E B Esu1,2, M Chibuzor1, E Aquaisua1,3, E Udoh1,4, O Sam5, S Okoroafor6, M Ongom6, E Effa7, A Oyo-Ita1,8, M Meremikwu9. 1. Cochrane Nigeria, Institute of Tropical Diseases Research and Prevention, University of Calabar Teaching Hospital, Calabar, Nigeria. 2. Department of Public Health, College of Medical Sciences, University of Calabar, Calabar, Nigeria. 3. Cross River Health & Demographic Surveillance System, University of Calabar, Calabar, Nigeria. 4. Paediatrics Department, University of Uyo Teaching Hospital, Uyo, Akwa Ibom, Nigeria. 5. Universal Health Coverage/Life Course, World Health Organization Inter-Country Support Team, Ouagadougou, Burkina Faso. 6. Health Systems Strengthening Cluster, World Health Organization Country Office, Abuja, Nigeria. 7. Department of Internal Medicine, College of Medical Sciences, University of Calabar, Calabar, Nigeria. 8. Department of Community Medicine, University of Calabar Teaching Hospital, Calabar, Nigeria. 9. Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria.
Abstract
BACKGROUND: Global health workforce shortages exist with disparities in the skill mix and distribution of health workers. Rural and underserved populations are often disadvantaged in terms of access to health care. METHODS: This systematic review summarized all systematic reviews that assessed interventions for improving attraction and retention of health workers in rural and underserved areas. We systematically searched selected electronic databases up to 31 March 2020. The authors independently screened the reviews, extracted data and assessed the certainty of evidence using GRADE. Review quality was assessed using the ROBIS tool. RESULTS: There was a paucity of evidence for the effectiveness of the various interventions. Regulatory measures were able to attract health workers to rural and underserved areas, particularly when obligations were attached to incentives. However, health workers were likely to relocate from these areas once their obligations were completed. Recruiting rural students and rural placements improved attraction and retention although most studies were without control groups, which made conclusions on effectiveness difficult. CONCLUSIONS: Cost-effective utilization of limited resources and the adoption and implementation of evidence-based health workforce policies and interventions that are tailored to meet national health system contexts and needs are essential.
BACKGROUND: Global health workforce shortages exist with disparities in the skill mix and distribution of health workers. Rural and underserved populations are often disadvantaged in terms of access to health care. METHODS: This systematic review summarized all systematic reviews that assessed interventions for improving attraction and retention of health workers in rural and underserved areas. We systematically searched selected electronic databases up to 31 March 2020. The authors independently screened the reviews, extracted data and assessed the certainty of evidence using GRADE. Review quality was assessed using the ROBIS tool. RESULTS: There was a paucity of evidence for the effectiveness of the various interventions. Regulatory measures were able to attract health workers to rural and underserved areas, particularly when obligations were attached to incentives. However, health workers were likely to relocate from these areas once their obligations were completed. Recruiting rural students and rural placements improved attraction and retention although most studies were without control groups, which made conclusions on effectiveness difficult. CONCLUSIONS: Cost-effective utilization of limited resources and the adoption and implementation of evidence-based health workforce policies and interventions that are tailored to meet national health system contexts and needs are essential.
Authors: Adam Ahmat; Sunny C Okoroafor; James Avoka Asamani; Delanyo Dovlo; Jean Jacques Salvador Millogo; Mourtala Mahaman Abdou Illou; Jennifer Nyoni Journal: BMJ Glob Health Date: 2022-05