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Analysis of context factors in compulsory and incentive strategies for improving attraction and retention of health workers in rural and remote areas: a systematic review.

Liu X, Dou L, Zhang H, Sun Y, Yuan B - Hum Resour Health (2015)

Bottom Line: Micro-level factors refer to the policy implementation process including funding sources, administrative agency, legislation process, monitoring and evaluation.Macro-, meso- and micro-level context factors can play different roles in agenda setting, policy formulation and implementation of health interventions to attract and retain rural health workers.These factors should be systematically considered in the different stages of policy process and evaluation.

View Article: PubMed Central - PubMed

Affiliation: China Centre for Health Development Studies, Peking University, Mailbox box 505, 38 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China. xliu@bjmu.edu.cn.

ABSTRACT

Background: Current literature systematically reports that interventions to attract and retain health workers in underserved areas need to be context specific but rarely defines what that means. In this systematic review, we try to summarize and analyse context factors influencing the implementation of interventions to attract and retain rural health workers.

Methods: We searched online databases, relevant websites and reference lists of selected literature to identify studies on compulsory rural service programmes and financial incentives. Forty studies were selected. Information regarding context factors at macro, meso and micro levels was extracted and synthesized.

Results: Macro-level context factors include political, economic and social factors. Meso-level factors include health system factors such as maldistribution of health workers, growing private sector, decentralization and health financing. Micro-level factors refer to the policy implementation process including funding sources, administrative agency, legislation process, monitoring and evaluation.

Conclusions: Macro-, meso- and micro-level context factors can play different roles in agenda setting, policy formulation and implementation of health interventions to attract and retain rural health workers. These factors should be systematically considered in the different stages of policy process and evaluation.

No MeSH data available.


The selection process for studies included in the review.
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Related In: Results  -  Collection

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Fig1: The selection process for studies included in the review.

Mentions: The review focuses on two types of intervention strategies: compulsory rural services programmes and direct and indirect financial incentives. The target population may include both existing health professionals and medical students. Studies were included in the analysis when context or process information of the interventions was discussed. Literatures were excluded if the papers had no introduction of interventions or if interventions were not about compulsory rural service programmes and financial incentives. Two reviewers independently assessed potential studies for inclusion and resolved disagreements through discussion. The study selection process is shown in FigureĀ 1.Figure 1


Analysis of context factors in compulsory and incentive strategies for improving attraction and retention of health workers in rural and remote areas: a systematic review.

Liu X, Dou L, Zhang H, Sun Y, Yuan B - Hum Resour Health (2015)

The selection process for studies included in the review.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4508764&req=5

Fig1: The selection process for studies included in the review.
Mentions: The review focuses on two types of intervention strategies: compulsory rural services programmes and direct and indirect financial incentives. The target population may include both existing health professionals and medical students. Studies were included in the analysis when context or process information of the interventions was discussed. Literatures were excluded if the papers had no introduction of interventions or if interventions were not about compulsory rural service programmes and financial incentives. Two reviewers independently assessed potential studies for inclusion and resolved disagreements through discussion. The study selection process is shown in FigureĀ 1.Figure 1

Bottom Line: Micro-level factors refer to the policy implementation process including funding sources, administrative agency, legislation process, monitoring and evaluation.Macro-, meso- and micro-level context factors can play different roles in agenda setting, policy formulation and implementation of health interventions to attract and retain rural health workers.These factors should be systematically considered in the different stages of policy process and evaluation.

View Article: PubMed Central - PubMed

Affiliation: China Centre for Health Development Studies, Peking University, Mailbox box 505, 38 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China. xliu@bjmu.edu.cn.

ABSTRACT

Background: Current literature systematically reports that interventions to attract and retain health workers in underserved areas need to be context specific but rarely defines what that means. In this systematic review, we try to summarize and analyse context factors influencing the implementation of interventions to attract and retain rural health workers.

Methods: We searched online databases, relevant websites and reference lists of selected literature to identify studies on compulsory rural service programmes and financial incentives. Forty studies were selected. Information regarding context factors at macro, meso and micro levels was extracted and synthesized.

Results: Macro-level context factors include political, economic and social factors. Meso-level factors include health system factors such as maldistribution of health workers, growing private sector, decentralization and health financing. Micro-level factors refer to the policy implementation process including funding sources, administrative agency, legislation process, monitoring and evaluation.

Conclusions: Macro-, meso- and micro-level context factors can play different roles in agenda setting, policy formulation and implementation of health interventions to attract and retain rural health workers. These factors should be systematically considered in the different stages of policy process and evaluation.

No MeSH data available.