Volume 7, Issue 1 (3-2023)                   EBHPME 2023, 7(1): 13-24 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Alimoradnori M, Aghaei Hashjin A, Karami B. Policy Analysis of Retention of Physicians in Deprived Areas in Iran Using a Framework of Policy Analysis Triangle. EBHPME 2023; 7 (1) :13-24
URL: http://jebhpme.ssu.ac.ir/article-1-413-en.html
Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran , aghaei.a@iums.ac.ir
Abstract:   (820 Views)

Background: The retention of physicians' policy is recommended by the World Health Organization (WHO) to achieve the goals of the health system and justice in access to health services. The aim of this study was policy analysis of retention of physicians in deprived areas and providing some recommendations for improvement of this plan.
Methods: This was a qualitative study regarding policy which used Walt and Gilson's triangle framework and Kingdon's multiple streams. Data were collected using a deep semi-structured interview with 30 participants and a review of upstream laws and regulations. After that, all the interviews were recorded, transcribed, and reviewed. Then, data were analyzed through MAXQDA/12 and content analysis.
Results: The findings of this study were categorized according to the policy context, content, and process, and actors who played a significant role in designing and implementing this policy.
Conclusion: The policy of retaining physicians in rural areas requires the support of the majority of the country's political and health authorities, and providing infrastructure for health providers. This policy not only increases the quality of services, but also is effective in increasing the patients' access to healthcare services in deprived areas.
 

Full-Text [PDF 1400 kb]   (439 Downloads) |   |   Full-Text (HTML)  (140 Views)  

 


Type of Study: Original article | Subject: Health Policy
Received: 2022/11/15 | Accepted: 2023/03/28 | Published: 2023/03/30

References
1. Asghari Sh, Kirkland MC, Blackmore J, Boyd S, Farrell A, Rourke J, et al. A systematic review of reviews: Recruitment and retention of rural family physicians. Can J Rural Med. 2020; 25(1): 20-30. [DOI: 10.4103/CJRM.CJRM_4_19]
2. World Health Organization. Increasing access to health workers in remote and rural areas through improved retention: global policy recommendations. World Health Organization. Available from URL: http://apps.who.int/iris/ handle/10665/44369. Last access: 31 December, 2022.
3. Mohammadiaghdam N, Doshmangir L, Babaie J, Khabiri R, Ponnet K. Determining factors in the retention of physicians in rural and underdeveloped areas: A systematic review. BMC Fam Pract. 2020; 21(1): 216. [DOI: 10.1186/s12875-020-01279-7]
4. Rocha EMS, Boiteux PDA, de Azevedo GD, Siqueira CEG, Andrade MAC. Educational predictors for the retention of physicians in remote and unassisted areas: A narrative review. Revista Brasileira de Educação Médica . 2020; 44(01). [DOI: 10.1590/1981-5271v44.1-20190281]
5. Ehsani-Chimeh E, Majdzadeh R, Delavari S, Najafi Gharebelagh M, Rezaei S, Homaie Rad E. Physicians' retention rate and its effective factors in the Islamic Republic of Iran. East Mediterr Health J. 2018; 24(9): 830-7. [DOI: 10.26719/2018.24.9.830]
6. Lehmann U, Dieleman M, Martineau T. Staffing remote rural areas in middle- and low-income countries: A literature review of attraction and retention. BMC Health Serv Res. 2008; 8: 19. [DOI: 10.1186/1472-6963-8-19]
7. Larsen Soles T, Wilson CR, Oandasan IF. Family medicine education in rural communities as a health service intervention supporting recruitment and retention of physicians. Can Fam Physician. 2017; 63(1): 28-32.
8. Herbert R. Canada’s health care challenge: Recognizing and addressing the health needs of rural Canadians. Lethbridge Undergrad Res J. 2007; 2(1): 1-8.
9. Buchan J, Couper ID, Tangcharoensathien V, Thepannya Kh, Jaskiewicz W, Perfilieva G, Dolea C. Early implementation of WHO recommendations for the retention of health workers in remote and rural areas. Bull World Health Organ. 2013; 91(11): 834-40. [DOI: 10.2471/BLT.13.119008]
10. Kumar S, Clancy B. Retention of physicians and surgeons in rural areas-what works?. J Public Health. 2021; 43(4): e689-e700. [DOI: 10.1093/ pubmed/fdaa031]
11. Handoyo NE, Rahayu GR, Claramita M, Ash J, Schuwirth LWT. Personal resilience and rural doctors retention: A study in Indonesia. Rural Remote Health. 2020; 20(4): 6097. [DOI: 10.22605/ RRH6097]
12. Cortez LR, Guerra EC, da Silveira NJD, Noro LRA. The retention of physicians to primary health care in Brazil: Motivation and limitations from a qualitative perspective. BMC Health Serv Res. 2019 ; 19(1): 57. [DOI: 10.1186/s12913-018-3813-3]
13. Lafortune C, Gustafson J. Interventions to improve recruitment and retention of physicians in rural and remote Canada: A systematic review. UWOMJ. 2019; 88(1). [DOI: 10.5206/uwomj.v88i1.6184]
14. Vaezi H, Aghajani M, Rategar M, Shahrami A, Lotfi F, Olyaeemanesh A, et al. Implementing the healthtransformation plan with emphasis on supporting the survival of physicians in deprived areas: The results and challenges. Hakim Health Sys Res. 2017; 19(4): 238-47. [In Persian]
15. Emami Razavi SH, Shali M, Mirzaei S, Nikbakht Nasrabadi AR, Khazaeipour Z. Challenges of physicians working long in deprived areas in Iran. Payavard. 2021; 15(3): 224-34. [In Persian]
16. Mollaei B, Moghri J, Ghavami V, Tabatabaee SS. Factors related to the willingness of working physicians to stay in rural areas and their evaluation according to the recommendations of the World Health Organization: A case study. Journal of Health Administration. 2021; 23(4): 40-50. [In Persian] [DOI: 10.29252/ jha.23.4.40]
17. Davari F, Sajadi HS, Ehsani-Chimeh E, Alimohammadzadeh KH. Incentive policies for the retention of physicians and nurses in deprived areas of the Islamic Republic of Iran. Health Inf Manage. 2020; 17(4): 159-66. [In Persian]
18. Mehtarpour M, Tajvar M. Policy analysis of family physician plan and referral system in iran using policy analysis triangle framework. Health_Based Research. 2018; 4(1): 31-49. [In Persian]
19. Yousefinezhadi T, Mosadeghrad AM, Arab M, Ramezani M, Akbari Sari A. An analysis of hospital accreditation policy in Iran. Iran J Public Health. 2017; 46(10): 1347-58.
20. Keyvanara M, ShaarbafchiZadeh N, Alimoradnori M. Effective factors on occupational burnout among the operating room staff in teaching hospitals affiliated with Isfahan Medical University: A qualitative content analysis. EBHPME. 2019; 3(3): 202-11. [DOI: 10.18502/jebhpme.v3i3.1509]
21. Murray-Webster R, Simon P. Making sense of stakeholder mapping. PM World today. 2006; 8(11): 1-5.
22. Sajadi HS, Hosseini M, Dehghani A, Khodayari R, Zandiyan H, Hosseini SS. The policy analysis of Iran’s health transformation plan in therapeutic services. Hakim Health Sys Res. 2018; 21(2): 71-88. [In Persian]
23. Liu X, Dou L, Zhang H, Sun Y, Yuan B. Analysis of context factors in compulsory and incentive strategies for improving attraction and retention of health workers in rural and remote areas: A systematic review. Hum Resour Health. 2015; 13: 61. [DOI: 10.1186/s12960-015-0059-6]
24. Koike S, Isse T, Kawaguchi H, Ogawa M. Retention among full-time occupational physicians in Japan. Occup Med (Lond). 2019; 69(2): 139-42. [DOI: 10.1093/occmed/kqy130]
25. Flores ELL, Manahan EMR, Lacanilao MPB, Ladaw IMBT, Mallillin MMB, Mappatao NTQ, et al. Factors affecting retention in the Philippine National Rural Physician Deployment Program from 2012 to 2019: A mixed methods study. BMC Health Serv Res. 2021; 21(1): 1201. [DOI: 10.1186/s12913-021-07219-0]
26. Ogundeji Y, Clement F, Wellstead D, Farkas B, Manns B. Primary care physicians' perceptions of the role of alternative payment models in recruitment and retention in rural Alberta: A qualitative study. CMAJ Open. 2021; 9(3): E788-E94. [DOI: 10.9778/cmajo.20200202]
27. Bashar F, Islam R, Khan ShM, Hossain Sh, Sikder AAS, Yusuf SSh, et al. Making doctors stay: Rethinking doctor retention policy in a contracted-out primary healthcare setting in urban Bangladesh. PLoS ONE. 2022; 17(1): e0262358. [DOI: 10.1371/journal.pone.0262358]
28. Morken C, Bruksch-Meck K, Crouse B, Traxler K. Factors influencing rural physician retention following completion of a rural training track family medicine residency program. WMJ. 2018; 117(5): 208-10.
29. Asefzadeh S, Rafiei S, Ranjbar M, Kazemifar A, Akbari Sh. Influencing factors on physicians' retention in training hospitals of Qazvin University of Medical Sciences in 2017-2018. Evidence Based Health Policy, Management & Economics. 2020; 4(1): 23-31. [DOI: 10.18502/jebhpme.v4i1.2554]
30. Amiresmaili M, Jamebozorgi MH, Jamebozorgi AH, Arab-Zozani M. Retention of dental practitioners in rural health services in Iran: Experiences from Kerman province. Dental Research Journal. 2022; 19: 34.
31. Davari F, Sajadi, HS, Ehsani-Chimeh E, Alimohammadzade K. Incentive policies for the retention of physicians and nurses in deprived areas of the Islamic Republic of Iran. Health Information Management. 2020; 17(4): 159-66. [DOI: 10.22122/him.v17i4.4093]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Evidence Based Health Policy, Management and Economics

Designed & Developed by : Yektaweb