Worldwide, Lao PDR has been identifiedamong 57 countries with a critical shortage and skeweddistribution of its health workforce, especially in remoteand rural areas (Guilbert 2006, World Bank 2015). Healthcareeducation is provided by the public sector through ninepublic health training institutes in the country: TheUniversity of Health Sciences (UHS) in Vientiane Capitalprovides medical related programs including medicine,dentistry, pharmacy, medical technology, nursing basicsciences and post graduate studies, with the otherinstitutions located at provincial levels: three RegionalPublic Health Colleges, four Provincial Public HealthSchools and one Nursing School. The annual output from theseinstitutions is approximately 2,000 (Department ofOrganization and Personnel (DOP), 2013). This study focuseson supply-side policies to determine the key challenges andpolicy implications regarding improved availability andretention of staff in remote areas. This possibly stemsfrom, among other reasons, the following: (a) limitedgovernment quotas to recruit and place health workers inrural areas (i.e. in 2013 1,045 recruitment quotas wereallocated to MOH, of which 882 (84.4 percent) were given toprovinces, districts and health centers nationwide); (b)health workers’preference to work in urban areas with betterincome and professional career development opportunities;and (c) low self-confidence of new graduates to workindependently in rural areas which is attributable toinsufficient clinical practice during training, due in partto the excessive number of student intakes to traininginstitutes. The shortage of middle and high level healthworkers at primary and secondary health care facility levelsleads to a major gap in access to quality health careservices between urban and rural areas.
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