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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 The document review included published and unpublished reports, policy notifications and articles on human resources for health (HRH) in Odisha and similar settings.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.

While Australia has continued to invest in polices and strategies aimed at improving rural health service provision, many communities still confront a disproportionate share of the rural workforce shortage. The NSW Rural Doctors Network (RDN) contributes its perspectives about the importance of a whole of life career and the meandering stream concept to support the retention of health professionals rurally. We unpack these concepts and examine how they bring to light a new and useful approach to addressing rural workforce challenges and potentially contribute to building a stronger integrated care approach.

The approach used involved tapping into RDN's 30-years of experience in recruitment and retention of remote and rural health professionals, combined with insights from relevant existing and emerging evidence.

We suggest that reframing retention to consider a life stage approach to career will guide more effective targeting of rural health policies, workforce planning, collaborative approaches and allocation of incentives. We posit that an understanding and acceptance of modern lifestyles and career pathways, and a celebration of career commitment to serving rural communities, is necessary for successful recruitment and retention of Australia's future rural health workforce beyond the training pipeline.

We outline and visually represent RDN's meandering stream approach to building and retaining a capable rural health workforce through addressing life cycle and workforce level needs. This perspective paper draws on RDN's direct experience in the field.

The purpose of this paper is to identify the challenges when recruiting and retaining rural physicians and to ascertain methods that make rural physician recruitment and retention successful. There are studies that suggest rural roots is an important factor in recruiting rural physicians, while others look at rural health exposure in medical school curricula, self-actualization, community sense and spousal perspectives in the decision to practice rural medicine.

An extensive literature review was performed using Academic Search Complete, PubMed and The Cochrane Collaboration. Key words were rural, rural health, community hospital(s), healthcare, physicians, recruitment, recruiting, retention, retaining, physician(s) and primary care physician(s). Inclusion criteria were peer-reviewed full-text articles written in English, published from 1997 and those limited to USA and Canada. Articles from foreign countries were excluded owing to their unique healthcare systems.

While there are numerous articles that call for special measures to recruit and retain physicians in rural areas, there is an overall dearth. This review identifies several articles that suggest recruitment and retention techniques. There is a need for a research agenda that includes valid, reliable and rigorous analysis regarding formulating and implementing these strategies.

Rural Americans are under-represented when it comes to healthcare and what research there is to assist recruitment and retention is difficult to find. This paper identify the relevant research and highlights key strategies.

Education, training and continuing professional development are amongst the evidence-based initiatives for attracting and retaining rural and remote health professionals. With rapidly increasing access to and use of digital technology worldwide, there are new opportunities to leverage training and support for those who are working in rural and remote areas. In this paper we determine the key elements associated with the utility of digital technologies to provide education, training, professional learning and support for rural health workforce outside the University and tertiary sector.

A scoping review of peer-reviewed literature from Australia, Canada, US and New Zealand was conducted in four bibliographic databases – Medline complete, CINAHL, Academic Search complete and Education Complete. Relevant studies published between January 2010 and September 2020 were identified. The Levac et al. (2010) enhanced methodology of the Arksey and O'Malley (2005) framework was used to analyse the literature.

The literature suggests there is mounting evidence demonstrating the potential for online platforms to address the challenges of rural health professional practice and the tyranny of distance. After analysing 22 publications, seven main themes were found – Knowledge and skills (n = 13), access (n = 10), information technology (n = 7), translation of knowledge into practice (n = 6), empowerment and confidence (n = 5), engagement (n = 5) and the need for support (n = 5). Ongoing evaluation will be critical to explore new opportunities for digital technology to demonstrate enhanced capability and retention of rural health professionals.

To date there has been limited examination of research that addresses the value of digital platforms on continuing professional development, education and support for rural health professionals outside the university and tertiary training sectors.

Devolution of fiscal and administrative autonomy to public schools is a global phenomenon now. Various models of school autonomy have been adopted both in developing and developed countries. The purpose of this paper is to explore the impact of devolution of fiscal autonomy to public primary schools through Parent–Teacher Councils (PTCs) on retention of primary school children in the Khyber Pakhtunkhwa (KP) province, Pakistan.

Two sources of data were used to analyze the research question: Education Management Information System for the years 2006–2011 and 2007–2012, and a specially designed survey questionnaire used to compile information about PTCs from 222 public primary schools in the KP Province. Multiple linear regressions were conducted to examine whether PTC reforms are related to retention rates. An education production function approach was used to examine the effect of “inputs” (PTC reform) on “outputs” (retention).

The regression results indicate that reforms in procedural mechanisms to spend PTC budget and schools with separate classrooms for each grade level are significant in improving retention to the last grade of primary. The results also indicate that retention in all-girls’ schools tend to be significantly lower compared to all-boys’ schools.

First, the integration of data sets resulted in a small sample size, 361 schools, out of which the researcher could visit only 222 schools (10 schools per district) due to time and financial constraints. There may be a probability that with a larger sample size the author findings may look slightly different. However, this is the only current data set collected by the researcher in KP, Pakistan. Second, an ideal way of calculating retention is to track each and every child enrolled in a school over a period of five years and to calculate retention at the end of Grade 5 called true cohort model. However, due to unavailability of such kind of data, a more commonly used method, called reconstructed cohort method, is employed. In this method, data on enrollment by grade are used for six consecutive years, with an assumption that the student flow rates will remain unchanged over time and across grades.

The findings of this study provide vital policy input to the Government of Pakistan in particular and other developing countries in general. The study reveals that PTCs have critical impacts on educational outcomes, school productivity and return on public sector educational investment thus providing an impetus for further strengthening of PTC and community participation. Besides, this study offers significant implications as to how school-based management programs will lead to outcomes under resource scarcity in developing countries.

The paper has implications for the role of school leadership and community participation and for how to engender community involvement in marginalized areas where communities often do not have the time, resources or confidence to participate in their schools. Besides, community participation in parent–teacher meetings means that the school budget is spent transparently and with consensus. Hence, the chances of misuse of funds are minimized to a considerable extent, a dilemma faced by many developing countries. Finally, the collection of PTC-related data regularly especially details about budget allocated, spent and, the unutilized budget may result in better record keeping, which was found lacking during the visit.

The uniqueness and originality of this paper can be gauged from the fact that no systematic study exists with regards to the impact of school autonomy on students’ retention to the last grade of primary in KP province – a poor and conflict-ridden region in a low-income country (Pakistan). Also, the data collection from primary and secondary sources was not an easy task. However, the researcher as a civil servant has to use personal contacts to collect primary and secondary data. Hence, this study is unique and first of its kind in nature. No such research has been conducted so far by any researcher, especially in KP.

The paper aims to analyse how the medical profession, the pro‐competition organisation, and the rural community have responded to the rural doctor shortage with reference to international medical graduates (IMGs) as reported in Australian newspapers.

Utilising the commercially available database LexisNexis during 2003, the author keyed in “overseas trained doctors” and retrieved 641 Australian newspaper articles. The qualitative data analysis software NVivo2 has assisted the author to organise the data, informed by critical realism and narrative analysis.

While the medical profession is undoubtedly committed to serving the health needs of the Australian public, the medical community is less than united in addressing the rural doctor shortage, especially through the employment of large numbers of IMGs. The handling of IMGs has led to tensions not only between the locally trained and IMGs, but also between rural and non‐rural doctors, and between younger and established doctors. The medical professional institutions seemed relatively detached from the adverse consequences of the shortage of doctors in the rural community. This contrasts the efforts demonstrated by the Rural Doctors Association and the rural community.

This paper concludes with a critical realist and narrative analysis and resolving of the rural doctor shortage and recommends close communication and consultation among the diverse interest groups rather than their engaging in blaming one another. This would be an obvious starting point to address the rural doctor shortage, which may partly be achieved by the effective use of services by IMGs.

This chapter reports a study of school provision for first generation learners in a tribal community in Maharashtra, India. The chapter considers how a group of children transferred from a government school provision of poor quality into a new and inclusive privately funded school with a more child centered approach. It examines issues relating both, to access and the quality of education available to meet the needs of first generation learners. The main aim of this study was to investigate educational opportunities and the challenges of this change in provision from the perspectives of children and their parents. This study provides unique insights into the needs of first generation learners by presenting their own voices as a means of articulating their experiences through a process of transition.

The purpose of this paper is to investigate the effect of commitment and customer’s satisfaction on the relationship between service quality and customer retention.

The research was conducted on the entire customer rural banks (BPR) in Makassar, South Sulawesi Province; the sample size comprised 300 respondents. Analysis equipment used in this study is a quantitative approach that is inferential statistical analysis with structural equation modeling based variance is known as a method WarpPLS.

The results of the analysis show that there is significant influence between the variables of service quality, commitment, customer satisfaction, and customer retention. It was also found that the results of the variables commitment and customer satisfaction mediate the effect of service quality on customer’s retention.

The study showed the mediation effect (using the Sobel test) of service quality on customer retention using commitment and customer satisfaction as intervening variables in rural banks; and the study was conducted in the customer rural banks (BPR) in Makassar, South Sulawesi Province, where no such study for this relationship has been conducted previously.

This study seeks to undertake a systematic review to consolidate existing empirical evidence on the impact of financial and non‐financial incentives on motivation and retention of health workers in Ghana's district hospitals.

The study employed a purely quantitative design with a sample of 285 health workers from ten district hospitals in four regions of Ghana. A stepwise regression model was used in the analysis.

The study found that financial incentives significantly influence motivation and intention to remain in the district hospital. Further, of the four factor model of the non‐financial incentives, only three (leadership skill and supervision, opportunities for continuing professional development and availability of infrastructure and resources) were predictors of motivation and retention.

A major limitation of the study is that the sample of health workers was biased towards nurses (n=160; 56.1 percent). This is explained by their large presence in remote districts in Ghana. A qualitative approach could enrich the findings by bringing out the many complex views of health workers regarding issues of motivation and retention, since quantitative studies are better applied to establish causal relationships.

The findings suggest that appropriate legislations backing salary supplements, commitment‐based bonus payments with a set of internal regulations and leadership with sound managerial qualities are required to pursue workforce retention in district hospitals.

This study seeks to explore health workers' perceptions and experiences on incentives for motivating and retaining them in primary health-care facilities in rural Ghana.

Phenomenological research design was used to explore health workers’ experiences and perceptions on their incentive packages. Sixty-eight in-depth interviews were conducted with health-care workers in primary health-care facilities and analyzed using thematic analysis approach.

The findings show health-care workers’ perceptions on their incentives, ranging from low awareness, unfair distribution, favoritism, means of punishment and incentives regarded unattractive. The preferred incentive packages identified were salary increase, housing availability, recognition, adequate supplies, and risk and responsibility allowances. Health-care workers suggested for the modification of incentives including vehicle importation waiver, reduction in study leave years and opportunity to pursue desired courses.

The findings suggest that incentives that align with health-care workers’ preferences can potentially improve their motivation and influence retention. Health-care workers’ concern on incentives having been used as favors and punishment as well as unfair distribution should be addressed by health managers and policymakers, to achieve the desired purpose of motivating and retaining them in rural areas. Appropriate internal monitoring mechanisms are needed for incentives regulation and to improve health workers’ retention in rural Ghana.