Training a Fit-For-Purpose Rural Health Workforce for Low- and Middle-Income Countries (LMICs): How Do Drivers and...

Area of Science:

• Global Health
• Medical Education
• Health Workforce Development

Background:

• Health equity for rural populations in low- and middle-income countries (LMICs) is challenged by social, economic, cultural, and environmental factors.
• A health workforce educated to meet local needs and address rural pathway determinants is crucial for underserved areas.

Purpose of the Study:

• To examine factors influencing health professional learners' intention to practice in rural and underserved areas.
• To compare these intentions between country income settings and analyze educational strategies' effectiveness in LMICs.

Main Methods:

• An international prospective cohort study (THEnet Graduate Outcome Study) of over 6,000 learners from nine health professional schools in seven countries.
• Learner surveys at entry, exit, and 1, 4, 7, and 10 years post-graduation, triangulated with sociocultural and policy analysis.

Main Results:

• Rural background strongly associated with intention to practice rurally at both entry and exit.
• Shift in intention from working abroad to in-country practice observed between entry and exit.
• Learners at exit showed greater intent for generalist careers, but policy and pathway limitations in LMICs were noted.

Conclusions:

• Socially accountable health professional education can foster a workforce intending to practice in rural areas.
• Addressing educational and structural factors is key to improving rural health workforce distribution in LMICs.