Upscaling the recruitment and retention of human resources for health at primary healthcare centres in Lebanon: a qualitative study

Abstract

The sustainability of primary healthcare (PHC) worldwide has been challenged by a global shortage in human resources for health (HRH). This study is a unique attempt at systematically soliciting and synthesising the voice of PHC and community stakeholders on the HRH recruitment and retention strategies at the PHC sector in Lebanon, the obstacles and challenges hindering their optimisation and the recommendations to overcome such obstacles. A qualitative design was utilised, involving 22 semi-structured interviews with PHC experts in Lebanon conducted in 2013. Nvivo qualitative data analysis software was employed for the thematic analysis of data collected from interviews. Five comprehensive themes emerged: understanding PHC scope, HRH recruitment issues, HRH retention challenges, rural areas' specific challenges and stakeholders' recommendations. Analysis of stakeholders' responses revealed a lack of a unified understanding of the PHC scope impacting the capacity for appropriate HRH planning. Identified impediments to recruitment included the suboptimal supply of HRH, financial constraints and poor management. Retention difficulties were attributed to poor working environments, financial constraints and lack of professional development. There was consensus that HRH challenges faced were aggravated in rural areas, jeopardising the equitable access to PHC services of quality. Equitable access was also jeopardised by the reported shortage of female HRH in a sociocultural context where many females prefer providers of the same gender. The study sets the path towards upscaling recruitment and retention policies and practices through the endorsement of a nationally acknowledged PHC definition and scope, the sustainable development of the PHC workforce and through the implementation of targeted recruitment and retention strategies addressing rural settings and gender equity. Decision-makers and planners are urged to identify HRH as the most important input for the success of PHC programmes and interventions, especially in the growing fields of mental health and geriatric care.

Investigating the job satisfaction of healthcare providers at primary healthcare centres in Lebanon: A national cross-sectional study

“…In these networks, the PHCCs are not standardised, but are rather granted autonomy of the management of their HCP, including decisions related to the HCP salaries. However, the PHC sector faces a number of challenges including the shortage of its generalists (Alameddine, Khodr, Mourad, Yassoub, & Abi Ramia, ; El‐Jardali, Longeunesse, Jamal, & Kronfol, ) and nurses (El‐Jardali, Dimassi, Dumit, Jamal, & Mouro, ). The shortage is further exacerbated by HCP migration (Akl et al., ; El‐Jardali et al., ), impeding consequently the appropriate provision of services in PHCCs (Alameddine et al., ).…”

Distribution Analysis of Doctors in Indonesia

“…Doctors in Lebanon prefer to practice independently in urban areas. There are at least five main problems that cause doctors not to be interested in primary services, namely low understanding of concepts, scope of work in primary services, recruitment issues, problems with low doctor retention and challenges faced by doctors working in remote areas and retarded, and the role of their policymakers (Alameddine et al, 2016). Retention of doctors especially those working in primary services is low due to low income.…”

Primary Health Care from the perception of women living in a rural area

“…In addition, a key component of structuring policy for health systems of rural areas is centered on the training of human resources to work in these regions who are qualified and trained in family and community medicine, in resolute ways for managing the most common problems, as well as providing comprehensive and continuous care to populations living in these territories (25) . These recommendations have great potential to contribute in overcoming the ruralurban gap and to provide quality health care to this demand if incorporated into the design of policies for providing and securing professionals (7) .…”