scholarly journals Willingness and professional motivations of medical students to work in rural areas: a study in Alexandria, Egypt

2013 ◽  
Vol 1 (1) ◽  
pp. 4 ◽  
Author(s):  
Aida M. Mohamed

Retaining health workers in rural areas is challenging for a number of reasons, e.g. personal preferences, difficult work conditions and low remuneration. Our aim was to determine the effect of motivational factors on willingness to accept postings to rural underserved areas in Alexandria, Egypt and to identify perceived attributes of rural service.,A cross-sectional survey involving 302 4th-year medical students was conducted in March-July 2012. Logistic regression analysis was used to assess the association between students’ willingness to accept rural postings and their professional motivations, rural exposure and family parental professional and educational status (PPES). Perceived attributes to rural service were also assessed. Over 85% students were born in urban areas and 41.4% came from affluent backgrounds. More than half students reported strong intrinsic motivation to study medicine. After controlling for demographic characteristics and rural exposure, motivational factors significantly influenced willingness to practice in rural areas. High-family PPES was consistently associated with lower willingness to work in rural areas. A sizable portion of medical students are motivated to study and practice medicine in rural areas. Efforts should be made to build on motivation during medical training and designing rural postings, as well as favor lower PPES students for admission and improving organizational and contextual issues of rural service.

Medicina ◽  
2013 ◽  
Vol 49 (6) ◽  
pp. 45
Author(s):  
Kamila Faizullina ◽  
Galina Kausova ◽  
Zhanna Kalmataeva ◽  
Ardak Nurbakyt ◽  
Saule Buzdaeva

Background and Objective. The number of new entrants to higher medical schools of Kazakhstan increased by 1.6 times from 2007 to 2012. However, it is not known how it will affect the shortage of human resources for health. Additionally, human resources for health in rural areas of Kazakhstan are 4 times scarcer than in urban areas. The aim of the present study was to investigate the intentions of students toward their professional future and readiness to work in rural areas, as well as to determine the causes for dropping out from medical schools. Material and Methods. A cross-sectional survey was conducted in 2 medical universities in Almaty during the academic year 2011–2012. The study sample included medical students and interns. In total, 2388 students participated in the survey. The survey tool was an anonymous questionnaire. Results. The students of the first years of studies compared with those of later years of studies were more optimistic about the profession and had more intentions to work in the medical field. Only 8% of the students reported a wish to work in rural localities. On the other hand, 4% of the students did not plan to pursue the profession. On the average, every third medical student dropped out on his/her own request. Conclusions. Associations between intentions to work according to the profession and the year of studies, faculty, and residence area before enrolling in a medical school were documented. The majority of the students who came from rural areas preferred to stay and look for work in a city, which might contribute to an unequal distribution of physicians across the country.


BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e043365
Author(s):  
Subhasish Das ◽  
Md. Golam Rasul ◽  
Md Shabab Hossain ◽  
Ar-Rafi Khan ◽  
Md Ashraful Alam ◽  
...  

IntroductionWe conducted a cross-sectional survey to assess the extent and to identify the determinants of food insecurity and coping strategies in urban and rural households of Bangladesh during the month-long, COVID-19 lockdown period.SettingSelected urban and rural areas of Bangladesh.Participants106 urban and 106 rural households.Outcome variables and methodHousehold food insecurity status and the types of coping strategies were the outcome variables for the analyses. Multinomial logistic regression analyses were done to identify the determinants.ResultsWe found that around 90% of the households were suffering from different grades of food insecurity. Severe food insecurity was higher in urban (42%) than rural (15%) households. The rural households with mild/moderate food insecurity adopted either financial (27%) or both financial and food compromised (32%) coping strategies, but 61% of urban mild/moderate food insecure households applied both forms of coping strategies. Similarly, nearly 90% of severely food insecure households implemented both types of coping strategies. Living in poorest households was significantly associated (p value <0.05) with mild/moderate (regression coefficient, β: 15.13, 95% CI 14.43 to 15.82), and severe food insecurity (β: 16.28, 95% CI 15.58 to 16.97). The statistically significant (p <0.05) determinants of both food compromised and financial coping strategies were living in urban areas (β: 1.8, 95% CI 0.44 to 3.09), living in poorest (β: 2.7, 95% CI 1 to 4.45), poorer (β: 2.6, 95% CI 0.75 to 4.4) and even in the richer (β: 1.6, 95% CI 0.2 to 2.9) households and age of the respondent (β: 0.1, 95% CI 0.02 to 0.21).ConclusionBoth urban and rural households suffered from moderate to severe food insecurity during the month-long lockdown period in Bangladesh. But, poorest, poorer and even the richer households adopted different coping strategies that might result in long-term economic and nutritional consequences.


2015 ◽  
Vol 12 (2) ◽  
pp. 121-125
Author(s):  
KR Thapa ◽  
BK Shrestha ◽  
MD Bhattarai

Background Posting of doctors in remote rural areas has always been a priority for Government; however data are scarce in the country about experience of doctors of working in remote areas after medical graduation.Objective A questionnaire survey of doctors was planned to analyze their experience of working after graduation in remote rural areas in various parts of the country.Method The cross-sectional survey was done by convenience sampling method. A one-page questionnaire with one partially closed-end and five open-end type questions was distributed to the doctors who had worked in remote rural areas after graduation under various governments’ postings.Result Two-third of participants had their home in urban areas and 89.8% had stayed for 1 to 5 years. About half of the participants had difficulty in getting the posting in the remote areas of their choice. Most participants indicated provision of opportunities for Residential (postgraduate) Training as their reasons of going to remote areas as well as their suggestions to encourage young graduates to go there. Similarly most also suggested appropriate career, salary and incentives to encourage doctors to go to work in remote areas. About 85% of participants pointed out the major problem faced while posted in remote areas as difficulty in handling varied situations with no guidance or seniors available around.Conclusion The notable points indicated by the participants are centered on the opportunity for Residential Training and difficulties faced without such training. Residential Training is a priority to be considered while planning the health policy for optimum health care of people.Kathmandu University Medical Journal Vol.12(2) 2014: 121-125


2019 ◽  
Author(s):  
Ingmar Schäfer ◽  
Heike Hansen ◽  
Thomas Ruppel ◽  
Dagmar Lühmann ◽  
Hans-Otto Wagner ◽  
...  

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).


Author(s):  
Hailay Gesesew ◽  
Pamela Lyon ◽  
Paul Ward ◽  
Kifle Woldemichael ◽  
Lillian Mwanri

Evidence exists that suggests that women are vulnerable to negative HIV treatment outcomes worldwide. This study explored barriers to treatment outcomes of women in Jimma, Southwest Ethiopia. We interviewed 11 HIV patients, 9 health workers, 10 community advocates and 5 HIV program managers from 10 institutions using an in-depth interview guide designed to probe barriers to HIV care at individual, community, healthcare provider, and government policy levels. To systematically analyze the data, we applied a thematic framework analysis using NVivo. In total, 35 participants were involved in the study and provided the following interrelated barriers: (i) Availability— most women living in rural areas who accessed HIV cared less often than men; (ii) free antiretroviral therapy (ART) is expensive—most women who have low income and who live in urban areas sold ART drugs illegally to cover ART associated costs; (iii) fear of being seen by others—negative consequences of HIV related stigma was higher in women than men; (iv) the role of tradition—the dominance of patriarchy was found to be the primary barrier to women’s HIV care and treatment outcomes. In conclusion, barriers related to culture or tradition constrain women’s access to HIV care. Therefore, policies and strategies should focus on these contextual constrains.


2019 ◽  
Vol 68 (2) ◽  
pp. 73-80
Author(s):  
Riyadh A. Alhazmi ◽  
R. David Parker ◽  
Sijin Wen

Backround: Emergency medical services (EMS) workers are at risk of exposure to bloodborne pathogens and frequently exposed to blood and bodily fluids through percutaneous injuries. This study aimed to assess the consistency with which standard precautions (SPs) among rural and urban EMS providers were used. Methods: This study consisted of a cross-sectional survey conducted with a sample of certified EMS providers in West Virginia in which we ascertained details about sociodemographic characteristics, and the frequency of consistent SP. An email invitation was sent to a comprehensive list of agencies obtained from the Office of West Virginia EMS. Findings: A total of 248 out of 522 (47%) EMS providers completed the survey. The majority of the EMS providers (76%) consistently complied with SPs; however, more than one third (38%) of urban EMS providers indicated inconsistent use compared with 19% of rural EMS providers ( p = .002). Most EMS providers reported low prevention practices to exposure of blood and body fluids in both areas. Conclusion/Application to Practice: The results emphasize the need to enhanced safe work practices among EMS providers in both rural and urban areas through education and increasing self-awareness. Occupational health professional in municipalities that serve these workers are instrumental in ensuring these workers are trained and evaluated for their compliance with SPs while in the field.


2021 ◽  
Vol 24 (1) ◽  
pp. 68-78
Author(s):  
Rukmini Rukmini ◽  
Lusi Kristiani

One of the health efforts that have the opportunity to improve the health status of the elderly is traditional health services (Yankestrad). This paper aims to describe the use of Yankestrad among the elderly in Indonesia. The data source in this analysis is Riskesdas 2018, a research conducted by the Ministry of Health with the elderly (≥60 years) as the analysis unit. Data were analyzed descriptively. The results showed that the use of Yankestrad in the elderly was 37.0% and self-medication with traditional medicine was 17.3%. Young elderly people mostly use Yankestrad (37.9%), while self-medication with traditional medicine are dominated by elderly women (18.3%) in rural areas (19.5%). The use of Toga in the elderly in Indonesia (31.9%), mostly women (33.3%) in rural areas (36.3%). The most common types of Yankestrad used by the elderly were manual skills, potions, and homemade potions. Male elderly (55.5%) in urban areas (56.5%) used more prepared ingredients, while female elderly (43.6%) in rural areas (46.5%) preferred homemade ingredients. Older people with low expenditure levels tend to take advantage of prepared ingredients or homemade ingredients, while high expenditures tend to take advantage of manual skills. Traditional healers (98.2%) are the type of yakestrad used mostly by the elderly. In conclusion, Yankestrad in Indonesia is mostly used by the elderly, therefore it has the potential to be developed as an alternative model of health services for the elderly. Given the high interest of the elderly with Yankestrad and the use of traditional healers, it is necessary to provide Yankestrad facilities, especially in Puskesmas with traditional health workers who are able to provide safe and quality health services to the elderly. Abstrak Salah satu upaya kesehatan yang berpeluang meningkatkan status kesehatan lansia adalah pelayanan kesehatan tradisional (Yankestrad). Tulisan ini bertujuan untuk mengetahui gambaran pemanfaatan Yankestrad pada penduduk lansia di Indonesia. Sumber data dalam analisis ini adalah Riskesdas 2018. Riset yang dilakukan oleh Kementerian Kesehatan dengan unit analisis lansia (≥60 tahun). Analisis data secara deskriptif. Hasil menunjukkan, pemanfaatan Yankestrad pada lansia 37,0% dan upaya sendiri dengan obat tradisional 17,3%. Lansia muda terbanyak memanfaatkan Yankestrad (37,9%), sedangkan upaya sendiri dengan obat tradisonal didominasi lansia perempuan (18,3%) di perdesaan (19,5%). Pemanfaatan Toga pada lansia di Indonesia (31,9%), terbanyak perempuan (33,3%) di perdesaan (36,3%). Jenis Yankestrad terbanyak dimanfaatkan lansia adalah keterampilan manual, ramuan jadi dan ramuan buatan sendiri. Lansia laki-laki (55,5%) di perkotaan (56,5%) lebih banyak memanfaatkan ramuan jadi, sedangkan lansia perempuan (43,6%) di perdesaan (46,5%) lebih menyukai ramuan buatan sendiri. Lansia dengan tingkat pengeluaran rendah cenderung memanfaatkan ramuan jadi atau ramuan buatan sendiri, sedangkan pengeluaran tinggi cenderung memanfaatkan ketrampilan manual. Penyehat tradisional (98,2%) adalah jenis tenaga terbanyak dimanfaatkan lansia. Kesimpulan, Yankestrad di Indonesia lebih banyak dimanfaatkan oleh lansia, oleh karena itu berpotensi untuk dikembangkan sebagai alternatif model pelayanan kesehatan bagi lansia. Rekomendasi, mengingat tingginya minat para lansia dengan Yankestrad dan pemanfaatan penyehat tradisional, maka diperlukan penyediaan fasilitas Yankestrad khususnya di Puskesmas dengan tenaga kesehatan tradisional yang mampu memberikan pelayanan kesehatan yang aman dan berkualitas bagi para lansia.


2020 ◽  
Author(s):  
Bader Aldebasi ◽  
Abdulaziz I. Alhassan ◽  
Sami Al-Nasser ◽  
Mostafa Abolfotouh

Abstract Background. Many studies are available in the literature about e-health in Saudi Arabia, however, data is limited to a few organizations and does not necessarily reflect the the current and potential use of e-health for health care organizations in the country. The aims of this study were 1)To determine the levels of knowledge, attitude and practice of medical students on e-health, and 2) To identify the predictors of e-health practice. Methods. A cross-sectional survey of 440 medical students at the college of medicine, King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, was conducted, during October/November 2019, using a previously validated questionnaire, to assess: (1) knowledge in three domains; e-health definition (13 statements), fields of application of e-health (8 statements), methods of using e-health (7 statements), (2) attitude toward using e-health (8 statements) and (3) reported practice of e-health in medical training (5 statements). A scoring system was used to calculate the total and percentage score of knowledge, attitude and practice for each student. Multiple regression analysis was applied to identify predictors of e-health practice. Significance was considered at p<0.05. Results. Of 440 medical students surveyed, the majority were females (55.7%), of stream type1 (79.8%) and from families whose monthly income was more than 10,000SR (82.8%). Overall knowledge about e-health was unsatisfactory (PMS=71.6%), with only 43.6% of students reporting satisfactory level. However, this level was satisfactory for fields of application (Percentage mean score-PMS=76.6%) and unsatisfactory for definition of e-health (PMS=70.7%) and methods of its use (PMS=65.7%) domains. Overall attitude towads e-health use was positive (PMS=82.3%), with nearly three-quarters of students (73.4%) reporting positive attitude. Generally, good level of practice of e-health was reported by students (PMS=84.3%), with more than three-quarters of students (78.4%) reporting good practice. Adjusting for age, gender, stream, educational grade and family monthly income, good practice was significantly predicted with higher knowledge (t=2.22, p=0.03) and attitude (t=2.11, p=0.04) scores.Conclusion. This study provides basic information regarding medical students’ knowledge, attitude, and practice on e-health. More resources should be directed to elevate medical students’ knowledge and to motivate them to practice e-health using the available tools.


2020 ◽  
Vol 7 (3) ◽  
pp. 368-375
Author(s):  
Nuraina Nuraina

Maternity waiting home (MWH) is a home built in the compound or near to health facilities that provides standard medical and emergency obstetric care services. MWH is considered to be a key strategy to "bridge the geographical gap" in obstetric care between rural areas with poor access to equipped facilities, and urban areas where the services are available. This study aimed to systematically review the utilization of MWH to improve access to health service. The method of finding articles in this study was in the period 2014 to 2018, free full text, human species, and scholarly journals which were then identified using an electronic database from Pubmed, Proquest and Onesearch. Three articles were carried out with thematic analysis to identify the main points. Factors associated with the utilization of MWH included (1) Distance; (2) Complication during pregnancy; and (3) Income. Barrier in the utilization of MWH were (1) Inadequate number of room and postpartum bed; (2) Lack of water and sanitation facilities; and (3) Unavailable electricity. Partnership between health workers in rural facilities, stronger role of stakeholders, and a broader health system, were expected to increase the utilization of MWH.


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