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

Human Resources for Health

Beibei Yuan¹  Yang Sun³  Huan Zhang¹  Lixia Dou²  Xiaoyun Liu¹ 

[1] China Centre for Health Development Studies, Peking University, 38 Xueyuan Road, Haidian District 100191, Beijing, People’s Republic of China;Center for Woman and Child’s Health, China Center for Disease Control and Prevention, Beijing, China;School of Political Science and Public Administration, Wuhan University, 299 Bayi Road, Wuchang District, Wuhan, China

关键词: Rural areas;    Context factors;    Retention;    Attraction;    Human resources for health;   

Others  :  1221225
DOI  :  10.1186/s12960-015-0059-6

 received in 2014-10-26, accepted in 2015-07-09,  发布年份 2015

【 摘 要 】

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.

【 授权许可】

   
2015 Liu et al.

【 图 表 】

Figure 1.

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