LAUSR

OBJECTIVE the objective of this study is to understand the barriers final year midwifery students face when deciding to practice in a rural, deprived area. DESIGN a cross-sectional study design using a computer based structured survey. SETTING 15 of the 16 publicly funded midwifery colleges across all ten regions in Ghana. PARTICIPANTS a national sample of final-year midwifery students from publically funded midwifery colleges in Ghana. MEASUREMENTS basic frequencies and percentages were calculated for the variables cited as the top three factors motivating participants to study midwifery stratified by student type (post-basic verses diploma) and program location (urban, peri-urban, and rural). Odds ratios were calculated using separate logistic regression models to analyze the relationship between students' experience with rural communities and how it affected their willingness to work in a rural area following graduation. FINDINGS eight hundred and fifty-six midwifery students (N = 856) completed a computerised survey for a response rate of 91.8%. The top motivation to study midwifery was a 'desire to help others'. Over half (55%) of participants reported they will 'definitely work' (11%) or 'were likely to work' (44%) in a deprived area. When examined by student type and location of school, the top reason cited by participants was 'to serve humanity'. Those born in a rural area, currently living in a rural area, or under obligation to return to a rural or peri-urban area had greater odds of being willing to work in a deprived area after graduation. KEY CONCLUSIONS findings from our study are unique in that they examine the distinct motivational factors from a national sample of midwifery students about to join the workforce. Regardless of the type of student or the location of the school, midwifery students in Ghana were highly motivated by altruistic values. Strategies to address the rural shortage of midwifery providers in Ghana is presented. IMPLICATION FOR PRACTICE understanding the factors that motivate midwifery students to work in rural, deprived areas will help develop effective policy interventions affecting practice.