WHO releases guidelines for countries on how to attract, retain doctors, health care workers to rural areas

BMJ News reports on the WHO's recent release of a set of recommendations for countries on how to attract and retain doctors and other health care workers in rural areas (Zarocostas, 7/14).

"Globally, approximately one half of the population lives in rural areas, but less than 38% of the nurses and less than 25% of the physicians work there," according to the WHO. "While getting and keeping health workers in rural and remote areas is a challenge for all countries, the situation is worse in the 57 countries that have an absolute shortage of health workers."

The WHO guidelines come after the adoption of a voluntary code aimed at reducing the recruitment of health workers from developing countries facing medical staff shortages by the World Health Assembly in May. "After a year-long consultative effort, this document proposes sixteen evidence-based recommendations on how to improve the recruitment and retention of health workers in underserved areas," the WHO writes (July 2010).

The guidelines offer "intervention strategies in four main categories: education, regulation, financial incentives, and professional and personal support. They range from the use of targeted admission policies to enroll students from rural backgrounds in training in the health disciplines to compulsory service in rural areas for new graduates," BMJ writes. "The guidance also recommends financial incentives, such as hardship allowances, grants for housing, and free transportation, to create better working and living conditions for health workers," according to BMJ.

"The guidelines are a tool that can be used straightaway to address one of the triggers to internal and international migration: dissatisfaction with living and working conditions in rural areas," WHO Director-General Margaret Chan said, according to the news service.

The article references comments by Manuel Dayrit, head of human resources for health at WHO, who recently spoke of a growing awareness among health leaders over the need to reduce the global health worker shortages, and Jean-Marc Braichet, acting coordinator of WHO's health workforce retention and migration department, who spoke of the challenges of luring qualified doctors from cities to practice in rural communities. The article also notes how "[i]n some African countries, such as the Ivory Coast, the Democratic Republic of the Congo, and Mali, the overproduction of health workers has led to medical unemployment in cities despite shortages in rural areas," a point referenced in the report featuring the WHO recommendations (7/14).