Health‐personnel recruitment and retention target policy for health care providers in the rural communities: A retrospective investigation at Pudong New Area of Shanghai in China

Abstract

To tackle the shortage of health personnel in the rural areas of Pudong New Area of Shanghai, the local government issued an incentive policy as one of the medical reforms. The current investigation focused on the relevant incentive measures and their corresponding effects and problems with a view to providing referential and useful experiences for those who are engaged in addressing the same problem at home and abroad. The details of the incentive policy were derived from the government document, and the related data about the flow of the rural community health care providers, from the institutional investigation. As indicated by the current investigation, the incentive policy produced some positive effect in attracting health care providers to work in the rural community health centers, especially general practitioners, nurses, MS/MD degree holders, and intermediate professional title holders to be employed in the farther ones. However, it was turned out that the population of high quality health care providers was still not sufficient enough to cover the whole rural areas, which suggested that it was still hard to draw such qualified medical individuals. To conclude in the current investigation, we made three recommendations for the policymakers to take into account in terms of policy maintenance, benefits for health personnel, and guarantee of their lawful rights and interests.

Factors associated with increasing rural doctor supply in Asia-Pacific LMICs: a scoping review

“…The financial incentives (i.e., salary, hardship allowances) were among major attributes or challenges of doctors working in rural or remote locations [ 50 , 52 , 53 , 70 , 83 ]. The increasing incentive with remoteness was associated with an increase of rural doctor supply in China [ 32 , 84 ]. However, financial incentives were deemed less valuable for retention compared to other factors such as working environment, community and personal factor among rural doctors in Thailand [ 72 ] Appropriate financial incentives (i.e., salary, hardship allowances) were associated with doctors preference to work [ 36 , 46 , 84 ] or staying in rural locations [ 45 , 85 ].…”

“…The increasing incentive with remoteness was associated with an increase of rural doctor supply in China [ 32 , 84 ]. However, financial incentives were deemed less valuable for retention compared to other factors such as working environment, community and personal factor among rural doctors in Thailand [ 72 ] Appropriate financial incentives (i.e., salary, hardship allowances) were associated with doctors preference to work [ 36 , 46 , 84 ] or staying in rural locations [ 45 , 85 ]. Better financial incentives were desired by doctors [ 52 , 54 , 56 , 58 , 60 , 73 , 74 , 85 – 87 ] and medical students to address rural doctor shortages [ 36 , 40 , 47 , 59 , 75 – 80 , 88 , 89 ] b) Opportunity to earn additional income ‡ Opportunity to additional income refers to income-generating activities related to clinical service, usually in private sector, hence the term ‘private practice’ Government doctors working in rural areas have a more limited opportunity for private practice [ 32 , 50 , 73 , 90 ].…”

“…Many included studies (39%) did not provide a definition of rural. Many (39%) also defined ‘rural’ based on non-facility aspects such as level of socioeconomic deprivation [ 32 , 51 , 53 , 57 , 62 , 70 , 86 , 90 , 91 ], being located outside of metropolitan areas [ 26 – 29 , 48 , 82 ], population size [ 42 , 65 ], administrative unit definitions [ 36 , 77 , 84 ], and geographical access [ 50 , 52 , 56 , 58 , 83 ]. Some (14%) studies defined rural as working in primary care or community-level facilities or smaller hospitals [ 31 , 47 , 49 , 61 , 63 , 64 , 67 , 95 ].…”

“…A broad range of educational factors were associated with rural work, especially related to rural background. Both preference and actual work in rural locations were associated with having resided in rural areas during the school-age period, having graduated from a rurally located high school, or being a native of a particular (1) had no definition of rural or no description of the place characteristics where the study was done and this was not cross-referenced to an earlier study by the authors [66, 68, 69, 74-76, 78, 81, 92], or; (2) relied on respondents' own definition of rural [33-35, 37, 39, 40, 43-45, 54, 55, 73, 79, 80, 88, 89, 93, 94, 98] Facility-related Type of health facility 9 1 0 10 (14.1) Township-village health center [47,95], county or township hospital [61], community or primary or additional primary health centers, secondary hospital [67], community hospital [31,49], government rural health unit [63,64] Non-facility related Population size 2 0 0 2 (2.8) City/municipality with less than 100,000 population [65], district with < 25,000 population [42] Non-metropolitan 6 0 0 6 (8.5) Area outside the country capital and/or large city [26-29, 48, 82] Administrative unit 3 0 0 3 (4.2) Any area of county, town or village [36]; rural or farther rural [84]; township or rural county [77] One of the most rural regions in a country 2 4 4 10 (14.1) Rural relative to other areas in the country, such as: Kampong Chhnang in Cambodia, Guangxi in China [32]; Bac Giang, Lao Cai and Thai Binh in Vietnam [32,70]; Chattisgarh and Odisha in India [53,57,86,91], East Nusa Tenggara in Indonesia and Zamboanga in the Philippines [32,51,53,57,62,70,86,90] Access and/or topography 2 3 0 5 (7.0) Limited c...…”

An evaluation of the effects of general practitioner–supported patient noncommunicable diseases control model in Shanghai, China

“…Eight incentive measures were implemented to encourage health care providers to apply for the positions at the target community health centres. 17…”