Rural/Urban Imbalance

Exploring Health Workforce Inequalities: Case Studies from Three Countries

With the aim of arriving at a better understanding of specific dimensions of health workforce inequalities in their national contexts, three case studies are presented from Ethiopia, Brazil and Mexico. [from introduction]

Postgraduate Training at the Ends of the Earth: a Way to Retain Physicians?

Recruitment and retention of qualified health professionals, especially physicians, is a major challenge in health service delivery in the high north, similar to other remote areas of the world. This article describes a strategy to address this problem and evaluates the effect of the strategy for Finnmark, the northernmost county of Norway. [from abstract]

Impact Evaluation of a Young Medical Volunteers Project for Vietnam Rural Mountain

This study evaluates the health impacts of a volunteer intervention addressing health worker shortage in remote mountainous communities of Vietnam. [from abstract]

Increasing Access to Health Workers in Remote and Rural Areas through Improved Retention: Global Policy Recommendations

After a year-long consultative effort, this document proposes sixteen evidence-based recommendations on how to improve the recruitment and retention of health workers in underserved areas. It also offers a guide for policy makers to choose the most appropriate interventions, and to implement, monitor and evaluate their impact over time. [from publisher]

Analysis of a Survey on Young Doctors' Willingness to Work in Rural Hungary

There is not only a lack of human resources for health in Hungary, but significant inequalities are widespread, including in geographical distribution. This report, based on research carried out in 2008, deals with the willingness of young doctors to work outside Budapest. [adapted from abstract]

Emerging Opportunities for Recruiting and Retaining a Rural Health Workforce through Decentralized Health Financing Systems

This paper looks at the potential for decentralization to lead to better health workforce recruitment, performance and retention in rural areas through the creation of additional revenue for the health sector; better use of existing financial resources; and creation of financial incentives for health workers. [from introduction]

How Can Medical Schools Contribute to the Education, Recruitment and Retention of Rural Physicians in Their Region?

Developing a sufficient and sustainable rural physician workforce requires commitment and cooperation from communities, governments and medical schools. The author argues that medical education can play an important role in the recruitment and retention of rural physicians. [adapted from author]

How to Recruit and Retain Health Workers in Underserved Areas: the Senegalese Experience

This article outlines the introduction of a special contracting system to recruit health workers to improve the posting, recruitment and retention of health workers in rural and remote areas. [adapted from abstract]

Evaluated Strategies to Increase Attraction and Retention of Health Workers in Remote and Rural Areas

This paper builds on earlier work assessing the evidence on effectiveness of interventions to increase access to health workers in rural and remote areas - focusing mainly on studies that evaluated interventions and their impact on the health workforce and health systems performance. [adapted from introduction]

Chilean Rural Practitioner Programme: A Multidimensional Strategy to Attract and Retain Doctors in Rural Areas

This paper explores a long-standing strategy to attract and retain doctors in rural areas in Chile: the Rural Practitioner Programme. The objectives of the study are to describe this programme for rural doctors (médicos generales de zona), to characterize its multidimensional set of incentives and to carry out a preliminary evaluation of programme outcomes. [from introduction]

Compulsory Service Programmes for Recruiting Health Workers in Remote and Rural Areas: Do They Work?

This study compiled information on the numbers and types of health worker compulsory service programs in WHO countries.

Policy Interventions that Attract Nurses to Rural Areas: a Multicountry Discrete Choice Experiment

The objective of this study was to model the relative effectiveness of different policy interventions on the recruitment of nurses to rural areas in three different countries. [from introduction]

Who Wants to Work in a Rural Health Post? The Role of Intrinsic Motivation, Rural Background and Faith-Based Institutions in Ethiopia and Rwanda

This paper examines the extent to which health workers differ in their willingness to work in rural areas and the reasons for these differences, based on the data collected in Rwanda analysed individually and in combination with data from Ethiopia. [from introduction]

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]

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

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]

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]

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.

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]