Does an alignment of employment policies and individual preferences affect intention to stay in the profession? Evidence from Canadian Midwives

• Published in: Health policy (Amsterdam) Vol. 125; no. 4; pp. 450 - 458
• Main Authors: HakemZadeh, Farimah, Sayin, Firat K., Neiterman, Elena, Zeytinoglu, Isik Urla, Geraci, Johanna, Plenderleith, Jennifer, Lobb, Derek
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.04.2021; Elsevier Science Ltd
• Subjects: Alignment of actual and preferred employment policies; Compensation; Compensation method; Contractors; Employment; Employment policies; Employment status; Full-time/part-time; Health administration; Independent contractors; Intention to stay in the profession; Midwifery; Midwives; Occupational status; Part time employment; Policy making; Respondents; Rewards; Satisfaction; Statistics; Wages & salaries; Work; Canada; Midwives; Full-time/part-time; Alignment of actual and preferred employment policies; Compensation method; Employment status; Intention to stay in the profession
• ISSN: 0168-8510; 1872-6054
• DOI: 10.1016/j.healthpol.2021.01.005

•Alignment of actual/preferred employment policies contributes to intention to stay.•The most preferred compensation method is a blend of salary and courses of care.•Being an independent salaried professional is the most popular employee model•About half of midwives prefer a part-time schedule.•Financial-rewards satisfaction is an important moderator in intention to stay. This study examines whether alignment of actual and preferred employment policies, including compensation method, employment status, and work schedule, affect midwives’ intention to stay in the profession. The study further investigates the moderating effect of financial-rewards satisfaction and compares midwives’ policy preferences in urban/rural practices. Cross-sectional survey data from 549 midwives across Canada were analysed through descriptive statistics, bivariate correlations, and hierarchical linear regressions. Further regression analysis separated data for urban/rural practicing midwives. Three-quarters of the respondents are paid through a billable-course-of-care, while only one-third prefer this model. Another one-third prefer a combination of salary and billable-course-of-care. More than three-quarters of the respondents are independent contractors, but half prefer other forms of employee status. Lastly, half prefer a part-time work schedule, while others prefer full-time. Alignment of actual and preferred employment policies significantly explains midwives’ intention to stay in the profession. Intentions to stay in the profession for urban midwives is significantly affected by the alignment of actual and preferred compensation methods, but not for rural ones. Both urban and rural midwives report similar preferences for employment status and work schedule policies. Furthermore, satisfaction with financial rewards is significantly associated with their intention to stay. Policymakers can positively influence midwives’ intention to stay in the profession by facilitating alignment of their actual and preferred employment policies.