Physician importation--a solution to developing countries' rural health care problems?

Abstract

Developing countries almost universally suffer from severe health service shortages, particularly in rural areas. Manpower problems are the most critical aspect of the shortages. Iran has recently begun a massive program to increase physician supply in its rural areas by importation of physicians from India, Pakistan, and the Philippines. The present study investigated two questions: What are physicians' reasons for accepting a post in a rural area of another country, and what are the attitudes of residents in such rural

Human resource shortage in India’s health sector: a scoping review of the current landscape

“…1 ). Study characteristics [ 10 , 16 – 102 ] are described in detail in Supplementary Table 2 . The first research question was addressed in 30.6% of studies ( n = 27) whereas 69.3% of studies ( n = 61) addressed the second research question.…”

“…The thematic analysis of data regarding the second research question yielded five kinds of HRH-related problems that are causing a scarcity of HRH in India. The outcomes of each study are described in Supplementary Tables 3 and codes identified under each theme is shown in Supplementary Table 4 [ 10 , 16 – 102 ]. A summary of these themes is provided in Table 2 below:…”

“…Inadequate HRH production Due to an inadequate number of healthcare educational institutions in India, there is a lack of healthcare professionals 10 [ 65 , 66 , 74 , 75 , 80 , 81 , 88 , 102 ] The current medical colleges are also underfunded and underequipped, which results in substandard training of healthcare professionals 3. Job dissatisfaction Poor physical work conditions, autonomy, unhealthy relations with colleagues, boss and management 39 [ 10 , 16 , 18 , 19 , 22 , 24 , 26 – 28 , 30 , 34 , 39 , 41 , 43 , 46 , 51 , 53 , 54 , 58 , 59 , 61 – 66 , 71 , 75 , 78 , 81 , 84 , 88 , 89 , 91 , 92 , 94 , 96 , 99 , 102 ] Inadequate salary, no opportunities for promotion, no respect, and non-recognition leads to dissatisfaction Ineffective management of HRH causes major stress reactions, which can further contribute to job discontent, burnout, and poor QOL …”

Medical Education in the United States: A Resource for the Third World?

“…A study of Iran's recruitment of physicians from other underdeveloped countries in the mid-1970s to fill primary care positions in underserved rural towns and villages concluded that most of these physicians did not plan to remain in Iran and provide long-term care; that often they were not provided with the equipment or facilities necessary to provide effective care; and they on August 14, 2017 by HW Team usually were not preferred by the native populace over Iranian ancillary health workers. 15 Cuba has provided a more effective temporary source of physician manpower to Third World countries. After achieving a relatively high domestic health status, postrevolutionary Cuba has made a significant contribution to health care in countries such as Angola, Ethiopia, and Libya, and has provided virtually the entire health care delivery system for several smaller African nations.…”

Implementation of health screening programs using Ethnomedical resources

“…With minimal training, such practitioners may function to provide relatively low-cost, technologically appropriate, and culturally relevant health care as medical auxiliary personnel. Medical auxiliaries may be just as effective as physicians in diagnostic and therapeutic roles, and may be better accepted by the community (Koch-Weser 1978;Zeighami et al 1978). Studies in the Third World have also shown medical auxiliaries to be highly effective even in technically specialized fields (Climent et al 1978).…”