Objective  To analyze factors influencing turnover intention among health workers in township hospitals in China based on motivator-hygiene theory.

  Methods  We recruited health workers using multistage cluster sampling at 45 township health centers in three provinces of China. Then we conducted a self-administered questionnaire survey and deep interviews among 803 and 138 selected health workers in August 2013.

  Results  Among the turnover intention related factors reported by the participants, the three most concerned were income level (3.00 ± 4.615), working condition (5.31 ± 3.636), and social security (5.93 ± 5.029) and the three least satisfied to were income level (2.28 ± 0.899), social security (2.47 ± 0.919), and training opportunities (2.66 ± 0.954), respectively. The results of multiple regression analysis indicated that income level (β = – 0.265), living environment (β = – 0.274), unit management system (β = – 0.162) and workload (β = – 0.126) had significant impact on turnover intention. Among the participants interviewed, working condition, career development prospect and emotional impact on work were the main influence factors of turnover intention; while, inconvenience in daily life, lack of opportunity and lack of self ability were the main constraint factors for turnover.

  Conclusion  The job satisfaction is at a general level and health factor is more concerned than motivator factor for turnover among health workers in township hospitals in China. The results should be considered for the improvement of grassroots health care services.