Evalution of policies aimed at reducing urban-rural disparity in human resource for health in low and middle income countries : a systematic review

Date of Award


Document Type


Degree Name

Master of Science in Health Policy & Management (MSc Health Policy & Mgmt)


Community Health Sciences


The shortage of Human Resource for Health (HRH) in rural settings is a global concern that undermines the efforts for equitable healthcare delivery. Many Low & Middle Income Countries (LMICs) have embarked upon several corrective measures/ interventions to redress the issue of unavailability of health professionals in underserved areas. Despite coming up with corrective mechanisms, LM ICs are far from dealing with this problem. This study attempts to explore the gaps in policies aimed at reducing urban-rural disparity in health service delivery in LMICs. Methods: The search databases PubMed, Cochrane and CINAHL used for published papers/ documents. We found in total (n=1423) articles from all data bases including; `PubMed (n=1265 articles), `CINAHL' (n=67 articles) and Cochrane (n=91 articles). After the process of screening and exclusion on the basis of eligibility criteria, (n=8) papers were finally selected for the study reviewed. Results: The studies conducted in LMICs were evaluated using a conceptual framework with monetary benefits, non-monetary benefits, and educational training and regulatory policies as main themes. The findings of the study revealed that the policies for financial incentives and professional growth had tangible impact on the retention of HRH in rural areas of LMICs, whereas, the impact of non-financial interventions needs to be explored. One study reported that the obligatory services if implemented alone could have a negative impact. Conclusion: HRH retention in LMICs require an integrated policy approach, inclusive of financial and non financial benefits, along with the educational training among health professional in remote areas in developing countries. Besides, an effective monitoring and evaluation mechanism should be in place.

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