Interventions for improved retention of skilled health workers in rural and remote areas

Manas Ranjan Behera, Chardsumon Prutipinyo, Nithat Sirichotiratana, Chukiat Viwatwongkasem

Annals of Tropical Medicine and Public Health 2017 10(1):16-21

Background: Worldwide, rural inequitable distribution and dearth of health professionals pose poor functioning of health services. In this study, we gather interventions aimed at increasing the proportion of health professionals working in rural and remote areas. Methods: We searched PUBMED, MEDLINE, EMBASE and google scholar database with key words such as "doctors", "nurses" "health workers", "health care professionals" and "human resources for health". Further, comprehensive data base of relevant literature on recruitment or retention or both, of health workers in rural and remote areas has been searched through the websites of different government, non-government, national and international agencies. Results: We found that, there are mainly four interventions employed for improved rural retention. These interventions are generally grouped into educational, financial, regulatory, personal and professional strategies. We also judged the effectiveness of the intervention provided in the literature. Conclusion: Currently, there is limited reliable evidence regarding the effects of these interventions aimed at addressing the maldistribution of health professionals. Hence, well-designed observational studies are needed to confirm that educational, financial, regulatory, personal and professional strategies might influence the health workers' decision to stay in underserved areas. Further, the state governments, public health schools and medical colleges should ensure that when interventions are implemented, their impacts can be measured through scientifically rigorous approaches to establish the true effects of these measures for improved rural recruitment and retention.

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