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Developing effective policy strategies to retain health workers in rural Bangladesh: a policy analysis

Rawal, Lal B, Joarder, Taufique, Islam, Sheikh Mohammed Shariful, Uddin, Aftab and Ahmed, Syed Masud 2015, Developing effective policy strategies to retain health workers in rural Bangladesh: a policy analysis, Human resources for health, vol. 13, pp. 1-10, doi: 10.1186/s12960-015-0030-6.

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Title Developing effective policy strategies to retain health workers in rural Bangladesh: a policy analysis
Author(s) Rawal, Lal B
Joarder, Taufique
Islam, Sheikh Mohammed SharifulORCID iD for Islam, Sheikh Mohammed Shariful orcid.org/0000-0001-7926-9368
Uddin, Aftab
Ahmed, Syed Masud
Journal name Human resources for health
Volume number 13
Article ID 36
Start page 1
End page 10
Total pages 10
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2015-05-20
ISSN 1478-4491
1478-4491
Keyword(s) rural retention
policies
human resource for health
Bangladesh
science & technology
social sciences
life sciences & biomedicine
health policy & services
industrial relations & labor
health care sciences & services
business & economics
Summary INTRODUCTION: Retention of human resources for health (HRH), particularly physicians and nurses in rural and remote areas, is a major problem in Bangladesh. We reviewed relevant policies and provisions in relation to HRH aiming to develop appropriate rural retention strategies in Bangladesh.

METHODS: We conducted a document review, thorough search and review of relevant literature published from 1971 through May 2013, key informant interviews with policy elites (health policy makers, managers, researchers, etc.), and a roundtable discussion with key stakeholders and policy makers. We used the World Health Organization's (WHO's) guidelines as an analytical matrix to examine the rural retention policies under 4 domains, i) educational, ii) regulatory, iii) financial, and iv) professional and personal development, and 16 sub-domains.

RESULTS: Over the past four decades, Bangladesh has developed and implemented a number of health-related policies and provisions concerning retention of HRH. The district quota system in admissions is in practice to improve geographical representation of the students. Students of special background including children of freedom fighters and tribal population have allocated quotas. In private medical and nursing schools, at least 5% of seats are allocated for scholarships. Medical education has a provision for clinical rotation in rural health facilities. Further, in the public sector, every newly recruited medical doctor must serve at least 2 years at the upazila level. To encourage serving in hard-to-reach areas, particularly in three Hill Tract districts of Chittagong division, the government provides an additional 33% of the basic salary, but not exceeding US$ 38 per month. This amount is not attractive enough, and such provision is absent for those working in other rural areas. Although the government has career development and promotion plans for doctors and nurses, these plans are often not clearly specified and not implemented effectively.

CONCLUSION: The government is committed to address the rural retention problem as shown through the formulation and implementation of related policies and strategies. However, Bangladesh needs more effective policies and provisions designed specifically for attraction, deployment, and retention of HRH in rural areas, and the execution of these policies and provisions must be monitored and evaluated effectively.
Language eng
DOI 10.1186/s12960-015-0030-6
Field of Research 1110 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2015, Rawal et al.
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30111853

Document type: Journal Article
Collections: School of Exercise and Nutrition Sciences
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.