Deployment

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

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]

This paper presents a structural map of a health system based on a synthesis of a needs-based analytic framework and a supply side framework, showing the interactive connections between its major components, which could be expanded at a later date to show the linkages between the tasks performed by a health workforce and the cadres of personnel that could supply those tasks. [adapted from author]

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]

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]

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]

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]

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]

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]

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

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]

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]

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]

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]

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]

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

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]

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.

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]