scholarly journals Increasing Rural Recruitment and Retention through Rural Exposure during Undergraduate Training: An Integrative Review

2020 ◽  
Vol 17 (17) ◽  
pp. 6423
Author(s):  
Jens Holst
Keyword(s):  
Urban Areas ◽  
Medical Training ◽  
Rural Practice ◽  
Integrative Review ◽  
High Quality Research ◽  
Cross Sectional ◽  
Recruitment And Retention ◽  
Hand Search ◽  
Access To Medical Care ◽  
Practice Methods

Objectives: Ensuring nationwide access to medical care challenges health systems worldwide. Rural exposure during undergraduate medical training is promising as a means for overcoming the shortage of physicians outside urban areas, but the effectiveness is widely unknown. This integrative review assesses the effects of rural placements during undergraduate medical training on graduates’ likelihood to take up rural practice. Methods: The paper presents the results of a longitudinal review of the literature published in PubMed, Embase, Google Scholar and elsewhere on the measurable effects of rural placements and internships during medical training on the number of graduates in rural practice. Results: The combined database and hand search identified 38 suitable primary studies with rather heterogeneous interventions, endpoints and results, mostly cross-sectional and control studies. The analysis of the existing evidence exhibited predominantly positive but rather weak correlations between rural placements during undergraduate medical training and later rural practice. Beyond the initial scope, the review underpinned rural upbringing to be the strongest predictor for rural practice. Conclusions: This review confirms that rural exposure during undergraduate medical training to contributes to recruitment and retention in nonurban settings. It can play a role within a broader strategy for overcoming the shortage of rural practitioners. Rural placements during medical education turned out to be particularly effective for rural-entry students. Given the increasing funding being directed towards medical schools to produce graduates that will work rurally, more robust high-quality research is needed.

scholarly journals Regional differences in reasons for consultation and general practitioners’ spectrum of services in Northern Germany – Results of a cross-sectional observational study

2019 ◽  
Author(s):  
Ingmar Schäfer ◽  
Heike Hansen ◽  
Thomas Ruppel ◽  
Dagmar Lühmann ◽  
Hans-Otto Wagner ◽  
...  
Keyword(s):  
Observational Study ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Training ◽  
Practice Trial ◽  
Cross Sectional ◽  
Federal States ◽  
German Federal States ◽  
Number Of Patients ◽  
Individual Consultation

Abstract Background Among other factors, the patients’ consultation reasons and GPs’ spectrum of services determine the process and outcome of the medical treatment. So far, however, there has been little information on differences in reasons for consultation and GPs’ services between urban and rural areas. Our study’s goal was thus to investigate these factors in relation to the regional location of GPs’ practices. Methods We conducted a cross-sectional observational study based on standardised GP interviews in a quota sampling design. All counties and independent cities within a radius of 120 km around Hamburg were divided into three regional categories (urban area, environs, rural area) and stratified proportionally to the population size. Differences in the number of reasons for consultation and services were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the German federal states and administrative districts. Differences in individual consultation reasons and services were identified by logistic regression via stepwise forward and backward selection. Results Primary care practices in 34 of the 37 selected administrative districts (91.9%) were represented in the dataset. In total, 211 GPs were personally interviewed. On average, GPs saw 344 patients per month with a slightly higher number of patients in rural areas. They reported 59.1 ± 15.4 different reasons for consultation and 30.3 + 3.9 different services. There was no statistically significant regional variation in the number of different consultation reasons, but there was a broader service spectrum by rural GPs (ß=-1.42; 95% confidence interval -2.75/-0.08; p=0.038) which was statistically explained by a higher level of medical training. Additionally, there were differences in the frequency of individual consultation reasons and services between rural and urban areas. Conclusion GPs in rural areas performed more frequently services usually provided by medical specialists in urban areas. This might be caused by a low availability of specialists in rural areas. The association between medical training and service spectrum might imply that GPs compensate the specific needs of their patients by completing advanced medical training before or after setting up a medical practice. Trial registration The study was registered in ClinicalTrials.gov (NCT02558322).

scholarly journals A Descriptive, Cross-Sectional Study of Ugandan Students in Health Care Education regarding Postgraduate Migration and Future Practice

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Arabat Kasangaki ◽  
Andrew Macnab ◽  
Faith Gagnon
Keyword(s):  
Health Care ◽  
Low Income ◽  
Urban Areas ◽  
Community Health Centers ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Rural Practice ◽  
Low Income Countries ◽  
Cross Sectional ◽  
Future Practice

A growing challenge of globalization is the migration of many healthcare trainees to richer nations when they complete their education. This loss of intellectual capital compromises the ability of low-income countries to provide adequate health care. Despite recognition of this loss most African nations keep no track of those they train. Effective investment in health care demands retention of this resource; the ability to direct healthcare providers where needed; understanding of local factors driving migration, choices regarding postgraduate training abroad, and future practice preference. Self-administered questionnaires were distributed to a random sample of 200 Uganda College of Health Sciences students for anonymous completion; 141/200 (70.5%) were completed; 84% of respondents intended to pursue postgraduate studies abroad; 63% to migrate within five years of graduation; 57% to work in urban areas. While partly due to global trends and awareness of international opportunities, this negative trend of migration and shunning rural practice is also influenced by sociopolitical and educational elements within Uganda. One option (adopted elsewhere) is mandatory practice in government community health centers for a period following graduation. But the ethics, consequences, and implications of current international migratory trends need to be addressed locally and by the global medical education community.

scholarly journals Regional differences in reasons for consultation and general practitioners’ spectrum of services in Northern Germany – Results of a cross-sectional observational study

2019 ◽  
Author(s):  
Ingmar Schäfer ◽  
Heike Hansen ◽  
Thomas Ruppel ◽  
Dagmar Lühmann ◽  
Hans-Otto Wagner ◽  
...  
Keyword(s):  
Observational Study ◽  
Rural Areas ◽  
Urban Areas ◽  
Medical Training ◽  
Practice Trial ◽  
Cross Sectional ◽  
Federal States ◽  
German Federal States ◽  
Number Of Patients ◽  
Individual Consultation

Abstract Background Among other factors, the patients’ consultation reasons and GPs’ spectrum of services determine the process and outcome of the medical treatment. So far, however, there has been little information on differences in reasons for consultation and GPs’ services between urban and rural areas. Our study’s goal was thus to investigate these factors in relation to the regional location of GPs’ practices. Methods We conducted a cross-sectional observational study based on standardised GP interviews in a quota sampling design. All counties and independent cities within a radius of 120 km around Hamburg were divided into three regional categories (urban area, environs, rural area) and stratified proportionally to the population size. Differences in the number of reasons for consultation and services were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the German federal states and administrative districts. Differences in individual consultation reasons and services were identified by logistic regression via stepwise forward and backward selection. Results Primary care practices in 34 of the 37 selected administrative districts (91.9%) were represented in the dataset. In total, 211 GPs were personally interviewed. On average, GPs saw 344 patients per month with a slightly higher number of patients in rural areas. They reported 59.1 ± 15.4 different reasons for consultation and 30.3 + 3.9 different services. There was no statistically significant regional variation in the number of different consultation reasons, but there was a broader service spectrum by rural GPs (ß=-1.42; 95% confidence interval -2.75/-0.08; p=0.038) which was statistically explained by a higher level of medical training. Additionally, there were differences in the frequency of individual consultation reasons and services between rural and urban areas. Conclusion GPs in rural areas performed more frequently services usually provided by medical specialists in urban areas. This might be caused by a low availability of specialists in rural areas. The association between medical training and service spectrum might imply that GPs compensate the specific needs of their patients by completing advanced medical training before or after setting up a medical practice. Trial registration The study was registered in ClinicalTrials.gov (NCT02558322).

scholarly journals Factors influencing recruitment and retention of professional nurses, doctors and allied health professionals in rural hospitals in KwaZulu Natal

2017 ◽  
Vol 22 ◽  
Author(s):  
J. L. Haskins ◽  
Sifiso A. Phakathi ◽  
Merridy Grant ◽  
Christiane M. Horwood
Keyword(s):  
Rural Communities ◽  
Health Professionals ◽  
Rural Areas ◽  
Urban Areas ◽  
Allied Health Professionals ◽  
Cross Sectional ◽  
Recruitment And Retention ◽  
Factors Influencing ◽  
Kwazulu Natal ◽  
Professional Nurses

Introduction: In South Africa fewer health professionals (HPs) work in rural areas compared to urban areas, despite rural communities having greater health needs. This study explores factors influencing recruitment and retention of three categories of HPs in KwaZulu-Natal and has implications about how to retain them in rural areas.Methods: A cross-sectional, descriptive survey was conducted in 8 hospitals, 5 rural and 3 urban, in one district in KZN in 2011. Data were collected on single day in each hospital and all HPs on duty were requested to participate. We compared responses from rural and urban based HP as well as professional nurses (PNs), doctors, and allied HPs.Results: 417 questionnaires were completed: 150 from HPs in rural and 267 from HPs in urban hospitals. Perceptions of living/working in rural areas is negative and the quality of health care provided in rural areas is perceived as poor by all categories of HP. Rural-basedHPs were more likely to report living apart from spouse/partner (72.1% vs 37.0%, p < 0.001)and children (76.7% vs 36.9%, p < 0.001), and living in hospital accommodation (50.8% vs 28.9%; p < 0.001).Conclusions: Decisions made by HP about where to work are complex, multifactorial and should be tailored to each category of health professional.

KEJADIAN PENYAKIT HIPERTENSI DAN INDEKS MASSA TUBUH PADA PEREMPUAN YANG TINGGAL DI PEDESAAN DAN PERKOTAAN

2019 ◽  
pp. 127-136
Author(s):  
Venti Agustina
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Body Mass ◽  
Rural Women ◽  
Urban Areas ◽  
Stage I ◽  
Normal Body Mass Index ◽  
Cross Sectional ◽  
Normal Body ◽  
Stadium I

Hipertensiadalah penyebab kematian utama di Indonesia. Kematian akibat hipertensi lebih banyak terjadi di perkotaan dibandingkan di desa. Tingginya kejadian hipertensi dipengaruhi oleh faktor yang dapat dikontrol (obesitas,berat badan lebih, konsumsi garam berlebih,aktivitas fisik rendah, perokok, dan konsumsi alkohol) dan faktor yang tidak dapat dikontrol (genetik, usia, dan jenis kelamin). Penelitian bertujuan memberikan gambarandistribusi tekanan darah dan indeks massa tubuh (IMT) pendudukperempuan di kota maupun di desa.Desain penelitian adalah deskriptif kuatitatif dengan pendekatan cross sectional. Data primer didapatkan melalui pengukuran tekanan darah, tinggi badan dan berat badan. Penelitian dilakukan di Desa Kutowinangun Kidul, Kecamatan Tingkir,Salatiga yang mewakili penduduk perempuan di perkotaan dan Desa Batur, Kecamatan Getasan, Kabupaten Semarangyang mewakili penduduk perempuan pedesaan. Adapun jumlah sampel masing-masing 66 respondendan 72responden. Hasil penelitian menunjukkan bahwa kejadian penyakit hipertensi, resiko obese dan obese lebih didominasi oleh respondendi perkotaan dibandingkan di pedesaan dengan rentang usia di atas 46 tahun. Respondendi desa dengan indeks massa tubuh normal cenderung mengalami pre-hipertensi (8,3%) dan hipertensi stadium I (6,9%) sementararesponden dengan resiko obese dan obese cenderung mengalami hipertensi stadium I (1,4%).Respondendi kota dengan indeks massa tubuh normal cenderung mengalami pre hipertensi (6,06%), hipertensi stadium I (4,5%) dan II (7,5%). Responden dengan resiko obese cenderung mengalami hipertensi stadium I (4,5%), dan responden dengan obese I dan II cenderung mengalami pre-hipertensi (4,5%).   Hypertension is the leading cause of death in Indonesia. Deaths due to hypertension are more common in urban areas than in villages. The high incidence of hypertension is influenced by factors that can be controlled (obesity, overweight, excessive salt consumption, low physical activity, smokers, and alcohol consumption) and factors that cannot be controlled (genetic, age, and sex). The study aimed to provide an overview of blood pressure distribution and body mass index (BMI) of female residents in cities and villages. The study design was descriptive quantitative with a cross sectional approach. Primary data was obtained through measurements of blood pressure, height and weight. The study was conducted in Kutowinangun Kidul Village, Tingkir Subdistrict, Salatiga representing women in urban areas and Batur Village, Getasan Subdistrict, Semarang Regency, representing rural women. The number of samples was 66 respondents and 72 respondents respectively. The results showed that the incidence of hypertension, the risk of obese and obese was more dominated by respondents in urban areas than in rural areas with ages above 46 years. Respondents in villages with normal body mass index tended to experience pre-hypertension (8.3%) and stage I hypertension (6.9%) while respondents with obese and obese risk tended to experience stage I hypertension (1.4%). Respondents in cities with normal body mass index tended to experience pre-hypertension (6.06%), stage I hypertension (4.5%) and II (7.5%). Respondents with obese risk tended to experience stage I hypertension (4.5%), and respondents with obese I and II tended to experience pre-hypertension (4.5%).

HIV INFECTION AND SOME RELATED FACTORS IN FEMALE MASSAGE THERAPISTS IN QUANG NGAI PROVINCE

2015 ◽  
pp. 57-60
Author(s):  
Xuan Chuong Tran ◽  
Thi Thanh Hoa Le ◽  
Ngoc Van Nguyen ◽  
Thanh Nguyen
Keyword(s):  
Hiv Infection ◽  
Urban Areas ◽  
Risk Groups ◽  
Sexual Contact ◽  
Related Factor ◽  
Related Factors ◽  
Cross Sectional ◽  
Keywords Hiv ◽  
Study Results ◽  
Massage Therapists

Background: HIV/AIDS is still a dangerous infection in Vietnam and in the world. Studying of HIV infection and related factors in high risk groups, including female massage therapists is therefore very important. Aims: 1. To study the HIV infection in female massage therapists in Quang Ngai province. 2. To fine some related factors to HIV infection. Patients and methods: Female massage therapists working in Quang Ngai province. Cross-sectional, descriptive study. Results: The rate of HIV infection was 0.99%. Group older than 22 years old had higher rate of infection than group under 22 years old (1.80% vs 0.69%). The girls from urban areas or not using condom had higher rate of infection than group from rural or not using condom (1.57% vs 0.47% and 7.32% vs. 0.57%). Most of HIV infected belong to single or divorce groups. Conclusions: The rate of HIV infection in female massage therapists in Quang Ngai province was 0.99%. The HIV infection related factor was not using condom in sexual contact. Keywords: HIV, female massage therapists, Quang Ngai

scholarly journals Knowledge and intake of folic acid to prevent neural tube defects among pregnant women in urban China: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mingming Cui ◽  
Xiao-Lin Lu ◽  
Yan-Yu Lyu ◽  
Fang Wang ◽  
Xiao-Lu Xie ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Neural Tube ◽  
Neural Tube Defects ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Unplanned Pregnancy ◽  
Urban China ◽  
Cross Sectional

Abstract Background The prevalence of neural tube defects (NTDs) in China declined during 2000–2017 with periconceptional folic acid (FA) supplementation, which is effective in reducing the risk of birth defects. We aimed to assess the knowledge and actual use of FA among Chinese pregnant women and to explore factors associated with FA use before pregnancy. Methods All data were collected in face-to-face interviews during health visits among pregnant women. We collected information about knowledge and use of FA supplements and demographic, socioeconomic, and health status. One maternity and childcare hospital was chosen in each of four cities: Beijing, Huaibei, Kunming, and Haikou. In total, 435 pregnant women were randomly recruited for interviews conducted from June to December 2016. Results A total of 428 pregnant women were included in this survey. Of these, 82.0% (351/428) knew that FA can prevent NTDs, and 75.9% (325/428) knew the correct time to take FA. Overall, 65.9% (282/428) of women knew both that FA can prevent NTDs and the recommended time to take FA before pregnancy. Approximately 95.1% (407/428) of women reported having ever taken FA, only 46.3% (198/428) had begun to take FA supplementation before conception, and 64.5% (109/169) of women from rural areas failed to take FA before pregnancy. Women living in northern China (odds ratio [OR] = 1.81, 95% confidence interval [CI], 1.18–2.77), those with unplanned pregnancy (OR = 1.99, 95% CI 1.30–3.04), and highly educated women (OR = 2.37, 95% CI 1.45–3.88) were more likely to know about FA. Women who were homemakers (OR = 1.94, 95% CI 1.21–3.11) and had unplanned pregnancy (OR = 6.18, 95% CI 4.01–9.53) were less likely to begin taking FA before pregnancy. Conclusions Our survey showed that most pregnant women knew about FA. Although preconception intake of FA can help to reduce NTDs, improving the rate of FA intake before pregnancy is needed in urban areas of China, especially among homemakers and women from rural areas or with unplanned pregnancy. Campaigns are needed to increase awareness about FA and FA use before pregnancy among rural women, homemakers, and those with unplanned pregnancy and lower education levels.

scholarly journals Rural–Urban Differences in the Factors Affecting Depressive Symptoms among Older Adults of Two Regions in Myanmar

2021 ◽  
Vol 18 (6) ◽  
pp. 2818
Author(s):  
Yuri Sasaki ◽  
Yugo Shobugawa ◽  
Ikuma Nozaki ◽  
Daisuke Takagi ◽  
Yuiko Nagamine ◽  
...  
Keyword(s):  
Older Adults ◽  
Middle School ◽  
Depressive Symptoms ◽  
Rural Areas ◽  
Urban Areas ◽  
Depression Scale ◽  
Wealth Index ◽  
School Level ◽  
Cross Sectional ◽  
Middle School Level

The aim of the study was to investigate rural–urban differences in depressive symptoms in terms of the risk factors among older adults of two regions in Myanmar to provide appropriate intervention for depression depending on local characteristics. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from the two regions, for face-to-face interviews. Depressive symptoms were assessed using the 15-item version of the Geriatric Depression Scale (GDS). Depressive symptoms were positively associated with living in rural areas (B = 0.42; 95% confidence interval (CI): 0.12,0.72), female (B = 0.55; 95% CI: 0.31,0.79), illness during the preceding year (B = 0.68; 95% CI: 0.45,0.91) and non-Buddhist religion (B = 0.57; 95% CI: 0.001,1.15) and protectively associated with education to middle school level or higher (B = −0.61; 95% CI: −0.94, −0.28) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.30, −0.10). In women in urban areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.78; 95% CI: 0.36, 1.20) and protectively associated with education to middle school level or higher (B = −0.67; 95% CI: −1.23, −0.11), middle or high wealth index (B = −0.92; 95% CI: −1.59, −0.25) and the frequency of visits to religious facilities (B = −0.20; 95% CI: −0.38, −0.03). In men in rural areas, illness during the preceding year was positively associated with depressive symptoms (B = 0.87; 95% CI: 0.33, 1.42). In women in rural areas, depressive symptoms were positively associated with illness during the preceding year (B = 0.83; 95% CI: 0.36, 1.30) and protectively associated with primary education (B = −0.62; 95% CI: −1.12, −0.12) and the frequency of visits to religious facilities (B = −0.44; 95% CI: −0.68, −0.21). Religion and wealth could have different levels of association with depression between older adults in the urban and rural areas and men and women. Interventions for depression in older adults should consider regional and gender differences in the roles of religion and wealth in Myanmar.

scholarly journals Maternal depression and loss of children under the one-child family planning policy in China: a cross-sectional study of 300 000 women

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048554
Author(s):  
Hanyu Wang ◽  
Eric Frasco ◽  
Jie Shang ◽  
Minne Chen ◽  
Tong Xin ◽  
...  
Keyword(s):  
Family Planning ◽  
Maternal Depression ◽  
Urban Areas ◽  
The Elderly ◽  
Population Based ◽  
Cross Sectional Study ◽  
Only Child ◽  
Cross Sectional ◽  
Live Births ◽  
Child Group

ObjectivesThis study aims to explore the association between maternal depression and the loss of the only child under the family-planning (FP) policy.DesignCross-sectional data from a Chinese population-based study were analysed.SettingPopulation from 10 (5 rural and 5 urban) areas in China.ParticipantsAround 300 000 females were included in the study. The FP group was defined as women with one or two live births. Those with no surviving child were classified into the loss-of-only-child group. The non-FP group included women who had more than two live births. Logistic regression was used to assess the relationship between major depressive disorder (MDD) and family types, after stratification and adjustment.OutcomeMDD was assessed using the Composite International Diagnostic Inventory.ResultsThe odds of MDD are 1.42 times higher in the FP group in general (OR=1.42, 95% CI: 1.28 to 1.57), as opposed to the non-FP group. In particular, the odds of MDD are 1.36 times greater in the non-loss-of-only-child group (OR=1.36, 95% CI: 1.21 to 1.51) and 2.80 (OR=2.80, 95% CI: 0.88 to 8.94) times greater in the loss-of-only-child group, compared with the non-FP group. The associations between FP groups and MDD appeared to be stronger in the elderly population, in those who were married, less educated and those with a higher household income. The association was found progressively stronger in those who lost their only child.ConclusionsPeople in the FP group, especially those who lost their only child, are more susceptible to MDD than their counterparts in the non-FP group. Mental health programmes should give special care to those who lost their only child and take existing social policies and norms, such as FP policies, into consideration.

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