Rural/Urban Imbalance

The present study attempts to examine the role of specialist services in rural public health system of India in the areas of maternal and child healthcare. The study uses primary data collected through a survey of doctors and paramedical staff working at public health facilities regarding availability and quality of the specialist services in gynaecology, paediatrics and anaesthesia.

The intended goal was to obtain direct feedback about ethical issues and ethical training
needs from practitioners themselves who work in rural settings. Results identified three primary
ethical issues: dual relationships, confidentiality, and competence; and three primary ethical training needs: boundaries, state rules and regulations, and supervision. [from abstract]

This study is a rare attempt to explore the perspectives of health providers on the contract service policy, and investigate the demand side’s attitude toward the public health services delivered under the contract policy. This evidence from Xinjian County, Jiangxi Province, the first and most representative pilot site of the contract service, could serve as a reference for policymakers to understand the initial effects of the policy, whereby they can regulate and amend some items before extending it to the whole country. [from abstract]

Attracting healthcare professionals (HCPs) to rural areas and retaining them there remains a challenge. Current retention strategies focus on the factors that cause people to leave rural areas, but these strategies continue to fail to retain HCPs in these areas, and the situation in which there is a lack of quality and inadequacy of the type of health services is perpetuated. The literature describes factors that attract healthcare workers to work in rural areas, and this study contributes to a deeper understanding of this. [from abstract]

A guide to accounting for rural contexts in health policy, strategic planning and resourcing. Addressing the
specific rural health context in policy design, budget allocations and implementation plans is not yet a standard process in South Africa. This guide addresses that, to ensure that “the rural health context” is addressed adequately
when new policies and budgets are drawn up and implemented in the beautiful rural parts of our country. [adapted from resource]

The health seeking behaviour of a community determines how they use health services. Utilisation of health facilities can be influenced by the cost of services, distance to health facilities, cultural beliefs, level of education and health facility inadequacies such as stock-out of drugs.
This study will assess the health seeking practices and challenges in utilising health facilities in a rural community in Wakiso district, Uganda. [from abstract]

L’évaluation avait pour but d’apprécier la pertinence, l’efficacité et la viabilité de ce programme de médicalisation, notamment des stratégies développées pour attirer et maintenir les médecins dans les zones rurales. [from resource]

Rural acute care nursing requires an extensive breadth and depth of knowledge as well as the ability to quickly reason through problems in order to make sound clinical decisions. This reasoning often occurs within an environment that has minimal medical or ancillary support. Registered nurses (RN) new to rural nursing, and employers, have raised concerns about patient safety while new nurses make the transition into rural practice. [from introduction]

The study sought to investigate the factors contributing to the high turnover of clinical staff at two Catholic Health Services (CHS) hospitals of Andara and Nyangana in the Kavango region of Namibia. The conceptual framework, factors related to the decision to stay in or leave rural and remote areas, was adapted from Henderson and Tulloch (2008) and guided this study. [from abstract]

This paper assesses some analytical problems and approaches towards improving the utilization of primary health care services by the rural communities in Nigeria. This article examines some cross cutting issues in [Primary Health Care] PHC and outlines approaches to improve the use of health services by rural people. [adapted from abstract]

Improving maternal and reproductive health still remains a major challenge in most low-income countries especially in sub-Saharan Africa. The growing inequality in access to maternal health interventions is an issue of great concern. In Ghana, inadequate attention has been given to the inequality gap that exists amongst women when accessing antenatal care during pregnancy and skilled attendance at birth.

Many countries struggle to attract and retain sufficient numbers and types of health workers to provide quality services in rural and remote areas. To encourage country ownership and advocate for use of data for policy-making, the USAID-funded CapacityPlus project developed several tools, including the Rapid Retention Survey Toolkit; a companion software product, iHRIS Retain, developed in collaboration with the World Health Organization (WHO); and a discrete choice experiment user guide, developed in collaboration with the World Bank and the WHO. [from introduction]

This research tried to reveal the current situation and to track the future trends of the rural health workforce. By
stratified multistage cluster sampling processes, the baseline data of nationwide longitudinal survey were gathered
from China.

The trend toward collaborations between researchers and stakeholders in rural/remote health services innovation has the potential to address these issues; researchers can play their part by creating and accepting opportunities for such collaboration. [from authors]

This paper provides a snapshot of health and population trends in Pakistan, with a view toward demonstrating the changing paradigm of the urban-rural dynamic. A new health systems governance assessment approach toward urbanization and health issues is subsequently discussed, and the paper outlines a new framework of principles and their pertinence. [from abstract]

In this paper emphasis has been laid down to understand the rural healthcare system and the impact of NRHM in developing a positive and well-nourished country has been discussed. Various charts and tables were duly analyzed before arriving at a result. [from abstract]

The objective of the study was to identify a package for attracting and retaining health workers in underserved areas. [from abstract]

The idea for this policy emerged after finding a highly uneven distribution of health personnel across urban and rural areas, the availability of a large number of health officers in the labour market, and the opportunity given to the Ministry of Health by the government to recruit personnel through a specific budget allocation. [from abstract]

The purpose of this study was to determine the impacts of the various health worker retention strategies on health workers in two rural districts of Zambia. [from abstract]

The purpose of this contribution is to analyse and explain the South African HRH case, its
historical evolution, and post-apartheid reform initiatives aimed at addressing deficiencies
and shortfalls. [from abstract]

The objective of this study was to explore what the implementation of the [Ukwanda Rural Clinical School] meant for the practice of these physicians and to what extent the shift from full-time practising clinician to clinical teacher required them to adapt and change. [from abstract]

The purpose of this study was to investigate recent changes in the geographic distribution of pediatricians and the factors underlying this change. [from abstract]

In India, there is a constant tug of war in national policy on “Which health worker is needed in rural areas?” and “Who can, realistically, be got there?” In this article, we try to inform this debate by juxtaposing perspectives of three cadres involved in primary care in India—allopathic, ayurvedic and nursing—on rural service. We also identify key incentives for improved rural retention of these cadres. [adapted from abstract]

This article analyses (1) how financial incentives (salary top-ups) and non-financial incentives (housing and education) affect nurses’ willingness to work in remote areas of Tanzania and (2) how the magnitude of the incentives needed to attract health workers varies with the nurses’ geographic origin and their intrinsic motivation. [from abstract]

The purpose of this study was to compare rural and urban nursing students in relation to application, admission, and retention/graduation trends at a metropolitan state university in the Pacific Northwest area of the USA. [from abstract]

This study examined the trends in the geographic distribution of pediatricians as well as all physicians from 1996 to 2010 to identify the impact of the launch of a new training program for new medical graduates. [from abstract]

This study aimed to explore the current attitudes of new medical, dental and pharmacy graduates as well as determine the linkage between their characteristics and the preference for working in rural areas. [from abstract]

This study investigates the characteristic and the factors associated with the retention of nurses working in rural areas in Lebanon. [from abstract]

This study compared the rural attitudes, intention to fulfill mandatory rural service and competencies between medical graduates’ from two modes of admission, normal and special tracks in order to evaluate Thailand’s comprehensive policies for rural retention of medical doctor and other health professional, including education strategy and mandatory service. [adapted from abstract]

This umbrella review aims to synthesize the current evidence on the effectiveness of interventions to promote nurse retention in rural or remote areas, and to present a taxonomy of potential strategies to improve nurse retention in those regions. [from abstract]