Table 1. Proposed assessment indicators for rural retention and approaches.

Dimension of assessment	Indicators	Approaches
Policy implementation
Implementation of the 16 global policy recommendations on “increasing access to health workers in remote and rural areas through improved retention”	Level of implementation: qualitative assessment or Likert scale survey	Regular internal assessment by health ministries and key partners aim to identify policy, implementation and resources gap, and the comprehensiveness of bundle interventions
Output
Intention to stay in primary health care, five-year retention rate, proportion of health workers remaining in rural area	Per cent intention to stay in primary health care. Five-year survival analysis using Kaplan–Meier survival curves	Regular surveys of (i) different cadres of new graduate, (ii) in-service primary health-care workforce, on five-year intention to stay and leave the country, stay in primary health care, and postgraduate training need
Job satisfaction	Average satisfaction score by different cadres; key push factors	Primary health-care workforce survey of job satisfaction, identify and fix the gaps in particular on remunerations, workplace safety, professional isolation and support
No. and cadre mix of health workers recruited in primary health care, duration of service, percentage of filled post and vacancy rate	Trend of filled post and vacancy rate, by key cadres of professional, average year of primary health-care services	Strengthen human resources for health information that capture employment, mobility by professional mix
Health workforce absenteeism	Trend of absenteeism rate and reasons	Unannounced supervisory visits and assessment of reasons of absenteeism
Retention stability	Percentage of health workers who stay after one, two or three years	Routine employment database
Staff turnover	Percentage of staff remaining after one year	Routine employment database
Outcome
Health workforce performance: availability, competence, productivity, responsiveness	Level of competency (clinical, public health, communication and cultural), workload per full-time equivalent staff	Regular surveys that assess the competency, productivity and responsiveness among in-service primary health-care workforce
Coverage of key health interventions and health service use by population	Coverage of essential maternal, newborn, child and adolescent services, noncommunicable disease screening and treatment	Strengthen routine health information systems that capture coverage of immunization, antenatal care, delivery by skilled birth attendants, and others such as noncommunicable disease services
Primary health-care responsiveness	Health systems responsiveness score	Household survey to assess the primary health-care responsiveness to citizens’ health needs
Patient satisfaction	Average score of patient satisfaction with different services	Patient exit self-administered or interview questionnaire survey