Article type
Year
Abstract
Background: The shortage of health workers in rural and remote areas has become a significant global health problem that seriously affects the aspirations of achieving health equity for all. However, the research evidence for health workforce retention in rural or remote areas is different in quality, so it is difficult to support health decision-making better.
Objectives: Using evidence-based medicine (EBM) methods to synthesize and overview the evidence of recruiting and retaining health workers in rural or remote areas, so we could provide an evidence reference for health policy researchers and decision makers.
Methods: Four electronic databases: PubMed, the Cochrane Library, the Campbell Library, Web of Science, and the website of the World Health Organization and Google scholar search engines were consulted up to March 2014. The publication date was not limited. We assessed the quality of each review according to the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) criteria. The retention policies involved were synthesized and analyzed according to the 16 recommendations provided by the World Health Organization.
Results: We identified 14 systematic reviews (SRs), of which 10 (74.1%) SRs had been published between 2009 and 2013; two (14.3%) collected studies from low- and middle-income countries; and only one (7.1%) included randomized controlled trial. The methodological quality of the included SRs were graded into medium (eight SRs, 57.1%) and low (six SRs, 42.9%) respectively. Of all policy options, clinical rotations in rural areas during studies received the greatest focus (six SRs, 42.9%). Research gaps still exist in the areas of continuous professional development, enhanced scope of practice, different types of health workers, better living conditions and public recognition measures for rural health workers.
Conclusions: The amount of available evidence is small, and the methodological quality is poor; there are mainly observational studies that come primarily from high-income countries. The majority of retention policies for health workers in rural and remote areas lacks support from evidence-based research.
Objectives: Using evidence-based medicine (EBM) methods to synthesize and overview the evidence of recruiting and retaining health workers in rural or remote areas, so we could provide an evidence reference for health policy researchers and decision makers.
Methods: Four electronic databases: PubMed, the Cochrane Library, the Campbell Library, Web of Science, and the website of the World Health Organization and Google scholar search engines were consulted up to March 2014. The publication date was not limited. We assessed the quality of each review according to the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) criteria. The retention policies involved were synthesized and analyzed according to the 16 recommendations provided by the World Health Organization.
Results: We identified 14 systematic reviews (SRs), of which 10 (74.1%) SRs had been published between 2009 and 2013; two (14.3%) collected studies from low- and middle-income countries; and only one (7.1%) included randomized controlled trial. The methodological quality of the included SRs were graded into medium (eight SRs, 57.1%) and low (six SRs, 42.9%) respectively. Of all policy options, clinical rotations in rural areas during studies received the greatest focus (six SRs, 42.9%). Research gaps still exist in the areas of continuous professional development, enhanced scope of practice, different types of health workers, better living conditions and public recognition measures for rural health workers.
Conclusions: The amount of available evidence is small, and the methodological quality is poor; there are mainly observational studies that come primarily from high-income countries. The majority of retention policies for health workers in rural and remote areas lacks support from evidence-based research.