High Intention-to-leave and Factors among Health Professionals in War-torn Tigray, Ethiopia: a Mixed Methods Study
1
Health Systems, Mekelle University, College of Health Sciences, School of Public Health, Mekelle, Ethiopia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Health professionals in conflict-affected settings face immense challenges. This could lead to high intention-to-leave and attrition rates among the workforce, which in turn could affect the overall recovery. Recently, Ethiopia’s Tigray region was devastated by war, which destroyed 96.7% health facilities and attacks on health workers, the WHO reported. We report findings on intention-to-leave among health workers, factors, and mechanisms to retain them in this hostile environment. Methods and Materials: We employed a mixed-methods design with 2366 professionals from six accessible zones in Ethiopia’s war-torn Tigray region in 2023. Full structural equation modeling was employed to identify determinants of intention-to-leave. We triangulated the quantitative with the qualitative findings.
RESULTS:
Nearly 60% professionals intended to leave. Burnout, distress, satisfaction, and vicarious trauma were major predictors. Economic, governance, security, and social reasons emerged as major themes for intentions to leave. Identified interventions were improving the work environment, free health service, transport service, performance-based recognition, housing, enough salary, extra payment for extra work, equipping facilities with enough supplies, strong associations, and sustainable peace. Innovative contribution to policy: Stakeholders can craft retention strategies to alleviate burnout, distress, improve work climate, and living conditions.
Health professionals in conflict-affected settings face immense challenges. This could lead to high intention-to-leave and attrition rates among the workforce, which in turn could affect the overall recovery. Recently, Ethiopia’s Tigray region was devastated by war, which destroyed 96.7% health facilities and attacks on health workers, the WHO reported. We report findings on intention-to-leave among health workers, factors, and mechanisms to retain them in this hostile environment. Methods and Materials: We employed a mixed-methods design with 2366 professionals from six accessible zones in Ethiopia’s war-torn Tigray region in 2023. Full structural equation modeling was employed to identify determinants of intention-to-leave. We triangulated the quantitative with the qualitative findings.
RESULTS:
Nearly 60% professionals intended to leave. Burnout, distress, satisfaction, and vicarious trauma were major predictors. Economic, governance, security, and social reasons emerged as major themes for intentions to leave. Identified interventions were improving the work environment, free health service, transport service, performance-based recognition, housing, enough salary, extra payment for extra work, equipping facilities with enough supplies, strong associations, and sustainable peace. Innovative contribution to policy: Stakeholders can craft retention strategies to alleviate burnout, distress, improve work climate, and living conditions.
| eISSN: | 2654-1459 |
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