Factors influencing the retention of health professionals in Lao People's Democratic Republic: A cross-sectional survey analysis.

Retention of qualified health professionals is critical for achieving universal health coverage (UHC) in Lao People's Democratic Republic (Lao PDR). Despite policy commitments, the public health sector continues to experience high turnover, especially among non-permanent staff. This study examined key factors influencing health professionals' intention to remain in government service. A cross-sectional survey was conducted from June to August 2023 among 1,873 public-sector health professionals in five provinces representing high and low-turnover areas. A structured questionnaire developed with the Department of Health Personnel (DHP) and administered via KoboToolbox collected data on demographics, employment status, income, motivation, and job satisfaction. Descriptive, bivariate, and multivariate logistic-regression analyses identified predictors of attrition intention. Overall, 37.4% of respondents reported having considered leaving the public sector. Contractual (AOR = 2.24, 95% CI: 1.573.21) and volunteer (AOR = 2.90, 95% CI: 1.904.44) staff were significantly more likely to intend departure than civil servants. Late salary or bonus payments (AOR = 2.25, 95% CI: 1.543.31) strongly increased attrition intent. Conversely, perceiving salary incentives and career-development opportunities as effective was protective (AOR = 0.35, 95% CI: 0.210.58, for moderately effective). Health professionals outside Vientiane Capital showed 3540% lower odds of intending to leave. Retention in Lao PDR is driven by employment security, financial predictability, and professional-development opportunities. Regularizing contractual and volunteer positions, ensuring timely remuneration, and expanding career pathways are critical to implementing the national Human Resources for Health (HRH) Development Strategy 20212030 and achieving UHC by 2025.