Realist review and synthesis of retention studies for health workers in rural and remote areas (original) (raw)
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Interventions for health workforce retention in rural and remote areas: a systematic review
Human Resources for Health
Background Attracting and retaining sufficient health workers to provide adequate services for residents of rural and remote areas has global significance. High income countries (HICs) face challenges in staffing rural areas, which are often perceived by health workers as less attractive workplaces. The objective of this review was to examine the quantifiable associations between interventions to retain health workers in rural and remote areas of HICs, and workforce retention. Methods The review considers studies of rural or remote health workers in HICs where participants have experienced interventions, support measures or incentive programs intended to increase retention. Experimental, quasi-experimental and observational study designs including cohort, case–control, cross-sectional and case series studies published since 2010 were eligible for inclusion. The Joanna Briggs Institute methodology for reviews of risk and aetiology was used. Databases searched included MEDLINE (OVID),...
Enhancing the Retention of Healthcare Workers in Rural Areas: A Systematic Review
IJSR, Vol (2), No (11), November 2023, 2023
Introduction: Rural areas globally face significant challenges in retaining healthcare workers, impacting the delivery of essential health services and exacerbating health disparities. This systematic review aimed to evaluate the effectiveness of various strategies implemented over the last 15 years to enhance healthcare worker retention in rural settings, with the goal of identifying evidence-based interventions that can inform policy and practice to improve rural healthcare delivery. Methods: The review focused exclusively on interventional studies and clinical trials published from 2007 to 2022. A comprehensive search of multiple databases, including PubMed, MEDLINE, Embase, CINAHL, and the Cochrane Library, was conducted using specific search terms related to healthcare worker retention in rural areas. Inclusion criteria targeted studies evaluating quantifiable outcomes of retention strategies, with exclusion criteria set to omit non-interventional studies, research focused on urban settings, and non-English publications. The study selection, data extraction, and quality assessment processes were rigorously conducted to ensure the reliability of the findings. Results: Twelve studies met the inclusion criteria, revealing a broad range of interventions from financial incentives and educational programs to supportive workplace interventions and community engagement strategies. Financial incentives demonstrated a notable positive impact on retention, with risk ratios ranging from 1.2 to 1.75, indicating a 20% to 75% increase in retention rates. Supportive workplace interventions also showed effectiveness, with a risk ratio of up to 1.4. However, the results for educational and community engagement strategies were more variable, suggesting the need for tailored approaches. Conclusions: The review highlights the effectiveness of targeted interventions in enhancing the retention of healthcare workers in rural areas, particularly financial incentives and supportive workplace interventions. These findings underscore the importance of implementing multifaceted, evidence-based strategies tailored to the unique challenges of rural healthcare settings to improve workforce stability and healthcare delivery.
Selecting interventions that succeed: Navigating through retention literature
NADE Digest, 2005
Many developmental educators have been assigned increased responsibilities for campus-wide enrollment management activities. A new system is needed for educators to more accurately sort through the rapidly growing database of information related to student retention. Th is will enable the reader to more quickly identify promising practices for further investigation. Th is article provides a scale to evaluate the likelihood of success among potential programs and identify them for further research. Scrutiny of potential retention programs must be increased by asking more questions early in the investigation process regarding: essential components of a program, research evaluation studies, barriers to successful implementation, and the availability of technical assistance to enable other institutions to successful adapt and adopt the student retention practice.
Bulletin of the World Health Organization, 2013
The maldistribution of health workers between urban and rural areas is a policy concern in virtually all countries. It prevents equitable access to health services, can contribute to increased health-care costs and underutilization of health professional skills in urban areas, and is a barrier to universal health coverage. To address this long-standing concern, the World Health Organization (WHO) has issued global recommendations to improve the rural recruitment and retention of the health workforce. This paper presents experiences with local and regional adaptation and adoption of WHO recommendations. It highlights challenges and lessons learnt in implementation in two countries - the Lao People's Democratic Republic and South Africa - and provides a broader perspective in two regions - Asia and Europe. At country level, the use of the recommendations facilitated a more structured and focused policy dialogue, which resulted in the development and adoption of more relevant and e...
Health workers' preferences and policy interventions to improve retention in rural areas in Thailand
2011
The human resources crisis in low-income countries has become increasingly apparent since the adoption of the Millennium Development Goals in 2000. The maldistribution of health workers within countries is a crucial problem felt most acutely in rural areas. Several international initiatives have stressed the important role played by human resources for health but despite this health worker shortages remains a key policy concern. The shortage of doctors and nurses in rural areas of Thailand is a recurring problem. Over the past 20 years the Thai government has introduced a range of strategies aimed at recruiting and retaining more in rural areas. There is a dearth of empirical data on health worker flows and behaviours and their implications on policy. A range of financial and non-financial factors have been described as playing a role in health workers' decisions and motivations, yet their relative importance when considering a rural posting remains unclear. Effective retention strategies need evidence-based information to support their design and implementation. This research set out to examine the job preferences of newly graduated doctors and nurses to identify effective policy interventions that could improve their recruitment and retention in rural areas. Similar studies were carried out in South Africa and Kenya. This policy brief provides findings from the baseline for this research as well as from a cohort of 198 doctors and 342 nurses. It is hoped that this will help the Thai government to better understand the impact current and future policy interventions might have on employment preferences and their influence on recruitment and retention of doctors and nurses in rural areas of Thailand.