Job Preferences of Doctors for Working in Rural Islamabad Capital Territory, Pakistan: a Discrete Choice Experiment

Rana, Sana Azmat

doi:10.4172/2472-1654.100043

Cited by 12 publications

(30 citation statements)

References 14 publications

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“…Pakistan is one of 57 countries with a serious deficiency in the health workforce. 353 Pakistan has a doctor-to-patient ratio of 1:1300, doctor-to-nurse ratio of 1:2·7, and nurse-topatient ratio of 1:20. 354 There are many informal healthcare providers in Pakistan, comprised of unqualified allopathic providers (eg, rural doctors or drug shop retailers), traditional healers, faith healers, Unani healers, and semi-qualified allopathic providers (eg, medical assistants, technicians, and community health workers).…”

Section: The Lancet Gastroenterology and Hepatology Commissionmentioning

confidence: 99%

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Sarin

Kumar

Eslam

et al. 2020

The Lancet Gastroenterology & Hepatology

393

303

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The Asia-Pacific region is home to more than half of the global population and accounted for 62·6% of global deaths due to liver diseases in 2015. 54·3% of global deaths due to cirrhosis, 72·7% of global deaths due to hepatocellular carcinoma, and more than two-thirds of the global burden of acute viral hepatitis occurred in this region in 2015. Chronic hepatitis B virus (HBV) infection caused more than half of the deaths due to cirrhosis in the region, followed by alcohol consumption (20·8%), non-alcoholic fatty liver disease (NAFLD; 12·1%), and chronic infection with hepatitis C virus (HCV; 15·7%). In 2015, HBV accounted for about half the cases of hepatocellular carcinoma in the region. Preventive strategies for viral hepatitis-related liver disease include increasing access to clean drinking water and sanitation. HBV vaccination programmes for neonates have been implemented by all countries, although birthdose coverage is extremely suboptimal in some. Availability of screening tests for blood and tissue, donor recall policies, and harm reduction strategies are in their initial stages in most countries. Many governments have put HBV and HCV drugs on their essential medicines lists and the availability of generic versions of these drugs has reduced costs. Efforts to eliminate viral hepatitis as a public health threat, together with the rapid increase in per-capita alcohol consumption in countries and the epidemic of obesity, are expected to change the spectrum of liver diseases in the Asia-Pacific region in the near future. The increasing burden of alcohol-related liver diseases can be contained through government policies to limit consumption and promote less harmful patterns of alcohol use, which are in place in some countries but need to be enforced more strictly. Steps are needed to control obesity and NAFLD, including policies to promote healthy lifestyles and regulate the food industry. Inadequate infrastructure and insufficient health-care personnel trained in liver diseases are issues that also need to be addressed in the Asia-Pacific region. The policy response of most governments to liver diseases has thus far been inadequate and poorly funded. There must be a renewed focus on prevention, early detection, timely referral, and research into the best means to introduce and improve health interventions to reduce the burden of liver diseases in the Asia-Pacific region. 168 www.thelancet.com/gastrohep Vol 5 February 2020The Lancet Gastroenterology & Hepatology Commission accounted for 108 276 (8·2%) of the total liver-related deaths in the region in 2015, compared with 929 (1·2%) of 72 437 in the USA and 4032 (0·3%) of 197 179 in Europe. Deaths in the Asia-Pacific region represented three-quarters of the global total number of deaths due to acute viral hepatitis. In 2015, the region accounted for three-quarters of the global total number of deaths related to acute HBV, almost two-thirds of those due to acute hepatitis A infection, and almost 80% of those due to acute hepatitis E infection. Of all deaths du...

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Section: The Lancet Gastroenterology and Hepatology Commissionmentioning

confidence: 99%

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Sarin

Kumar

Eslam

et al. 2020

The Lancet Gastroenterology & Hepatology

393

303

View full text Add to dashboard Cite

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“…Being enrolled in a special track, in which the scholarship tied to compulsory service provided for those recruited from rural areas, in addition to being recruited from rural areas and received a rurally enhanced curriculum, was associated with better rural preference [48,49] [50,53], spouse employment [53], access to electricity and water supply [36], transportation [49], were among the key reasons for unwillingness to work rurally There is evidence that preference to work in rural locations is associated with: short travel time to work [91], availability of transportation for official and unofficial use [76], positive perception of living conditions [47], and good educational facilities and connectivity [56]. However, in other studies, associations were not found between rural preference and: housing allowance or support [58,75], access to a vehicle [58] and spouse and child education [34] Overall better living conditions [6,10,11,35,45,65,70,71], housings [76,92], basic infrastructure (i.e., electricity, water, communications connectivity) [52,57,59,88], transportation [57,72,74,76], access to nearest town [41], and children schooling facilities [73], were also important attributes to rural preference. Females regarded housing provision higher than males [58,74] [53,…”

Section: Preference Bmentioning

confidence: 99%

Factors associated with increasing rural doctor supply in Asia-Pacific LMICs: a scoping review

et al. 2020

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Background More than 60% of the world’s rural population live in the Asia-Pacific region. Of these, more than 90% reside in low- and middle-income countries (LMICs). Asia-Pacific LMICs rural populations are more impoverished and have poorer access to medical care, placing them at greater risk of poor health outcomes. Understanding factors associated with doctors working in rural areas is imperative in identifying effective strategies to improve rural medical workforce supply in Asia-Pacific LMICs. Method We performed a scoping review of peer-reviewed and grey literature from Asia-Pacific LMICs (1999 to 2019), searching major online databases and web-based resources. The literature was synthesized based on the World Health Organization Global Policy Recommendation categories for increasing access to rural health workers. Result Seventy-one articles from 12 LMICs were included. Most were about educational factors (82%), followed by personal and professional support (57%), financial incentives (45%), regulatory (20%), and health systems (13%). Rural background showed strong association with both rural preference and actual work in most studies. There was a paucity in literature on the effect of rural pathway in medical education such as rural-oriented curricula, rural clerkships and internship; however, when combined with other educational and regulatory interventions, they were effective. An additional area, atop of the WHO categories was identified, relating to health system factors, such as governance, health service organization and financing. Studies generally were of low quality—frequently overlooking potential confounding variables, such as respondents’ demographic characteristics and career stage—and 39% did not clearly define ‘rural’. Conclusion This review is consistent with, and extends, most of the existing evidence on effective strategies to recruit and retain rural doctors while specifically informing the range of evidence within the Asia-Pacific LMIC context. Evidence, though confined to 12 countries, is drawn from 20 years’ research about a wide range of factors that can be targeted to strengthen strategies to increase rural medical workforce supply in Asia-Pacific LMICs. Multi-faceted approaches were evident, including selecting more students into medical school with a rural background, increasing public-funded universities, in combination with rural-focused education and rural scholarships, workplace and rural living support and ensuring an appropriately financed rural health system. The review identifies the need for more studies in a broader range of Asia-Pacific countries, which expand on all strategy areas, define rural clearly, use multivariate analyses, and test how various strategies relate to doctor’s career stages.

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“…Pakistan rank sixth in the world population wise and as per its requirement the health human workforce in quite insufficient. Pakistan is one of the 57 countries that critically deficient in human health resource [42]. In Pakistan doctor to patient ration is 1:1300, nurse to patient ratio is 1:20 whereas, doctor to nurse ratio is 1:2.7.…”

Section: Health System Human Resource Situationmentioning

confidence: 99%

Situation Analysis of Health Care System of Pakistan: Post 18 Amendments

Khan¹

2019

Health Care Current Reviews

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Objective of the study: The aim of this paper is to highlight the actions taken by the government in various health performance system domains post 18 th Amendment. Methodology: Health system performance domains were identified through the websites of WHO and Eastern Mediterranean Regional Office of WHO (EMRO). Then the actions required in various health system performance domains were identified and the literature related to health system performance domains and 18 th Amendment was reviewed through electronic databases and health care acts and related bills of each province. Inter-provincial analysis was done analyzing the vision, mission, aims and objectives of each and every provincial healthcare commission along with the monitoring and evaluation, licensing, governance and complaint systems provided on the respective databases of each province. Results: This will surely help in attaining the access, quality and equity to health care services. Conclusion: The health system is in process of regeneration, with provincial empowerment in the country's federal system. While 18 th Constitutional Amendment has created opportunities as well challenges, but the possible way forward to improve health sector is improving the governance system.

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Job Preferences of Doctors for Working in Rural Islamabad Capital Territory, Pakistan: a Discrete Choice Experiment

Cited by 12 publications

References 14 publications

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Factors associated with increasing rural doctor supply in Asia-Pacific LMICs: a scoping review

Situation Analysis of Health Care System of Pakistan: Post 18 Amendments

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