Evaluated strategies to increase attraction and retention of health workers in remote and rural areas

Abstract

Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. ‫املقالة.‬ ‫لهذه‬ ‫الكامل‬ ‫النص‬ ‫نهاية‬ ‫يف‬ ‫الخالصة‬ ‫لهذه‬ ‫العربية‬ ‫الرتجمة‬ Abstract The lack of health workers in remote and rural areas is a worldwide concern. Many countries have proposed and implemented interventions to address this issue, but very little is known about the effectiveness of such interventions and their sustainability in the long run. This paper provides an analysis of the effectiveness of interventions to attract and retain health workers in remote and rural areas from an impact evaluation perspective. It reports on a literature review of studies that have conducted evaluations of such interventions. It presents a synthesis of the indicators and methods used to measure the effects of rural retention interventions against several policy dimensions such as: attractiveness of rural or remote areas, deployment/recruitment, retention, and health workforce and health systems performance. It also discusses the quality of the current evidence on evaluation studies and emphasizes the need for more thorough evaluations to support policy-makers in developing, implementing and evaluating effective interventions to increase availability of health workers in underserved areas and ultimately contribute to reaching the United Nations' Millennium Development Goals.

Strategies to improve health coverage and narrow the equity gap in child survival, health, and nutrition

“…38 Factors associated with an increased likelihood of practising in a rural area include being from a rural area, [39][40][41][42] having a spouse from a rural area, 41,42 male sex, 41 and stated intent to practise in a rural area at the time of enrolment. 41 Recruitment and training for rural practice, provider incentives, compulsory service, scholarships, and improved working and living conditions are additional promising strategies to overcome bottle necks associated with geographical access and availability of human resources, particularly in rural settings.…”

“…For example, reviews that considered strategies' eff ects on equity and found promising pro-poor eff ects included those assessing expanded roles for community health workers, 10,11,16 task shifting, 31,32 the expanded use of private service providers, 23,34 strategies to reduce fi nancial barriers to access, 37 and strategies to increase humanresource availability and geographical access. 38,39,43 The other paper in this Series 6 builds on our recommendations and uses data from 15 low-income and middleincome countries to describe how a UNICEF modelling team developed and applied a model that simulates the potential eff ect of implementation of the most promising of these strategies in the context of an equity-based approach to health and nutrition programming. 6 …”

Balancing the cost of leaving with the cost of living: drivers of long-term retention of health workers: an explorative study in three rural districts in Eastern Uganda

“…The challenge of attaining this ideal is most critically observed in rural settings [1]. The attraction and retention of health-care professionals in rural and underserved areas is essential in ensuring that these areas acquire equitable care [2].…”

Mais Médicos: um programa brasileiro em uma perspectiva internacional

“…More and more countries seek measures to assure the universality of health coverage, as well as the strengthening of a health system operative and adequate to the health needs of the population 8 . The uneven distribution of health professionals, especially physicians, represents an important limition to reaching these objectives.…”

“…The World Health Organization estimates that 50% of the world's population lives in remote rural areas, but these areas are served by less than 25% of the medical workforce 5 . Many countries are seeking solutions to increase the coverage of primary care in vulnerable areas attracting health professionals to these regions 6,7,8 . These strategies include: regulation policies such as mandatory service; monetary incentives such as scholarships; non-monetary incentives such as the extension of the permanent visa for foreigners 9,10 .…”