175 lines
5.6 KiB
YAML
175 lines
5.6 KiB
YAML
abstract: 'Equity in health outcomes for rural and remote populations in low- and
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middle-income countries (LMICs) is limited by a range of socio-economic,
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cultural and environmental determinants of health. Health professional
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education that is sensitive to local population needs and that attends
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to all elements of the rural pathway is vital to increase the proportion
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of the health workforce that practices in underserved rural and remote
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areas. The Training for Health Equity Network (THEnet) is a
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community-of-practice of 13 health professional education institutions
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with a focus on delivering socially accountable education to produce a
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fit-for-purpose health workforce. The THEnet Graduate Outcome Study is
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an international prospective cohort study with more than 6,000 learners
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from nine health professional schools in seven countries (including four
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LMICs; the Philippines, Sudan, South Africa and Nepal). Surveys of
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learners are administered at entry to and exit from medical school, and
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at years 1, 4, 7, and 10 thereafter. The association of learners''
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intention to practice in rural and other underserved areas, and a range
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of individual and institutional level variables at two time points-entry
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to and exit from the medical program, are examined and compared between
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country income settings. These findings are then triangulated with a
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sociocultural exploration of the structural relationships between
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educational and health service delivery ministries in each setting,
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status of postgraduate training for primary care, and current policy
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settings. This analysis confirmed the association of rural background
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with intention to practice in rural areas at both entry and exit.
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Intention to work abroad was greater for learners at entry, with a
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significant shift to an intention to work in-country for learners with
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entry and exit data. Learners at exit were more likely to intend a
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career in generalist disciplines than those at entry however lack of
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health policy and unclear career pathways limits the effectiveness of
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educational strategies in LMICs. This multi-national study of learners
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from medical schools with a social accountability mandate confirms that
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it is possible to produce a health workforce with a strong intent to
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practice in rural areas through attention to all aspects of the rural
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pathway.'
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affiliation: 'Larkins, S (Corresponding Author), James Cook Univ, Coll Med \& Dent,
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Anton Breinl Res Ctr Hlth Syst Strengthening, Douglas, Qld, Australia.
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Johnston, Karen; Woolley, Torres; Ketheesan, Sarangan; Larkins, Sarah, James Cook
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Univ, Coll Med \& Dent, Anton Breinl Res Ctr Hlth Syst Strengthening, Douglas, Qld,
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Australia.
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Guingona, Monsie; Cristobal, Fortunato L., Ateneo de Zamboanga Univ, Sch Med, Zamboanga
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City, Philippines.
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Elsanousi, Salwa; Othman, Abu-Bakr, Univ Gezira, Fac Med, Gezira, Sudan.
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Mbokazi, Jabu, Walter Sisulu Univ, Sch Med, Mthatha, South Africa.
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Labarda, Charlie, Univ Philippines, Sch Hlth Sci, Manila, Philippines.
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Upadhyay, Shambhu; Acharya, Balkrishna, Patan Acad Hlth Sci, Patan, Nepal.
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Hogenbirk, John C., Laurentian Univ, Ctr Rural \& Northern Hlth Res, Sudbury, ON,
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Canada.
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Craig, Jonathan C., Flinders Univ S Australia, Coll Med \& Publ Hlth, Adelaide,
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SA, Australia.
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Neusy, Andre-Jacques, Training Hlth Equ Network, New York, NY USA.'
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article-number: '582464'
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author: Johnston, Karen and Guingona, Monsie and Elsanousi, Salwa and Mbokazi, Jabu
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and Labarda, Charlie and Cristobal, Fortunato L. and Upadhyay, Shambhu and Othman,
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Abu-Bakr and Woolley, Torres and Acharya, Balkrishna and Hogenbirk, John C. and
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Ketheesan, Sarangan and Craig, Jonathan C. and Neusy, Andre-Jacques and Larkins,
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Sarah
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author-email: sarah.larkins@jcu.edu.au
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author_list:
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- family: Johnston
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given: Karen
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- family: Guingona
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given: Monsie
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- family: Elsanousi
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given: Salwa
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- family: Mbokazi
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given: Jabu
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- family: Labarda
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given: Charlie
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- family: Cristobal
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given: Fortunato L.
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- family: Upadhyay
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given: Shambhu
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- family: Othman
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given: Abu-Bakr
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- family: Woolley
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given: Torres
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- family: Acharya
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given: Balkrishna
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- family: Hogenbirk
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given: John C.
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- family: Ketheesan
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given: Sarangan
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- family: Craig
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given: Jonathan C.
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- family: Neusy
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given: Andre-Jacques
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- family: Larkins
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given: Sarah
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da: '2023-09-28'
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doi: 10.3389/fpubh.2020.582464
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eissn: 2296-2565
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files: []
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journal: FRONTIERS IN PUBLIC HEALTH
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keywords: 'rural practice intention; rural medical practice; barriers and enablers;
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rural practice; human resources for health (HRH); LMIC = low; and
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middle-income countries; practice intentions; social accountability'
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keywords-plus: EDUCATION; SYSTEMS; CARE
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language: English
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month: OCT 19
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number-of-cited-references: '30'
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orcid-numbers: 'Ketheesan, Sarangan/0000-0002-2323-338X
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Johnston, Karen/0000-0002-0477-4666
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Hogenbirk, John C/0000-0003-0841-4657
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Larkins, Sarah/0000-0002-7561-3202
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Craig, Jonathan/0000-0002-2548-4035'
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papis_id: b65bfed1de3ba62dd3891fd75574f311
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ref: Johnston2020trainingfitforpurpos
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researcherid-numbers: 'Ketheesan, Sarangan/ABB-1898-2021
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Johnston, Karen/ABD-7646-2020
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Hogenbirk, John C/A-7619-2015
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Larkins, Sarah/A-2319-2013
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Craig, Jonathan/E-2813-2013'
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times-cited: '4'
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title: 'Training a Fit-For-Purpose Rural Health Workforce for Low- and Middle-Income
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Countries (LMICs): How Do Drivers and Enablers of Rural Practice Intention Differ
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Between Learners From LMICs and High Income Countries?'
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type: article
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unique-id: WOS:000583258000001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '2'
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volume: '8'
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web-of-science-categories: Public, Environmental \& Occupational Health
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year: '2020'
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