Editorial: Effective Strategies to Develop Rural Health Workforce in Low and Middle-Income Countries (LMICs) (original) (raw)
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What works where you are? A snapshot of training in five ruralcommunities
2004
It has been widely reported in recent years that Australia’s regional and rural communities have extensive needs for skill development. Vocational education and training can assist these communities to develop the necessary skills to enable them to survive and to prosper in a social and economic environment transformed by globalisation, national policies and regulatory imperatives. The purpose of this research was to investigate the implementation of training packages in rural areas and the ways in which providers, community and industry stakeholders interact to achieve positive training outcomes. The major drivers of training in the five communities examined in this study were the same as those that influence training activity throughout regional and metropolitan Australia. National training policy, industry skill requirements and state government initiatives played paramount roles in determining what and how training was delivered. Considerable influence was also brought to bear b...
Attempts at Empowering Rural Communities through Vocational Skills: Some Guiding Theories
Cross-Currents: An International Peer-Reviewed Journal on Humanities & Social Sciences, 2019
The high unemployment rates in the rural areas call for the empowerment of both the young and old on survival skills. This will help them to participate in the informal economy for their livelihoods. Informal jobs offer valuable opportunities for young unskilled workers in terms of skill acquisition and career advancement. To be specific, they serve as a stepping stone to formal jobs, which offer better conditions in terms of pay, insurance, job security, and other amenities at work. Although the existence of a large informal sector may distort tax collection and reduce productivity, informal job opportunities may in fact be welfare enhancing for the young and unskilled workers in developing countries, because these jobs help workers gain expertise and build professional networks for improving their career prospects. Integrated Skills Outreach Programme is one TVET way of equipping rural populations with skills to fend for themselves.
Reimaging Primary Health Care Workforce in Rural and Underserved Settings
2020
This series is produced by the Health, Nutrition, and Population Global Practice of the World Bank. The papers in this series aim to provide a vehicle for publishing preliminary results on HNP topics to encourage discussion and debate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations, or to members of its Board of Executive Directors or the countries they represent. Citation and the use of material presented in this series should take into account this provisional character. The World Bank does not guarantee the accuracy of the data included in this work. The boundaries, colors, denominations, and other information shown on any map in this work do not imply any judgment on the part of the World Bank concerning the legal status of any territory or the endorsement or acceptance of such boundaries.
BMC Health Services Research, 2010
Background: Kenya has bold plans for scaling up priority interventions nationwide, but faces major human resource challenges, with a lack of skilled workers especially in the most disadvantaged rural areas. Methods: We investigated reasons for poor recruitment and retention in rural areas and potential policy interventions through quantitative and qualitative data collection with nursing trainees. We interviewed 345 trainees from four purposively selected Medical Training Colleges (MTCs) (166 pre-service and 179 upgrading trainees with prior work experience). Each interviewee completed a self-administered questionnaire including likert scale responses to statements about rural areas and interventions, and focus group discussions (FGDs) were conducted at each MTC. Results: Likert scale responses indicated mixed perceptions of both living and working in rural areas, with a range of positive, negative and indifferent views expressed on average across different statements. The analysis showed that attitudes to working in rural areas were significantly positively affected by being older, but negatively affected by being an upgrading student. Attitudes to living in rural areas were significantly positively affected by being a student at the MTC furthest from Nairobi. During FGDs trainees raised both positive and negative aspects of rural life. Positive aspects included lower costs of living and more autonomy at work. Negative issues included poor infrastructure, inadequate education facilities and opportunities, higher workloads, and inadequate supplies and supervision. Particular concern was expressed about working in communities dominated by other tribes, reflecting Kenya's recent election-related violence. Quantitative and qualitative data indicated that students believed several strategies could improve rural recruitment and retention, with particular emphasis on substantial rural allowances and the ability to choose their rural location. Other interventions highlighted included provision of decent housing, and more rapid career advancement. However, recently introduced short term contracts in named locations were not favoured due to their lack of pension plans and job security. Conclusions: This study identified a range of potential interventions to increase rural recruitment and retention, with those most favored by nursing students being additional rural allowances, and allowing choice of rural location. Greater investment is needed in information systems to evaluate the impact of such policies.
�If Only Someone Had Told Me ��: Lessons From Rural Providers: Lessons From Rural Providers
J Rural Health, 2010
Purpose: Health care providers face challenges in rural service delivery due to the unique circumstances of rural living. The intersection of rural living and health care challenges can create barriers to care that providers may not be trained to navigate, resulting in burnout and high turnover. Through the exploration of experienced rural providers' knowledge and lessons learned, this study sought to inform future practitioners, educators, and policy makers in avenues through which to enhance training, recruiting, and maintaining a rural workforce across multiple health care domains. Methods: Using a qualitative study design, 18 focus groups were conducted, with a total of 127 health care providers from Alaska and New Mexico. Transcribed responses from the question, "What are the 3 things you wish someone would have told you about delivering health care in rural areas?" were thematically coded. Findings: Emergent themes coalesced into 3 overarching themes addressing practice-related factors surrounding the challenges, adaptations, and rewards of being a rural practitioner. Conclusion: Based on the themes, a series of recommendations are offered to future rural practitioners related to community engagement, service delivery, and burnout prevention. The recommendations offered may help practitioners enter communities more respectfully and competently. They can also be used by training programs and communities to develop supportive programs for new practitioners, enabling them to retain their services, and help practitioners integrate into the community. Moving toward an integrative paradigm of health care delivery wherein practitioners and communities collaborate in service delivery will be the key to enhancing rural health care and reducing disparities.
Reimagining primary health care workforce in rural and underserved settings
2020
This Discussion Paper starts at the local level and reimagines primary health care (PHC) and the PHC workforce from the perspective of people living in rural and underserved urban areas of low- and middle-income countries (LMICs). Drawing on research evidence and successful examples, it presents a “start local” health service delivery model, health system design framework, and financing models intended to ensure highquality local comprehensive PHC is available and accessible to all. Core PHC team members (community health workers, registered nurses, specialist family physicians, and administrators) and other health practitioners are generalists in their disciplines, working together in collaborative practice as the frontline providers of care that responds to the health needs of the population they serve. The most successful model of education and training for local comprehensive PHC is socially accountable, immersive community-engaged education woven into a facilitated education an...
Australian Journal of Rural Health, 2018
This review article reports on the contribution of university Departments of Rural Health and Rural Clinical Schools to the development of rural health and the rural health workforce and is set at the Australian Government's university Departments of Rural Health and Rural Clinical Training and Support Programs. The main outcome measures include educational infrastructure, clinical academic workforce, student numbers, community engagement, research outputs, rural health and workforce outcomes. As a result, university Departments of Rural Health and Rural Clinical Schools have established a substantial geographical footprint covering most of the rural and remote populations and regions across Australia. They have a large distributed rural clinical academic workforce that exceeds 1300. Medical student numbers on long-term placements have increased threefold from inception to 1200 annually. Allied health and nursing numbers doubled over 10 years to 4000 in 2013 and are projected to double again by 2018. In 2013, they published 363 peer-reviewed papershalf of which specifically addressed rural and/or remote health issues. High levels of intention to practise rurally and uptake of rural and remote practice following exposure to rural training have been reported, especially for medicine. Thus, university Departments of Rural Health and Rural Clinical Schools constitute a national network of academic units that deliver academically enriched clinical education and training for medical, nursing and allied health students and fulfil an essential academic role for the health system in rural and remote Australia. Community engagement and accountability to region are hallmarks of the program. Early evidence of the uptake of rural and remote practice following exposure to rural training has set expectations for the Rural Health Multidisciplinary Training Program. KEY WORDS: program evaluation, rural health academic centres, rural health education and training, rural health workforce development.