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dc.contributor.authorRamani, Sudhaen_US
dc.contributor.authorRao, Krishna Den_US
dc.contributor.authorRyan, Mandyen_US
dc.contributor.authorVujicic, Markoen_US
dc.contributor.authorBerman, Peteren_US
dc.date.accessioned2014-12-02T21:27:40Z
dc.date.issued2013en_US
dc.identifier.citationRamani, Sudha, Krishna D Rao, Mandy Ryan, Marko Vujicic, and Peter Berman. 2013. “For more than love or money: attitudes of student and in-service health workers towards rural service in India.” Human Resources for Health 11 (1): 58. doi:10.1186/1478-4491-11-58. http://dx.doi.org/10.1186/1478-4491-11-58.en
dc.identifier.issn1478-4491en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:13454668
dc.description.abstractBackground: While international literature on rural retention is expanding, there is a lack of research on relevant strategies from pluralistic healthcare environments such as India, where alternate medicine is an integral component of primary care. In such contexts, there is a constant tug of war in national policy on “Which health worker is needed in rural areas?” and “Who can, realistically, be got there?” In this article, we try to inform this debate by juxtaposing perspectives of three cadres involved in primary care in India—allopathic, ayurvedic and nursing—on rural service. We also identify key incentives for improved rural retention of these cadres. Methods: We present qualitative evidence from two states, Uttarakhand and Andhra Pradesh. Eighty-eight in-depth interviews with students and in-service personnel were conducted between January and July 2010. Generic thematic analysis techniques were employed, and the data were organized in a framework that clustered factors linked to rural service as organizational (salary, infrastructure, career) and contextual (housing, children’s development, safety). Results: Similar to other studies, we found that both pecuniary and non-pecuniary factors (salary, working conditions, children’s education, living conditions and safety) affect career preferences of health workers. For the allopathic cadre, rural primary care jobs commanded little respect; respondents from this cadre aimed to specialize and preferred private sector jobs. Offering preferential admission to specialist courses in exchange for a rural stint appears to be a powerful incentive for this cadre. In contrast, respondents from the Ayurvedic and nursing cadres favored public sector jobs even if this meant rural postings. For these two cadres, better salary, working and rural living conditions can increase recruitment. Conclusions: Rural retention strategies in India have predominantly concentrated on the allopathic cadre. Our study suggests incentivizing rural service for the nursing and Ayurvedic cadres is less challenging in comparison to the allopathic cadre. Hence, there is merit in strengthening rural incentive strategies for these two cadres also. In our study, we have developed a detailed framework of rural retention factors and used this for delineating India-specific recommendations. This framework can be adapted to other similar contexts to facilitate international cross-cadre comparisons.en
dc.language.isoen_USen
dc.publisherBioMed Centralen
dc.relation.isversionofdoi:10.1186/1478-4491-11-58en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4222605/pdf/en
dash.licenseLAAen_US
dc.subjectHuman resourcesen
dc.subjectIncentivesen
dc.subjectRural retentionen
dc.subjectRural recruitmenten
dc.subjectPrimary healthcareen
dc.subjectIndiaen
dc.titleFor more than love or money: attitudes of student and in-service health workers towards rural service in Indiaen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalHuman Resources for Healthen
dash.depositing.authorBerman, Peteren_US
dc.date.available2014-12-02T21:27:40Z
dc.identifier.doi10.1186/1478-4491-11-58*
dash.contributor.affiliatedBerman, Peter


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