Introduction: Healthcare service delivery in India is not possible without strengthening the primary healthcare system. Most of the Indian states struggle with the medical workforce especially doctors at Primary Health Centers (PHCs). Chhattisgarh being tribal state with mostly rural area is not an exception. It’s not easy to retain doctors at PHCs unless there is systematic investment in understanding their plans for career, preferences for medical specialization, desired location to serve and overall approach to work in rural and remote areas. This study attempts to explore the various factors during academic tenure which influence medical students to make decisions about working in rural areas through public health service. Methodology: A cross-sectional survey was conducted in all the six government medical colleges in the state of Chhattisgarh. Data was collected from 1917 students admitted in last 5 years in all 6 Government Medical colleges. Study was conducted using a self-administered semi structured questionnaire. Data was analyzed using SPSS version 20. Results: Of 1,917 respondents, 50.9% were female. Overall, 38.1% expressed willingness to serve in rural areas. Gender, social category, residential background, and academic year significantly influenced willingness (p < 0.05). Students from tribal backgrounds (AOR=2.84; 95% CI: 2.10–3.84), rural upbringing (AOR=2.17; 95% CI: 1.58–2.99), and first/second-year students (AOR=1.92; 95% CI: 1.33–2.78) showed higher inclination. Motivational factors included better housing, incentives, and exposure to rural health facilities. Nearly 90.8% preferred post graduation immediately after MBBS, regardless of background. Conclusion: The Indian public sector has introduced a range of financial and non-financial incentives to encourage health workers, particularly allopathic doctors, to serve in rural areas. However, most existing strategies address isolated challenges or are implemented only after the completion of medical training. Our findings suggest the need to move away from this fragmented incentive model towards a comprehensive ‘package’ approach that creates a supportive and enabling environment during the MBBS period itself, thereby shaping career choices early on. Only through such an approach can government service and rural postings become genuinely attractive options for health professionals.
| Published in | Central African Journal of Public Health (Volume 12, Issue 1) |
| DOI | 10.11648/j.cajph.20261201.12 |
| Page(s) | 11-18 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2026. Published by Science Publishing Group |
Career Choice, Health Workforce, Medical Students, Public Sector, Rural Health
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APA Style
Singh, G. (2026). Push or Pull Factors: Willingness of Medical Students to Work in Rural Areas. Central African Journal of Public Health, 12(1), 11-18. https://doi.org/10.11648/j.cajph.20261201.12
ACS Style
Singh, G. Push or Pull Factors: Willingness of Medical Students to Work in Rural Areas. Cent. Afr. J. Public Health 2026, 12(1), 11-18. doi: 10.11648/j.cajph.20261201.12
@article{10.11648/j.cajph.20261201.12,
author = {Gajendra Singh},
title = {Push or Pull Factors: Willingness of Medical Students to Work in Rural Areas},
journal = {Central African Journal of Public Health},
volume = {12},
number = {1},
pages = {11-18},
doi = {10.11648/j.cajph.20261201.12},
url = {https://doi.org/10.11648/j.cajph.20261201.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20261201.12},
abstract = {Introduction: Healthcare service delivery in India is not possible without strengthening the primary healthcare system. Most of the Indian states struggle with the medical workforce especially doctors at Primary Health Centers (PHCs). Chhattisgarh being tribal state with mostly rural area is not an exception. It’s not easy to retain doctors at PHCs unless there is systematic investment in understanding their plans for career, preferences for medical specialization, desired location to serve and overall approach to work in rural and remote areas. This study attempts to explore the various factors during academic tenure which influence medical students to make decisions about working in rural areas through public health service. Methodology: A cross-sectional survey was conducted in all the six government medical colleges in the state of Chhattisgarh. Data was collected from 1917 students admitted in last 5 years in all 6 Government Medical colleges. Study was conducted using a self-administered semi structured questionnaire. Data was analyzed using SPSS version 20. Results: Of 1,917 respondents, 50.9% were female. Overall, 38.1% expressed willingness to serve in rural areas. Gender, social category, residential background, and academic year significantly influenced willingness (p < 0.05). Students from tribal backgrounds (AOR=2.84; 95% CI: 2.10–3.84), rural upbringing (AOR=2.17; 95% CI: 1.58–2.99), and first/second-year students (AOR=1.92; 95% CI: 1.33–2.78) showed higher inclination. Motivational factors included better housing, incentives, and exposure to rural health facilities. Nearly 90.8% preferred post graduation immediately after MBBS, regardless of background. Conclusion: The Indian public sector has introduced a range of financial and non-financial incentives to encourage health workers, particularly allopathic doctors, to serve in rural areas. However, most existing strategies address isolated challenges or are implemented only after the completion of medical training. Our findings suggest the need to move away from this fragmented incentive model towards a comprehensive ‘package’ approach that creates a supportive and enabling environment during the MBBS period itself, thereby shaping career choices early on. Only through such an approach can government service and rural postings become genuinely attractive options for health professionals.},
year = {2026}
}
TY - JOUR T1 - Push or Pull Factors: Willingness of Medical Students to Work in Rural Areas AU - Gajendra Singh Y1 - 2026/02/09 PY - 2026 N1 - https://doi.org/10.11648/j.cajph.20261201.12 DO - 10.11648/j.cajph.20261201.12 T2 - Central African Journal of Public Health JF - Central African Journal of Public Health JO - Central African Journal of Public Health SP - 11 EP - 18 PB - Science Publishing Group SN - 2575-5781 UR - https://doi.org/10.11648/j.cajph.20261201.12 AB - Introduction: Healthcare service delivery in India is not possible without strengthening the primary healthcare system. Most of the Indian states struggle with the medical workforce especially doctors at Primary Health Centers (PHCs). Chhattisgarh being tribal state with mostly rural area is not an exception. It’s not easy to retain doctors at PHCs unless there is systematic investment in understanding their plans for career, preferences for medical specialization, desired location to serve and overall approach to work in rural and remote areas. This study attempts to explore the various factors during academic tenure which influence medical students to make decisions about working in rural areas through public health service. Methodology: A cross-sectional survey was conducted in all the six government medical colleges in the state of Chhattisgarh. Data was collected from 1917 students admitted in last 5 years in all 6 Government Medical colleges. Study was conducted using a self-administered semi structured questionnaire. Data was analyzed using SPSS version 20. Results: Of 1,917 respondents, 50.9% were female. Overall, 38.1% expressed willingness to serve in rural areas. Gender, social category, residential background, and academic year significantly influenced willingness (p < 0.05). Students from tribal backgrounds (AOR=2.84; 95% CI: 2.10–3.84), rural upbringing (AOR=2.17; 95% CI: 1.58–2.99), and first/second-year students (AOR=1.92; 95% CI: 1.33–2.78) showed higher inclination. Motivational factors included better housing, incentives, and exposure to rural health facilities. Nearly 90.8% preferred post graduation immediately after MBBS, regardless of background. Conclusion: The Indian public sector has introduced a range of financial and non-financial incentives to encourage health workers, particularly allopathic doctors, to serve in rural areas. However, most existing strategies address isolated challenges or are implemented only after the completion of medical training. Our findings suggest the need to move away from this fragmented incentive model towards a comprehensive ‘package’ approach that creates a supportive and enabling environment during the MBBS period itself, thereby shaping career choices early on. Only through such an approach can government service and rural postings become genuinely attractive options for health professionals. VL - 12 IS - 1 ER -