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dc.contributor.authorRao, Krishna D.en_US
dc.contributor.authorRyan, Mandyen_US
dc.contributor.authorShroff, Zubinen_US
dc.contributor.authorVujicic, Markoen_US
dc.contributor.authorRamani, Sudhaen_US
dc.contributor.authorBerman, Peteren_US
dc.date.accessioned2014-03-11T10:16:08Z
dc.date.issued2013en_US
dc.identifier.citationRao, Krishna D., Mandy Ryan, Zubin Shroff, Marko Vujicic, Sudha Ramani, and Peter Berman. 2013. “Rural Clinician Scarcity and Job Preferences of Doctors and Nurses in India: A Discrete Choice Experiment.” PLoS ONE 8 (12): e82984. doi:10.1371/journal.pone.0082984. http://dx.doi.org/10.1371/journal.pone.0082984.en
dc.identifier.issn1932-6203en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:11879270
dc.description.abstractThe scarcity of rural doctors has undermined the ability of health systems in low and middle-income countries like India to provide quality services to rural populations. This study examines job preferences of doctors and nurses to inform what works in terms of rural recruitment strategies. Job acceptance of different strategies was compared to identify policy options for increasing the availability of clinical providers in rural areas. In 2010 a Discrete Choice Experiment was conducted in India. The study sample included final year medical and nursing students, and in-service doctors and nurses serving at Primary Health Centers. Eight job attributes were identified and a D-efficient fractional factorial design was used to construct pairs of job choices. Respondent acceptance of job choices was analyzed using multi-level logistic regression. Location mattered; jobs in areas offering urban amenities had a high likelihood of being accepted. Higher salary had small effect on doctor, but large effect on nurse, acceptance of rural jobs. At five times current salary levels, 13% (31%) of medical students (doctors) were willing to accept rural jobs. At half this level, 61% (52%) of nursing students (nurses) accepted a rural job. The strategy of reserving seats for specialist training in exchange for rural service had a large effect on job acceptance among doctors, nurses and nursing students. For doctors and nurses, properly staffed and equipped health facilities, and housing had small effects on job acceptance. Rural upbringing was not associated with rural job acceptance. Incentivizing doctors for rural service is expensive. A broader strategy of substantial salary increases with improved living, working environment, and education incentives is necessary. For both doctors and nurses, the usual strategies of moderate salary increases, good facility infrastructure, and housing will not be effective. Non-physician clinicians like nurse-practitioners offer an affordable alternative for delivering rural health care.en
dc.language.isoen_USen
dc.publisherPublic Library of Scienceen
dc.relation.isversionofdoi:10.1371/journal.pone.0082984en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3869745/pdf/en
dash.licenseLAAen_US
dc.subjectMedicineen
dc.subjectGlobal Healthen
dc.subjectNon-Clinical Medicineen
dc.subjectHealth Care Policyen
dc.subjectHealth Systems Strengtheningen
dc.subjectHealth Care Providersen
dc.subjectNursesen
dc.subjectPhysiciansen
dc.subjectHealth Economicsen
dc.subjectCost Effectivenessen
dc.subjectHealth Care Qualityen
dc.subjectMedical Careersen
dc.subjectPublic Healthen
dc.subjectSocial and Behavioral Sciencesen
dc.subjectEconomicsen
dc.titleRural Clinician Scarcity and Job Preferences of Doctors and Nurses in India: A Discrete Choice Experimenten
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalPLoS ONEen
dash.depositing.authorBerman, Peteren_US
dc.date.available2014-03-11T10:16:08Z
dc.identifier.doi10.1371/journal.pone.0082984*
dash.contributor.affiliatedBerman, Peter


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