Table 1.
Selected interventions to improve recruitment and retention of health workers in remote and rural areas
| Category of intervention | Examples |
|---|---|
| A. Education and continuous professional development interventions | Building of a medical school in rural or remote area |
| Recruitment from and training in rural areas | |
| Targeted admission of students from rural background | |
| Early and increased exposure to rural practice during undergraduate studies (diversification of location of training sites) | |
| Educational outreach programmes | |
| Community involvement in selection of students | |
| Support for continuous professional development, career paths | |
| B. Regulatory interventions | Compulsory service requirements for health professionals (bonding schemes) |
| Conditional licensing (license to practice in exchange of location in rural areas for foreign doctors) | |
| Loan repayment schemes (paid studies in exchange of services in rural areas for 4-6 years) | |
| Increased opportunities for recruitment to civil service | |
| Recognize overseas qualifications | |
| Policies enabling the production of different types of health workers (mid-level cadres, substitution, task shifting) | |
| C. Financial incentives (direct and indirect) | Higher salaries for rural practice |
| Rural allowances, including installation kit | |
| Pay for performance | |
| Different remuneration methods (fee for service, capitation etc) | |
| Loans (housing, vehicle) | |
| Grants for family education | |
| Other non-wage benefits | |
| D. Personal and professional support | General improvement in rural infrastructure (housing, roads, phones, water supplies, radio communication etc |
| Improved working and living conditions, including opportunities for child schooling and spouse employment, ensured adequate supplies of technologies and drugs | |
| Strengthening HR management support systems | |
| Supportive supervision | |
| Special awards, civic movement, and social recognition | |
| Flexible contract opportunities for part-time work | |
| Measures to reduce the feeling of isolation of health workers (professional/specialist networks, remote contact through telemedicine and telehealth) | |
Source: Adapted from World Health Organization, (2010) [25]