Background: Attracting healthcare professionals (HCPs) to rural areas and retaining them there remains a challenge. Current retention strategies focus on the factors that cause people to leave rural areas, but these strategies continue to fail to retain HCPs in these areas, and the situation in which there is a lack of quality and inadequacy of the type of health services is perpetuated. The literature describes factors that attract healthcare workers to work in rural areas, and this study contributes to a deeper understanding of this.

Method: This was a qualitative study in which in-depth interviews and focus groups were used, together with an appreciative inquiry approach. Fourteen participants were purposively selected for the study. Data were coded and the themes extracted and critically analysed by two researchers. Ethics clearance was obtained from the University of the Free State.

Results: Intrinsic themes included having a “calling” to work in an area, team work and community affiliation. Extrinsic themes related to the geographical location, diversity of work, functional referral networks, and strong management and leadership structures.

Conclusion: This research offers a different way of viewing what attracts healthcare workers to work in rural areas by focusing on the positive factors that encourage them to remain, rather than on the negative factors that make them want to leave. The findings complement the existing literature, and also include fresh ideas with regard to understanding the reasons behind the retention of rural healthcare workers from an asset-based perspective. The resulting conceptual framework helped to foster a paradigm shift with respect to re-thinking the retention strategy.