Division of Health Professions Education, School of Allied Health, University of Western Australia, Perth, WA, Australia.
Duke National University Singapore Medical School, Singapore, Singapore.
Int J Health Policy Manag. 2022 Oct 19;11(10):2022-2037. doi: 10.34172/ijhpm.2021.160. Epub 2021 Nov 15.
Medical workforce shortages in rural and remote areas are a global issue. High-income countries (HICs) and low- and middle-income countries (LMICs) seek to implement strategies to address this problem, regardless of local challenges and contexts. This study distilled strategies with positive outcomes and success from international peer-reviewed literature regarding recruitment, retention, and rural and remote medical workforce development in HICs and LMICs.
The Arksey and O'Malley scoping review framework was utilised. Articles were retrieved from electronic databases Medline, Embase, Global Health, CINAHL Plus, and PubMed from 2010-2020. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guideline was used to ensure rigour in reporting the methodology in the interim, and PRISMA extension for scoping review (PRISMA-ScR) was used as a guide to report the findings. The success of strategies was examined against the following outcomes: for recruitment - rural and remote practice location; for development - personal and professional development; and for retention - continuity in rural and remote practice and low turnover rates.
Sixty-one studies were included according to the restriction criteria. Most studies (n=53; 87%) were undertaken in HICs, with only eight studies from LMICs. This scoping review found implementation strategies classified as Educational, Financial, and Multidimensional were successful for recruitment, retention, and development of the rural and remote medical workforce.
This scoping review shows that effective strategies to recruit and retain rural and remote medical workforce are feasible worldwide despite differences in socio-economic factors. While adjustment and adaptation to match the strategies to the local context are required, the country's commitment to act to improve the rural medical workforce shortage is most critical.
农村和偏远地区的医疗劳动力短缺是一个全球性问题。高收入国家（HICs）和中低收入国家（LMICs）都试图实施战略来解决这个问题，而不论当地的挑战和背景如何。本研究从国际同行评议文献中提取了在 HICs 和 LMICs 中针对招聘、保留和农村及偏远地区医疗劳动力发展具有积极成果和成功的战略。
利用 Arksey 和 O'Malley 的范围综述框架。从电子数据库 Medline、Embase、Global Health、CINAHL Plus 和 PubMed 中检索 2010 年至 2020 年的文章。使用 Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 指南来确保在报告方法时的严谨性，并使用范围综述扩展 (PRISMA-ScR) 作为报告结果的指南。根据以下结果检查战略的成功：招聘方面-农村和偏远地区的实践地点；发展方面-个人和专业发展；保留方面-农村和偏远地区实践的连续性和低离职率。
根据限制标准，有 61 项研究符合纳入标准。大多数研究（n=53；87%）是在 HICs 进行的，只有 8 项研究来自 LMICs。本范围综述发现，招聘、保留和农村及偏远地区医疗劳动力发展的教育、财务和多维实施策略是成功的。
本范围综述表明，尽管社会经济因素存在差异，但在全球范围内，吸引和保留农村和偏远地区医疗劳动力的有效策略是可行的。虽然需要调整和适应以匹配策略与当地情况，但国家采取行动改善农村医疗劳动力短缺的承诺是最重要的。
