A Systematic Review of the Strategies to Address Health Worker Shortage in Rural and Remote Areas of Low- and Middle-Income Countries
Purpose: The aim of this paper is to examine the literature on strategies to address the maldistribution of health workers between urban and rural and remote areas of low- and middle-income countries.
Sample: 16 peer-review articles that address strategies to recruit and retain health workers in rural and remote areas of low- and middle-income countries.
Methods: A systematic literature review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Findings: Embase, PubMed and Web of Science, were searched resulting in 731 articles, 16 articles were included after screening. Across the 16 articles, the main categories to address the maldistribution of health workers between urban and rural and remote areas were Use of Public Sector Employment, Rural and remote Employment Incentives, Student and School Based Strategies, and Health Infrastructure and Retention.
Conclusion: There is not just one type of strategy that can successfully address the maldistribution of health workers between urban and rural and remote areas. To address population health in countries suffering from maldistribution of health workers use of increasing the availability of public sector employment, increasing incentives for health workers to work in rural/ remote areas, partnering with health worker training programs and schools, and building up high quality infrastructure and other interventions to retain health workers in rural and remote areas are successful. Future research should evaluate interventions to recruit and retain health workers in rural and remote areas and look at population health as a result. The ultimate goal for recruitment and retention of health workers in rural and remote areas is improving population health and this has not been considered in past research.
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