Health worker perspectives on Greenlandic healthcare - resources, sustainability and work-life-balance.

Greenland faces severe challenges with the recruitment and retention of health workers. A healthcare reform from 2010 did not have the expected effect. On this background we explored health worker perspectives on barriers and opportunities for improvements. To generate knowledge of opportunities and challenges in delivering culturally relevant healthcare, and knowledge of conditions for developing a sustainable work environment. Interviews with healthcare staff from all regions were carried out and analysed within a hermeneutic-phenomenological approach. Although better cohesion of healthcare and improved communication across health units was experienced, lack of support, training, and high staff turnover overloaded the permanent staff leading to staff flight and increased use of short-term health workers. Following a need among the population, health workers call for increased focus on health promotion. They request leadership that includes local knowledge and skills to prioritise, organise and develop culturally safe healthcare, based also on the perspectives of service users. Greenland has dedicated health workers holding local knowledge of significance for care and treatment. Prioritisation of health promotion is considered necessary and satisfactory but must be supported by strategic leadership. Further, a satisfactory work-life seems closely related to recruitment and retention.