Retention of general practitioners in rural Nepal: A qualitative study

Butterworth, Katrina; Hayes, Bruce; Neupane, Bhusan

doi:10.1111/j.1440-1584.2008.00976.x

Cited by 36 publications

(47 citation statements)

References 11 publications

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“…Family medicine programs developed in Nepal, South Africa and Brazil may be best suited for Indian conditions. [212223]…”

Section: Family Medicine: Transferring Ownership To Primary Care Physmentioning

confidence: 99%

Academic institutionalization of community health services: Way ahead in medical education reforms

Kumar

2012

J Family Med Prim Care

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Policy on medical education has a major bearing on the outcome of health care delivery system. Countries plan and execute development of human resource in health, based on the realistic assessments of health system needs. A closer observation of medical education and its impact on the delivery system in India reveals disturbing trends. Primary care forms backbone of any system for health care delivery. One of the major challenges in India has been chronic deficiency of trained human resource eager to work in primary care setting. Attracting talent and employing skilled workforce seems a distant dream. Talking specifically of the medical education, there are large regional variations, urban - rural divide and issues with financing of the infrastructure. The existing design of medical education is not compatible with the health care delivery system of India. Impact is visible at both qualitative as well as quantitative levels. Medical education and the delivery system are working independent of each other, leading outcomes which are inequitable and unjust. Decades of negligence of medical education regulatory mechanism has allowed cropping of multiple monopolies governed by complex set of conflict of interest. Primary care physicians, supposed to be the community based team leaders stand disfranchised academically and professionally. To undo the distorted trajectory, a paradigm shift is required. In this paper, we propose expansion of ownership in medical education with academic institutionalization of community health services.

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“…Family medicine programs developed in Nepal, South Africa and Brazil may be best suited for Indian conditions. [212223]…”

Section: Family Medicine: Transferring Ownership To Primary Care Physmentioning

confidence: 99%

Academic institutionalization of community health services: Way ahead in medical education reforms

Kumar

2012

J Family Med Prim Care

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“…A number of significant factors that can improve retention of physicians in rural practice has been studied in developed countries, notably the USA, Canada, New Zealand and Australia. 7 These include an adequate income, appropriate workload, locum provision, access to specialists’ advice and continuing education, spouse career opportunities and children education. 8 However, little is known about the transferability of these results to other healthcare professionals and to other settings, particularly developing countries.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing recruitment and retention of healthcare workers in rural and remote areas in developed and developing countries: an overview

Mbemba

Gagnon

Hamelin-Brabant

2016

J Public Health Africa

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Shortage of healthcare workers in rural and remote areas remains a growing concern both in developed and developing countries. This review aims to synthesize the significant factors impacting healthcare professionals’ recruitment and retention in rural and remote areas, and to identify those relevant for developing countries. This paper included the following steps: exploring scientific literature through predetermined criteria and extracting relevant information by two independents reviewers. The AMSTAR tool was used to assess the methodological quality. Of the 224 screened publications, 15 reviews were included. Four reviews focused on recruitment factors, and another four reviews focused on retention factors. The remaining focused both on recruitment and retention factors. The most important factors influencing recruitment were rural background and rural origin, followed by career development. Opportunities for professional advancement, professional support networks and financial incentives were factors impacting retention. While the main factors influencing recruitment and retention have been largely explored in the literature, the evidence on strategies to reduce the shortage of healthcare workers in rural area, particularly in developing countries, is low. Further research in this field is needed.

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“…However, evidence from surveys shows that clear career prospects are important factors in the choice of health workers to practise or not in a remote or rural area (91,92). Career ladders are common in urban and hospital settings, but it is possible to develop clear and specific career paths in rural settings as well.…”

Section: Summary Of the Evidencementioning

confidence: 99%

Geographical mobility of general practitioners in rural Australia

McGrail

Humphreys

2015

Medical Journal of Australia

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Objective: To describe the geographical mobility of general practitioners in Australia, both within rural areas and between rural and metropolitan areas. Design and participants: Annual panel survey of GPs between 2008 and 2012. Main outcome measures: Work location, categorised by a typology based on geographical location and community size; frequency of mobility (change of location category); and characteristics of those who moved. Results: There were 3906 participants in 2008 (representative cohort, 19% of Australia's GP workforce) and 3502, 3514, 3287 and 3361 in subsequent years. 1810 GPs participated in all 5 years, and 10 900 origin–destination pairs were observed after removing GP registrars from the dataset. A total of 133 GPs moved from rural to metropolitan locations, 103 moved from metropolitan to rural locations, and 271 observed location changes were within rural areas. Annual location retention rates were 95% in regional centres, 90% in small rural towns and 82% in very remote areas. GPs in small towns of < 5000 residents had the highest risk of leaving rural practice. Mobility rates were significantly higher for GPs who had worked in a location for under 3 years and those working as either contracted or salaried employees, and somewhat higher for international medical graduates. Younger age was a small predictor of increased mobility, while sex and family status had no association with mobility. Conclusion: GPs working in small communities and those in a rural location for less than 3 years are most at risk of leaving rural practice.

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Retention of general practitioners in rural Nepal: A qualitative study

Cited by 36 publications

References 11 publications

Academic institutionalization of community health services: Way ahead in medical education reforms

Academic institutionalization of community health services: Way ahead in medical education reforms

Factors influencing recruitment and retention of healthcare workers in rural and remote areas in developed and developing countries: an overview

Geographical mobility of general practitioners in rural Australia

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