Retention of medical doctors and nurses in rural areas of Odisha state, India – a policy analysis

Abstract

Purpose Retention of medical doctors and nurses in remote and rural areas is a key issue in India. The purpose of this paper is to assess the relevant policies and provisions with respect to health care professionals, aiming to develop feasible retention strategies in rural areas of Odisha state of India. Design/methodology/approach The study employed documentary review and key informant interviews with policy elites (health planners, policy maker, researchers, etc.). The document review included published and unpublished reports, policy notifications and articles on human resources for health (HRH) in Odisha and similar settings. Throughout the study, the authors adapted World Health Organization’s framework to study policies relevant to HRH retention in rural areas. The adapted framework comprised of the four policy domains, education, regulation, financial incentives, professional and personal support, and 16 recommendations. Findings In Odisha, the district quota system for admission is not practiced; however, students from special tribal and caste (Scheduled Tribe and Scheduled Caste) communities, Socially and Educationally Backward Classes of citizens, and Persons with Disabilities have some allocated quota to study medicine and nursing. Medical education has a provision of community placement in rural hospitals. In government jobs, the newly recruited medical doctors serve a minimum of three years in rural areas. Doctors are given with location-based incentives to work in remote and difficult areas. The government has career development, deployment, and promotion avenues for doctors and nurses; however, these provisions are not implemented effectively. Originality/value The government could address the rural retention problems, as illustrated in the study and put in place the most effective policies and provisions toward recruitment, deployment and attraction of HRH in remote and rural areas. At the same time, implementation HRH strategies and activities must be rigorously monitored and evaluated effectively.

Examining the relationship between living conditions, work environment and intent to stay among nurses in current posts in rural areas of Odisha state, India

“…This indicate that nurses who perceived their work environment and living conditions are supportive intended to work and stay more in remote and rural areas than other nurses. Related findings from other literatures suggest that supportive work environment and living conditions can increase rural retention at work among nurses [36][37][38][39] .…”

Identifying factors affecting dentists retention in deprived areas in Iran

“…The amount and manner of salary payment is a very strong motivating factor on increasing the willingness of dentists to stay in deprived areas. Similarly, Behera et al stated that financial incentives, including double wages and benefits, rural living allowances, etc., play an important role in the retention of physicians and nurses in rural areas of India 33 . Research in Afghanistan also shows that midwives are willing to work in rural centres in exchange for higher wages 31 …”

“…Similarly, Behera et al stated that financial incentives, including double wages and benefits, rural living allowances, etc., play an important role in the retention of physicians and nurses in rural areas of India. 33 Research in Afghanistan also shows that midwives are willing to work in rural centres in exchange for higher wages. 31 Delays in salary payment can reduce the tendency for dentists to stay in disadvantaged areas.…”

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“…Primary care plays a very crucial role in improving population health[ 25 26 ] and planetary health. [ 27 28 ] Primary care providers including CHWs worldwide counsel millions of patients every day and enjoy society's trust and recognition.…”