WHO: Half the World's Population Underserved by Health Systems

 

This week’s Bulletin of WHO focuses on strategies to increase service to rural areas. Quotes:

 

  • Globally, half of the population lives in rural areas but they are only served by less than a quarter of all doctors and less than a third of all nurses . .. It is critically important to succeed in this, particularly in the 57 low- and middle-income countries that are already plagued with critical shortages of health workers.
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  • Context matters and external factors influence to a great extent the success or failure of rural retention strategies.
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  • There is no one single-bullet solution to this problem … .A “pipeline-to-practice” approach to education for rural practice seems promising, particularly if medical schools embrace a social accountability framework to make them more responsible to communities. Compulsory service as a method for rural recruitment is widely used but rarely evaluated. Contracting systems are explored by some countries such as Senegal, while others focus on professional development to reduce feelings of isolation, as in Norway.
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  • Rural retention strategies must be applied in mutually reinforcing combinations or “bundles”...  Chile’s Rural Practitioner Programme linked financial incentives with education opportunities and personal support strategies .
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  • Effective retention strategies must respond to both the needs of the population and the expectations of health workers.
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  • Monitoring and evaluation should be built into the design and implementation of rural retention interventions.
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  • …  decentralization … [may]  lead to better health workforce recruitment, performance and retention in rural areas through the creation of additional revenue for the health sector and better use of existing financial resources.

 

 

 

 

The full article and journal are available at: http://www.who.int/bulletin/volumes/88/5/10-078485/en/index.html