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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

The retention of health human resources in primary healthcare centers in Lebanon: a national survey

BMC Health Services Research > Ausgabe 1/2012
Mohamad Alameddine, Shadi Saleh, Fadi El-Jardali, Hani Dimassi, Yara Mourad
Wichtige Hinweise

Competing interests

None to declare for any of the authors.

Authors’ contributions

MA: Conceptualized the study, wrote the proposal, secured funding, lead all aspects of data collection and analysis and prepared the first draft of the manuscript. He approved the final submitted version of this manuscript. SS: Conceptualized the study, contributed to data analysis of collected information and helped in the write up of the manuscript. He approved the final submitted version of this manuscript. FE: Helped with the conceptualization the study, contributed to the write up of the funded grant and significantly contributed to analysis and write up of the manuscript. He reviewed the manuscript and approved the final submitted version. HD: Lead the statistical analysis carried out in this study and contributed to the write up of the manuscript. He reviewed the manuscript and approved the final submitted version. YM: Contributed to data entry and analysis. Provided valuable support with the referencing and editing of the final version of the manuscript. All authors read and approved the final manuscript.



Critical shortages of health human resources (HHR), associated with high turnover rates, have been a concern in many countries around the globe. Of particular interest is the effect of such a trend on the primary healthcare (PHC) sector; considered a cornerstone in any effective healthcare system. This study is a rare attempt to investigate PHC HHR work characteristics, level of burnout and likelihood to quit as well as the factors significantly associated with staff retention at PHC centers in Lebanon.


A cross-sectional design was utilized to survey all health providers at 81 PHC centers dispersed in all districts of Lebanon. The questionnaire consisted of four sections: socio-demographic/ professional background, organizational/institutional characteristics, likelihood to quit and level of professional burnout (using the Maslach-Burnout Inventory). A total of 755 providers completed the questionnaire (60.5% response rate). Bivariate analyses and multinomial logistic regression were used to determine factors associated with likelihood to quit.


Two out of five respondents indicated likelihood to quit their jobs within the next 1–3 years and an additional 13.4% were not sure about quitting. The top three reasons behind likelihood to quit were poor salary (54.4%), better job opportunities outside the country (35.1%) and lack of professional development (33.7%). A U-shaped relationship was observed between age and likelihood to quit. Regression analysis revealed that high levels of burnout, lower level of education and low tenure were all associated with increased likelihood to quit.


The study findings reflect an unstable workforce and are not conducive to supporting an expanded role for PHC in the Lebanese healthcare system. While strategies aiming at improving staff retention would be important to develop and implement for all PHC HHR; targeted retention initiatives should focus on the young-new recruits and allied health professionals. Particular attention should be dedicated to enhancing providers’ role satisfaction and sense of job security. Such initiatives are of pivotal importance to stabilize the workforce and ensure its longevity.
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