14	0.33	0.000	1.59	2.89
Regional location	Addis Ababa (reference)
	Amhara	2.01	0.31	0.000	1.49	2.73
	Dire Dawa	1.05	0.50	0.90	0.41	2.68
	Harari	0.75	0.38	0.57	0.27	2.04
	Oromia	1.10	0.17	0.53	0.82	1.48
	Tigray	0.60	0.18	0.10	0.34	1.10

Abbreviations: GP, general practitioner; CI, confidence interval; IRR, incident rate ratio; SE, standard error.