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Rural Health Workforce

Søren Kudsk-Iversen, Naomi Shamambo, M Dylan Bould
The majority of the world's population lacks access to safe, timely, and affordable surgical care. Although there is a health workforce crisis across the board in the poorest countries in the world, anesthesia is disproportionally affected. This article explores some of the key issues that must be tackled to strengthen the anesthesia workforce in low- and lower-middle-income countries. First, we need to increase the overall number of safe anesthesia providers to match a huge burden of disease, particularly in the poorest countries in the world and in remote and rural areas...
April 2018: Anesthesia and Analgesia
Motlatso Mlambo, Abigail Dreyer, Rainy Dube, Nontsikelelo Mapukata, Ian Couper, Richard Cooke
INTRODUCTION: Medical education in South Africa is facing a major paradigm shift. The urgency to increase the number of suitable, qualified and socially accountable health sciences graduates has brought to the fore the need to identify alternative training platforms and learning environments, often in rural areas. Subsequently, the focus has now shifted towards strengthening primary health care and community based health services. This scoping review presents a synopsis of the existing literature on decentralized training platform (DTP) strategies for medical education internationally, outlining existing models within it and its impact...
March 2018: Rural and Remote Health
Liane Connelly, Beth E Burbach, Colleen Kennedy, Lisa Walters
BACKGROUND: The U.S. nursing workforce is facing a severe shortage of professionals due to an anticipated retirement of more than 500,000 RNs in the next 5 years. METHOD: An Escape to Nursing event was created and delivered in a rural medical center college of nursing in the spring of 2017. This faculty team developed four distinct rooms that were designed with key nursing concepts and patient health conditions. Recruits worked in teams to solve the patient health care puzzle, which then enabled them to proceed to the next room...
March 1, 2018: Journal of Nursing Education
Jennifer L Reed, Stephanie A Prince, Andrew L Pipe, Suzanne Attallah, Kristi B Adamo, Heather E Tulloch, Douglas Manuel, Kerri-Anne Mullen, J George Fodor, Robert D Reid
BACKGROUND: Nurses are the largest professional group within the health care workforce, and their work is perceived as being physically demanding. Regular physical activity helps to prevent or ameliorate cardiometabolic conditions (e.g. cardiovascular disease, diabetes). It is not known whether Canadian nurses are meeting current physical activity guidelines. OBJECTIVE: To assess the influence of the workplace on the physical activity and cardiometabolic health of nurses from hospitals in the Champlain region of Ontario, Canada...
February 13, 2018: International Journal of Nursing Studies
Nilesh Shah, Avinash Alan De Sousa
Compulsory service programmes for MBBS students have existed for many years in India and other parts of the world. Such programmes have been referred to differently as "obligatory", "mandatory", "requisite" and "compulsory" service. Governments look at these programmes as a means to deploy and retain the health workforce even as health professionals are lost to opportunities in other countries. Though these programmes have been successful, they have been carried out by enforcement on medical students to finish a rural bond...
January 23, 2018: Indian Journal of Medical Ethics
Anatole Manzi, Laetitia Nyirazinyoye, Joseph Ntaganira, Hema Magge, Evariste Bigirimana, Leoncie Mukanzabikeshimana, Lisa R Hirschhorn, Bethany Hedt-Gauthier
BACKGROUND: Inadequate antenatal care (ANC) can lead to missed diagnosis of danger signs or delayed referral to emergency obstetrical care, contributing to maternal mortality. In developing countries, ANC quality is often limited by skill and knowledge gaps of the health workforce. In 2011, the Mentorship, Enhanced Supervision for Healthcare and Quality Improvement (MESH-QI) program was implemented to strengthen providers' ANC performance at 21 rural health centers in Rwanda. We evaluated the effect of MESH-QI on the completeness of danger sign assessments...
February 23, 2018: BMC Health Services Research
Tarun Sen Gupta, Peter Johnson, Roy Rasalam, Richard Hays
BACKGROUND: James Cook University (JCU) enrolled its first cohort of 64 in 2000 into a 6-year undergraduate medical program aimed at producing graduates capable of meeting the needs of North Queensland, Australia, with a focus on rural, remote, Indigenous and tropical health. The school's 1465 graduates over 13 cohorts who have a pattern of practice likely to meet the region's health needs. The JCU course was the first new Australian medical program for 25 years. The number of Australian medical schools has since doubled, while enrollments have almost tripled...
February 19, 2018: Medical Teacher
Torres Woolley, Fortunato Cristobal, Jusie Siega-Sur, Simone Ross, Andre-Jacques Neusy, Servando Halili, Carole Reeve
INTRODUCTION: Hundreds of millions of people worldwide lack access to quality health services, largely because of geographic and socioeconomic maldistribution of qualified practitioners. This study describes differences between the practice locations of Philippines medical graduates from two 'socially accountable, community-engaged' health professional education (SAHPE) schools and the practice locations of graduates from two 'conventionally trained' medical schools located in the same respective geographic regions...
February 2018: Rural and Remote Health
Kate Fennell, Melissa Hull, Martin Jones, James Dollman
INTRODUCTION: The prevalence of chronic disease, mortality and suicide rates is higher in rural Australia than in urban centres. Understanding rural Australians' barriers to accessing health services requires urgent attention. The purpose of this study was to compare barriers to help-seeking for physical and mental health issues among rural South Australian adults. METHODS: A total of 409 people from three rural and remote regions in South Australia completed a computer-assisted telephone interview...
February 2018: Rural and Remote Health
Kenneth Maes, Svea Closser, Yihenew Tesfaye, Yasmine Gilbert, Roza Abesha
BACKGROUND: Many Community Health Workers (CHWs) experience the same socioeconomic and health needs as their neighbors, given that they are by definition part of their communities. Yet very few studies aim to measure and characterize experiences of deprivation, poverty, and wellbeing among community health workers. This study quantitatively examines deprivation and wellbeing in Ethiopia's Women's Development Army (WDA), a massive unpaid community health workforce intended to improve population health and modernize the country...
February 14, 2018: BMC Public Health
Halley Vora, Alice Chung, Azaria Lewis, Jim Mirocha, Farin Amersi, Armando Giuliano, Rodrigo F Alban
BACKGROUND: Surgical deserts (SDs) are defined as the geographic maldistribution of general surgeons of six or less per 100,000 population in underserved/rural counties. Disparities have been reported in breast cancer outcomes; however, the effect of SDs remains unknown. We sought to examine the effect of SDs on breast reconstruction (BR) after mastectomy and the differences between patients in both the cohorts. METHODS: Using the Nationwide Inpatient Sample database years 2007-2011, we identified International Classification of Diseases 9th edition codes for breast cancer, mastectomy, and BR in California...
March 2018: Journal of Surgical Research
Tony Smith, Merylin Cross, Susan Waller, Helen Chambers, Annie Farthing, Frances Barraclough, Sabrina W Pit, Keith Sutton, Kuda Muyambi, Stephanie King, Jessie Anderson
Introduction: Health workforce shortages have driven the Australian and other Western governments to invest in engaging more health professional students in rural and remote placements. The aim of this qualitative study was to provide an understanding of the lived experiences of students undertaking placements in various nonmetropolitan locations across Australia. In addition to providing their suggestions to improve rural placements, the study provides insight into factors contributing to positive and negative experiences that influence students' future rural practice intentions...
2018: Journal of Multidisciplinary Healthcare
Viroj Tangcharoensathien, Woranan Witthayapipopsakul, Warisa Panichkriangkrai, Walaiporn Patcharanarumol, Anne Mills
Thailand's health development since the 1970s has been focused on investment in the health delivery infrastructure at the district level and below and on training the health workforce. Deliberate policies increased domestic training capacities for all cadres of health personnel and distributed them to rural and underserved areas. Since 1975, targeted insurance schemes for different population groups have improved financial access to health care until universal health coverage was implemented in 2002. Despite its low gross national income per capita in Thailand, a bold decision was made to use general taxation to finance the Universal Health Coverage Scheme without relying on contributions from members...
January 31, 2018: Lancet
Pieter Serneels, Tomas Lievens
BACKGROUND: Most developing countries face important challenges regarding the quality of health care, and there is a growing consensus that health workers play a key role in this process. Our understanding as to what are the key institutional challenges in human resources, and their underlying driving forces, is more limited. A conceptual framework that structures existing insights and provides concrete directions for policymaking is also missing. METHODS: To gain a bottom-up perspective, we gather qualitative data through semi-structured interviews with different levels of health workers and users of health services in rural and urban Rwanda...
January 26, 2018: Human Resources for Health
Hye Ran Park, Sukh Que Park, Jae Hyun Kim, Jae Chan Hwang, Gwang Soo Lee, Jae-Chil Chang
Objective: In respect of the health and safety of the public, universal access to health care is an issue of the greatest importance. The geographic distribution of doctors is one of the important factors contributing to access to health care. The aim of this study is to assess the imbalances in the geographic distribution of neurosurgeons across Korea. Methods: Population data was obtained from the National Statistical Office. We classified geographic groups into 7 metropolitan cities, 78 non-metropolitan cities, and 77 rural areas...
January 2018: Journal of Korean Neurosurgical Society
Edgar Arnold Lungu, Amarech Guda Obse, Catherine Darker, Regien Biesma
Access to and utilisation of quality healthcare promotes positive child health outcomes. However, to be optimally utilised, the healthcare system needs to be responsive to the expectations of the population it serves. Health systems in many sub-Saharan African countries, including Malawi, have historically focused on promoting access to health services by the rural poor. However, in the context of increasing urbanisation and consequent proliferation of urban slums, promoting health of children under five years of age in these settings is a public health imperative...
2018: PloS One
Kristy Hill, Nichole Harvey, Catrina Felton-Busch, Judy Hoskins, Roy Rasalam, Peter Malouf, Sabina Knight
CONTEXT: In 2012, the new profession of Aboriginal and Torres Strait Islander health practitioner (ATSIHP) was registered under the Health Practitioner Regulation National Law Act 2009. The project in this present study evolved out of the Australian Government\'s recognition of the need for the existing Indigenous health worker (IHW) workforce to meet the minimum qualification requirements for registration as ATSIHPs through recognition of prior learning and/or further education. A total of 53 IHWs participated in the upskilling project between June 2014 and June 2015, with approximately 200 IHWs from Queensland expressing an interest in undertaking the training...
January 2018: Rural and Remote Health
Jeffrey Douaiher, Douglas J Inciarte, Edibaldo Silva
Immigration policy and health care policy remain principal undertakings of the federal government. The two have recently been pursued independently in the judicial and legislative arenas. Unbeknownst to many policymakers, however, national immigration policy and health care policy are linked in ways that, if unattended, could undermine the well-being of a significant portion of the US population, specifically medically underserved rural and urban populations. Using current data from a workforce report of the Association of American Colleges and the published literature, we demonstrate the significant impact that contemporary immigration policy directives may have on the number and distribution of international medical graduates who currently provide-and by the year 2025 will provide-a significant portion of primary health care in the United States, especially in underserved small urban and rural communities...
January 2018: Journal of the American Board of Family Medicine: JABFM
S S Hyder, Mary Amundson
INTRODUCTION: Recruitment of hospitalists and primary care physicians for Critical Access Hospitals and tertiary care hospitals in North Dakota is difficult. To address this challenge, 2 programs were implemented in Bismarck, North Dakota. METHODS: St. Alexius Medical Center created a hospitalist fellowship training program in collaboration with the University of North Dakota School of Medicine and Health Sciences and physicians willing to work in Critical Access Hospitals were offered a joint appointment to teach hospitalist fellows and obtain a clinical academic appointment at the university...
November 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
Sue Kirby, Fabian P Held, Debra Jones, David Lyle
Aim This study explored the partnership between universities and local primary schools to deliver a classroom-based paediatric communication impairment service provided by undergraduate speech pathology students. It aimed to understand how partnerships work to facilitate programme replication. BACKGROUND: The partners included universities sending students on rural clinical placement, local host academic units and primary schools who worked together to provide paediatric speech and language services in primary schools in three sites in Australia...
January 10, 2018: Primary Health Care Research & Development
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