Factors explaining the shortage and poor retention of qualified health workers in rural and remote areas of the Kayes, region of Mali: a qualitative study

Ahmed, Mohamed Ali Ag; Diakité, S; Sissoko, Koman; Gagnon, Marie Pierre; Charron, Sylvie

doi:10.22605/rrh5772

Cited by 7 publications

(12 citation statements)

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“… Witter et al 2017 [ 7 ] Understand gender influences on the health workforce in four fragile and post-conflict contexts Mixed methods 965 Physicians, medical assistance, nurses, midwives and others 44 56 Survey, document review, in-depth interviews and key informant interviews Gender analysis framework Sierra Leone and Zimbabwe 3. Ag Ahmed et al 2020 [ 12 ] Identify and understand the factors related to shortage and poor retention of skilled health workers in rural health districts of Kayes, Mali Qualitative 46 5 Physicians 35 Nurses 6 Decision-makers 59 41 In-depth interviews Thematic analysis Mali 4. Alameddin et al 2016 [ 13 ] Soliciting and synthesizing the voice of PHC and community stakeholders on the HRH recruitment and retention strategies Qualitative 22 Policy and decision-makers 36 64 Key informant interviews Thematic analysis Lebanon 5.…”

Section: Resultsmentioning

confidence: 99%

“…Women faced strong pressure from their husbands and families to leave rural regions to re-join their husbands, bringing challenges to women’s career progress. Based on the findings, the authors suggested adopting strategies considering the social norms, such as relocating spouses of civil servants to enhance retention of married staff in rural regions [ 12 ].…”

Section: Resultsmentioning

confidence: 99%

“…In addition, studies found the lack of women in decision-making positions limited women's voice at policy levels with resultant gender-blind HRH policies [ 1 , 11 , 43 ]. These findings emphasize the need for HRH policies and strategies that take into account gendered socio-cultural norms and gender equity [ 8 , 12 , 43 ].…”

Section: Discussionmentioning

confidence: 95%

“…In addition to interventions targeting maternal and child health, it is vital to control modifiable risk factors for non-communicable diseases, like hypertension, notably twice the global average in FCASs [ 9 ]. In some FCASs, including Afghanistan, Iraq, Lebanon, and Mali, the dominance of strong patriarchal structures creates additional health challenges for women by prohibiting women to receive care from male providers [ 10 , 12 – 16 ]. In addition, females require permission from male family members to access education and employment in some contexts [ 7 , 12 , 15 , 17 ], affecting women’s participation in the health workforce.…”

Section: Introductionmentioning

confidence: 99%

“…In some FCASs, including Afghanistan, Iraq, Lebanon, and Mali, the dominance of strong patriarchal structures creates additional health challenges for women by prohibiting women to receive care from male providers [ 10 , 12 – 16 ]. In addition, females require permission from male family members to access education and employment in some contexts [ 7 , 12 , 15 , 17 ], affecting women’s participation in the health workforce. Thus, women may face difficulty accessing care due to the non-availability of female healthcare providers [ 13 , 14 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Participation of women in the health workforce in the fragile and conflict-affected countries: a scoping review

et al. 2021

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Introduction and background The full participation of women as healthcare providers is recognized globally as critical to favorable outcomes at all levels, including the healthcare system, to achieving universal health coverage and sustainable development goals (SDGs) by 2030. However, systemic challenges, gender biases, and inequities exist for women in the global healthcare workforce. Fragile and conflict-affected states/countries (FCASs) experience additional pressures that require specific attention to overcome challenges and disparities for sustainable development. FCASs account for 42% of global deaths due to communicable, maternal, perinatal, and nutritional conditions, requiring an appropriate health workforce. Consequently, there is a need to understand the impact of gender on workforce participation, particularly women in FCASs. Methods This scoping review examined the extent and nature of existing literature, as well as identified factors affecting women's participation in the health workforce in FCASs. Following Arksey and O'Malley's scoping review methodology framework, a systematic search was conducted of published literature in five health sciences databases and grey literature. Two reviewers independently screened the title and abstract, followed by a full-text review for shortlisted sources against set criteria. Results Of 4284, 34 sources were reviewed for full text, including 18 primary studies, five review papers, and 11 grey literature sources. In most FCASs, women predominate in the health workforce, concentrated in nursing and midwifery professions; medicine, and the decision-making and leadership positions, however, are occupied by men. The review identified several constraints for women, related to professional hierarchies, gendered socio-cultural norms, and security conditions. Several sources highlight the post-conflict period as a window of opportunity to break down gender biases and stereotypes, while others highlight drawbacks, including influences by consultants, donors, and non-governmental organizations. Consultants and donors focus narrowly on programs and interventions solely serving women's reproductive health rather than taking a comprehensive approach to gender mainstreaming in planning human resources during the healthcare system’s restructuring. Conclusion The review identified multiple challenges and constraints facing efforts to create gender equity in the health workforce of FCASs. However, without equal participation of women in the health workforce, it will be difficult for FCASs to make progress towards achieving the SDG on gender equality.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Participation of women in the health workforce in the fragile and conflict-affected countries: a scoping review

et al. 2021

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Main Causes of Medicine Stock-Outs in Mauritania: A Qualitative Study

Ag Ahmed,

Coulibaly,

Ravinetto

et al. 2024

Preprint

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The number of medicine stock-outs (MSOs) is increasing globally. In Mauritania, they are recurring, although, to our knowledge, no study has yet been conducted to determine the causes. Therefore, this qualitative study aims to identify the main local or national causes of stock-outs to provide a common understanding and guide policy-makers towards corrective actions. The study was carried out in five health districts and at the regional and central levels. The samples were purposive. Two focus groups and twenty semi-structured individual interviews were held with 38 participants, including health professionals, managers from the Central Purchasing Office for Essential Medicines and Consumables (CAMEC), the Pharmacy and Laboratory Department (DPL) and the Ministry of Health (MoH). All interviews were recorded and transcribed. A thematic content analysis was carried out. Our findings indicate the national causes of MSOs at three healthcare system levels (operational, regional, and central). They were grouped into five categories: insufficient human resource capacity (number of staff, training, retention), communication and coordination problems between stakeholders, logistical constraints (transport, storage), financial constraints, inadequate forecasting of needs, and complex procurement procedures. These causes of MSOs are interconnected, and many could be addressed locally through solutions initiated and led by the Mauritanian authorities. To address MSOs sustainably, we suggest and discuss some possible actions, including reforms to improve CAMEC's governance and accountability and, more broadly, to strengthen the various pillars of the local health and pharmaceutical system.

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COVID-19 crisis overshadowing the health workforces’ rights and resilience: a systematic review

Khosravizadeh

Ahadinezhad

Rafiei

et al. 2022

IJHRH

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Purpose In the time of the COVID-19 crisis, many physical, psychological and spiritual difficulties are imposed on the front line staff and overshadow their rights, resilience and retention. In addition, the loss of this important organizational resource imposes huge costs on the system. The purpose of this study is systemic review of the influential factors, policies and strategies applied to defend the rights of health-care staff and improve the resilience and retention of health system human resources in the COVID-19 crisis. Design/methodology/approach This systematic review was conducted in 2021. Data were collected by keyword search in Google Scholar, PubMed, Scopus, Web of Science, Science Direct, Magiran, SID and Irandoc databases until December 2021. In addition, the quality of the studies was evaluated by three experts using the Strobe checklist. The analysis used in this study to categorize the results was thematic analysis. Findings Factors that cause tension and injustice to employees and also strategies to overcome it and increase their resilience were classified into general categories according to their nature. Factors included factors related to safety, economic and financial, staff characteristics, crisis management characteristics, organizational climate and working conditions. Existing strategies also fall into four categories of physical, psychological and spiritual health promotion strategies; organizational climate and work environment; education and empowerment and economic and financial. Originality/value This study is a systematic review of the factors that affect the health workforce rights and resilience of health-care personnel during the COVID-19 crisis. On the other hand, the policies and strategies used in different countries to overcome the difficulties and increase the resilience and retention of health workers have been summarized and can be used in other crises.

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Factors explaining the shortage and poor retention of qualified health workers in rural and remote areas of the Kayes, region of Mali: a qualitative study

Cited by 7 publications

References 0 publications

Participation of women in the health workforce in the fragile and conflict-affected countries: a scoping review

Participation of women in the health workforce in the fragile and conflict-affected countries: a scoping review

Main Causes of Medicine Stock-Outs in Mauritania: A Qualitative Study

COVID-19 crisis overshadowing the health workforces’ rights and resilience: a systematic review

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