Understanding the Complexities of Recruitment and Retention of Allied Health Professionals in Rural Health Settings Across Aotearoa: A Qualitative Study

Abstract

Background: Rural and remote communities in Aotearoa New Zealand face significant challenges in recruiting and retaining Allied Health Professionals (AHPs). While targeted investment exists to increase the numbers of doctors and nurses entering the rural workforce, comparatively little attention has been given to Allied Health Scientific and Technical professions. This study aimed to explore what matters to AHPs’ in rural contexts and how these insights could inform recruitment and retention practices. Methods: Drawing on Interpretive Descriptive methodology, semi-structured interviews were conducted with 18 AHPs from diverse professions, ethnicities and geographical locations across Aotearoa who had experience working in rural and/or remote settings. All participants were female, ranging in age from 23 to 63 years, representing seven allied health professions; social work (n = 7), physiotherapy (n = 4), occupational therapy (n = 2), music therapy (n = 2), psychology (n = 1), dietetics (n = 1), and pharmacy (n = 1). Participants identified as Pākehā | New Zealander (n = 11), Māori (n = 4), Samoan (n = 1), and beyond the Pacific (n = 2). Interviews explored career journeys, rural practice experiences, and employment decision factors. Data were analysed using six-phase Reflexive Thematic Analysis with ongoing researcher reflexivity and supervisory input. Results: Three key themes were constructed: (1) Sense of Connection and Belonging, highlighting the importance of feeling connected to teams, community and place; (2) Safe and Supported Practice, emphasising appropriate resources, professional development, and leadership relationships; (3) Creating Roles People Want to Come For, encompassing recruitment experiences, variety of work, growth pathways and scope of practice. These themes were infused with a cross-cutting concept of ‘Fit’, a felt sense of being in the right place, personally and professionally that emerged as a protective factor during challenges and key element for retention decisions. Conclusion: Successful recruitment and retention requires attention to both professional and personal factors, with particular emphasis on creating environments where AHPs feel valued, supported to develop their practice, and connected to their communities. The Fit concept offers a novel framework integrating professional, personal and place-based elements for understanding rural workforce retention. These insights provide evidence-based guidance for health policy makers, rural health organisations, professional bodies and tertiary education providers seeking to address persistent rural workforce shortages.