[Relationship between assignment of supervisory public health nurses and recruitment of municipal public health nurses].

Abstract

Objective　Municipal public health nurses (PHNs) provide diverse community health services, including the planning, implementation, and evaluation of local health policies. A well-planned and continuous recruitment system is essential for performing these duties effectively and efficiently; however, many municipalities face difficulties in securing adequate full-time PHNs amid increasing workloads, and establishing sustainable recruitment measures remains a challenge. In this context, supervisory PHNs are expected to possess the ability to establish systems for recruiting and training local government PHNs and are considered to play a crucial role in these processes. However, a quantitative evaluation of the relationship between assignment of supervisory PHNs and number of PHN recruits has not been conducted. This study aimed to clarify this association.Methods　This cross-sectional study was conducted by analyzing the data of 1,733 municipalities in the fiscal year 2020. Data on the presence of supervisory PHNs, number of full-time PHNs, annual PHN recruits, and the total population of each municipality were obtained from the Ministry of Health, Labour and Welfare's Survey on Public Health Nurse Activities by Area of Work and the Ministry of Internal Affairs and Communications' Population Census, and other official statistics. The outcome was the annual number of PHN recruits, and the main explanatory variable was the presence of a supervisory PHN. Multivariable negative binomial regression analysis was used to calculate incidence rate ratios and 95% confidence intervals (CIs), with adjustments for variables related to regional characteristics.Results　Of the 1,733 municipalities analyzed, 865 (49.9%) had a supervisory PHN. After adjusting for municipality size, retirements, and other covariates, municipalities with a supervisory PHN had 1.167 times more PHN recruits than those without a supervisory PHN (95% CI: 1.040-1.310).Conclusions　Municipalities with supervisory PHNs tended to have more PHN recruits than those without supervisory PHNs. This suggests that supervisory PHNs play a crucial role in securing PHN personnel through their involvement in recruitment planning, enhancing workplace attractiveness, and promoting strategic recruitment activities. This result may have important implications for the development of stable and continuous recruitment strategies for municipal PHNs.