Rural Practice Preferences among Medical Students in Ghana: a Discrete Choice Experiment

This paper examines the job attributes that influence the stated preferences of fourth year medical students in Ghana for rural deprived area postings. [adapted from author]

Striking the Right Balance: Health Workforce Retention in Remote and Rural Areas

This article discusses the issue of maldistribution, which is arguably the most critical workforce challenge, not only for achieving universal coverage but also for addressing inextricably linked workforce problems such as shortages and skill imbalances. In many countries, overall shortages are exacerbated, indeed even caused, by severe maldistribution. [adapted from author]

Wrong Schools or Wrong Students? The Potential Role of Medical Education in Regional Imbalances of the Health Workforce in the United Republic of Tanzania

This paper reviews available research evidence that links medical students’ characteristics with human resource imbalances and the contribution of medical schools in perpetuating an inequitable distribution of the health workforce. [from abstract]

Improving Health Workforce Recruitment and Retention in Rural and Remote Regions of Nigeria

This article posits that out-migration of health workers is not a critical contributor to health workforce shortages in Nigeria’s rural and remote areas and that more important factors include: contraction of government health spending as a percentage of GDP despite deteriorating health conditions, public health management systems that operate by default rather than by design, spartan living conditions outside urban areas, inadequate training of appropriate cadres of health staff, limited facilities and medications for effective delivery of clinical services, and burnout of overworked and unde

From Staff Mix to Skill Mix and Beyond: Towards a Systemic Approach to Health Workforce Management

This review describes evidence about the benefits and pitfalls of current approaches to human resources optimisation in health care. It concludes that in order to use human resources most effectively, health care organisations must consider a more systemic approach - one that accounts for factors beyond narrowly defined human resources management practices and includes organisational and institutional conditions. [from abstract]

Inequality in Access to Human Resources for Health: Measurement Issues

This background paper to the World Health Report 2006 discusses the various options to allow comparative analysis of inequalities in the distribution of health workers across and within countries, using a single summary measure of this distribution. The paper first presents the scale problem of various inequality indices, then tests how sensitive a simple ratio measure of the distribution of health workers is to changes in scale.

Interest in Rural Medicine among Osteopathic Residents and Medical Students

This study examines US osteopathic residents’ and medical students’ attitudes and willingness to practice in rural medicine. The multiple aims of this study were to determine: if there are any significant differences in interest in rural medicine among various levels of training; the relative age, gender, and race of those who are intending to pursue a career in rural health; and whether a number of demographic characteristics or participation in a rural elective significantly impacted interest in practicing in a rural area. [adapted from abstract]

Human Resources for the Delivery of Health Services in Zambia: External Influences and Domestic Policies and Practices: a Case Study of Four Districts in Zambia

The objective of this study was to analyse in what way HRH recruitment, deployment and retention at the district level are influenced by external funding; and to what extent this is in line with national and district policies and strategies. [from abstract]

Transition of Physician Distribution (1980–2002) in Japan and Factors Predicting Future Rural Practice

The maldistribution of physicians between urban and rural areas has long been an important political issue in Japan. The aim of this study was to evaluate long-term transition in the geographic distribution of physicians, and to reveal which rural physician characteristics predict their retention in rural areas. [adapted from abstract]

Where Do Students in the Health Professions Want to Work?

Rural and remote areas of Australia are facing serious health workforce shortages. While a
number of schemes have been developed to improve recruitment to and retention of the rural
health workforce, they will be effective only if appropriately targeted. This study examines
the factors that most encourage students attending rural clinical placements to work in rural
Australia, and the regions they prefer. [from abstract]

Distribution and Transitions of Physicians in Japan: a 1974-2004 Retrospective Cohort Study

This article presents the results of a study analyzing national trends in Japan regarding the distribution and career transitions of physicians among types of facilities and specialties over a 30-year period. [adapted from abstract]

International Medical Graduates and the Primary Care Workforce for Rural Underserved Areas

The proportion of international medical graduates (IMGs) serving as primary care physicians in rural underserved areas (RUAs) has important policy implications. We analyzed the 2000 American Medical Association Masterfile and Area Resource File to calculate the percentage of primary care IMGs, relative to U.S. medical graduates, working in RUAs. [from abstract]

Medical Schools in Rural Areas – Necessity or Aberration?

The purpose of this article was to analyze and compare the graduates of an urban- and a rural-located university in Democratic Republic of the Congo (DRC) where there is major maldistribution of physicians. While 70% of Congolese live in rural areas, relatively few doctors practice there. The results of the research for this article support the policy of establishing medical schools in rural areas, and also provide indications of approaches likely to increase the number and expertise of rural-located physicians. [adapted from abstract]

Community Service Doctors in Limpopo Province

This article describes the impact of community service doctors on offsetting the shortage of health professionals in public hospitals in South Africa. [adapted from introduction]

Critical Review of Interventions to Redress the Inequitable Distribution of Healthcare Professionals to Rural and Remote Areas

This review provides a comprehensive overview of the most important studies addressing the recruitment and retention of doctors to rural and remote areas of Australia. [adapted from abstract]

Financial Incentives for Return of Service in Underserved Areas: a Systematic Review

This article assesses the potential impact of financial incentives in alleviating health worker shortages in underserved areas through contracting future health workers to work for a number of years in an underserved area in exchange for a financial pay-off. [adapted from author]

Rural Origin Health Science Students in South African Universities

Increasing the proportion of rural-origin students in health sciences faculties has been shown to be one way of addressing of health care professionals in rural areas. This article discusses a retrospective descriptive study to determine the proportion of rural-origin students
at all medical schools in South Africa. [adapted from abstract]

Factors Influencing Occupational Therapy Students' Perceptions of Rural and Remote Practice

There is a serious shortage of health professionals in rural and remote areas in Australia and world wide. The purpose of this article was to add to existing information about allied health students, particularly occupational therapy students, and rural and remote practice by reviewing the literature on occupational therapy students’ perceptions of rural and remote practice. A variety of influencing factors were identified, as were the main characteristics of rural practice in relation to the future employment of students. [abstract]

Innovative Model Improving Success at University for Regional Australians Suffering Educational and Social Disadvantage

Regional Australia is critically short of registered nurses (RNs) due to an ageing nursing workforce and difficulty in attracting new staff. It is recognised that rural background is the most influential factor shaping a health professional’s decision to practise in regional areas. Because of this, Charles Sturt University offered a bachelor of nursing by distance education (DE), enabling rural and remote enrolled nurses (ENs)to upgrade their qualifications to RN. However, despite the flexible study mode offered, many rural and remote ENs were reluctant to progress to university study.

Making an Impact: Transforming Service at a Remote Hospital in Kenya

This issue of Voices discusses the impact of the Emergency Hiring Plan developed in combination with the Capacity Project and the Kenyan Ministry of Health to increase the number of qualified professionals working in Kenya’s public health facilities. [adapted from author]

Decentralization - Centralization Dilemma: Recruitment and Distribution of Health Workers in Remote Districts of Tanzania

This study highlights the experiences and challenges associated with decentralisation and the partial re-centralisation in relation to the recruitment and distribution of health workers. [from abstract]

Rural Allied Health Workforce Study: Background, Rationale and Questionnaire Development

The Rural Allied Health Workforce Study (RAHWS) uses a cross-sectional survey instrument with high validity to provide a large scale but detailed profile of the allied health workforce in regional, rural and remote Australia. The RAHWS survey instrument has been designed to provide uniform data across a wide range of healthcare settings and will be used to explore the rural allied health workforce in rural regions in Australia during 2009 and 2010. [from abstract]

Men's Partnership in Maternal Health (Tajikistan)

This video resource details the social, economic and health care services disparities between urban and rural areas of Tajikistan and how women there struggle with their health and the role of men, or the lack thereof, in supporting them. [adapted from synopsis]

Why Do Medical Graduates Choose Rural Careers?

This article reports on research that assessed international and national best practice in the selection of students for graduate entry medical courses in order to investigate correlations between medical student selection procedures and exposure to rural medical practice during medical training with choice of careers in rural medicine. Central to the study was the issue of the medical workforce shortage in Australia’s rural communities. [from introduction]

Mobility of Primary Health Care Workers in China

Rural township health centres and urban community health centres play a crucial role in the delivery of primary health care in China. The limited availability and low qualifications of human resources in health are among the main challenges facing lower-level health facilities. This paper aims to analyse the mobility of health workers in township and community health centres. [from abstract]

Changing Nature of Nursing Work in Rural and Small Community Hospitals

This study investigates the influence of demographic characteristics, provincial policies, organizational changes and emerging practice challenges on the rural–urban segments of the Canadian nursing workforce in order to describe the nature of nursing work from the perspective of rural nurse executives and frontline nurses. [adapted from introduction]

Increasing Access to Health Workers in Remote and Rural Areas through Improved Retention: Background Paper

This paper serves as background documentation for the first expert meeting for developing the evidence-based recommendations for increasing access to health workers in remote and rural areas through improved retention, to be held in Geneva on 2-4 February 2009. It is intended to provide an overview of the issues, challenges and potential solutions to the problem of inequitable access to health workers in remote and rural areas. [from introduction}

Evaluating and Designing Policy Options for Rural Retention: Some Insights from Niger

This presentation discusses an ineffective incentives effort to retain rural health workers and suggestions for more useful interventions.

Increasing Access to Health Workers in Remote and Rural Areas through Improved Retention

This presentation reviews the current state of health worker retention in rural areas, discusses interventions aimed at addressing the problem and describes the challenges and directions for solving it.

WHO Programme on Increasing Access to Health Workers in Remote and Rural Areas through Improved Retention

This presentation outlines the World Health Organization’s (WHO) efforts to scale up health care delivery in rural areas through health care worker retention programs.