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.
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 The document review included published and unpublished reports, policy notifications and articles on human resources for health (HRH) in Odisha and similar settings.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.
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.
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.
The authors would like to thank senior-level state officials who took time to be interviewed for this study. They also acknowledge the assistance received from Department of Health and Family Welfare (DOHFW), Odisha and extend their gratitude to Dr B.P. Mohapatra, Team Leader State Human Resource Management Unit, DOHFW-Odisha for their technical inputs and support in data collection process.
Behera, M.R., Prutipinyo, C., Sirichotiratana, N. and Viwatwongkasem, C. (2019), "Retention of medical doctors and nurses in rural areas of Odisha state, India – a policy analysis", International Journal of Workplace Health Management, Vol. 12 No. 4, pp. 178-196. https://doi.org/10.1108/IJWHM-05-2018-0057
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