• Cochrane Db Syst Rev · Jan 2009

    Review

    Interventions for increasing the proportion of health professionals practising in rural and other underserved areas.

    • Liesl Grobler, Ben J Marais, S A Mabunda, P N Marindi, Helmuth Reuter, and Jimmy Volmink.
    • Institute of Infectious Disease and Molecular Medicine (IIDMM), University of Cape Town, Faculty of Health Sciences, Anzio Road, Observatory, Western Province, South Africa, 7925. liesl.grobler@uct.ac.za
    • Cochrane Db Syst Rev. 2009 Jan 21 (1): CD005314CD005314.

    BackgroundThe inequitable distribution of health professionals, within and between countries, poses an important obstacle to the achievement of optimal attainable health for all.ObjectivesTo assess the effectiveness of interventions aimed at increasing the proportion of health professionals working in rural and other underserved areas.Search StrategyWe searched the specialised register of the Cochrane Effective Practice and Organisation of Care Group (up to July 2007), the Cochrane Central Register of Controlled Trials (CENTRAL) and the Database of Abstracts of Reviews of Effectiveness (up to July 2007), MEDLINE (1966 to July 2007), EMBASE (1988 to July 2007), CINAHL (1982 to July 2007) and LILACS (up to July 2007). We also searched reference lists of all papers and relevant reviews identified, and contacted authors of relevant papers regarding any further published or unpublished work.Selection CriteriaRandomised controlled trials, controlled trials (not strictly randomised), controlled before-after studies and interrupted time series studies evaluating the effects of various interventions (e.g. educational, financial or regulatory strategies) on the recruitment and/or retention of health professionals in under-served areas.Data Collection And AnalysisTwo reviewers independently screened titles and abstracts obtained from the search in order to identify potentially relevant studies.Main ResultsNo studies met the inclusion criteria.Authors' ConclusionsThere are no studies in which bias and confounding are minimised to support any of the interventions that have been implemented to address the inequitable distribution of health care professionals. Well-designed studies are needed to confirm or refute findings of various observational studies regarding educational, financial, regulatory and supportive interventions that may influence health care professionals' choice to practice in underserved areas. Governments and educators should ensure that where interventions are implemented this is done within the context of a well-planned study so that the true effects of these measures on recruitment and long term retention can be determined in various settings.

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