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Rural health workforce profile

Rural health workforce profile
Introduction
            Access to reliable and efficient health care was termed as a basic human right by the world health organization an arm body of the United Nations, and as a result all governments around the world are reviewing their medical services to ensure that health services are easily accessible to rural populations by 2015 (Klugman & Dalinis, 2008). In the medicine circles the terms rural health or rural medicine are used interchangeably to refer to the interdisciplinary study and provision of health care services to rural populations. It is generally thought that residents of metropolitan towns, counties, and cities generally have quick and easy access to medical services from medical institutions (Cheers, 1998). This is because many medical institutions are primarily located in urban centres, and generally people who live in rural areas are faced by different health challenges compared to the urban population (Francis, Burley & Cross, 2004). In cases of emergency they may not be able to get to a health facility as fast as it would be required, they are also required to travel for long distances just to get health care, and when they do get to the health care facility they are faced with the challenge of poor services due to lack of enough medical personnel and at times lack of specialist to take up their cases. This is what has lead to the development of rural health initiatives (Phillips, 2002)
Rural health
            It is generally viewed that the health of people living in rural areas is low compared to those who reside in metropolitan urban centres, by rural area it is implied that they are area separated by huge distances, inhabited by sparse populations, characterised by harsh climatic and geographical environments and high socio-economic diversity (Gray and Lawrence, 2001). Rural here implies to the characteristic features of rural life as compared to urban life (Mungall & Cox, 1999). There is no general definition of the term rural health but various scholars are of the view that definitions should be developed to a specific problem being addressed in a particular context (Humphreys and Rolley 1991).
Demographic Characteristics of the Workforce
Table 1 Practice activity: comparisons between ages, gender and full- or part-time workers

 
Category
Age (years)
Gender
N
Patients per month (SD)
Hours worked per week (SD)

Full time dentist
20-34
Male
9
243.3 (75.6)
40.7 (6.7)

Female
9
205.5 (62.6)
40.6 (3.2)

35-49
Male
20
278.7 (95.5)
40.7 (6.8)

Female
8
211.7 (70.3)
37.87 (8.0)

50-59
Male
16
311.2 (75.1)
38.2 (12.6)

Female
1
240.0
38.0

60+
Male
3
302.0 (87.6)
40.0(5.0)

Female
1
290.0
40.0

Part time dentist
35-49
Female
2
115.0 (15.6)
23.0 (12.7)

60+
Male
1
250.0
30.0

full time therapist
20-34
Female
6
242.0 (104.0)
38.91 (2.24)

35-49
Female
5
254.0 (53.1)
37.7 (0.61)

Part time therapist
 
 
20-34
Female
 
 
1
80.0
 
 
15.20

35-49
Female
8
93.75 (67.3)
23.92 (6.3)

 
 
 

(Table obtained Kruger & Tennant, 2004)
Generally the work force is largely comprised of more males than their female counterparts in the rural areas working in dentistry. The average age of most dentists was 42.7 years and that of therapist was 36.5, on average part time dentist worked for 25.31hrs per week, while full time worked for 39.72hrs per week. Full time and part-time therapists worked for 38.25hrs and 23.63hrs per week respectively. This study shows that most medical doctors in the rural set up are males, who are married with children. This profile is identical to rural general practitioners profile which shares many characteristics with dentistry. There should be close monitoring of the demographics in order to ensure they can provide the required quality of service in future.
Level and categories of workforce
Generally the workforce in rural health centres is comprised of the nurses, allied health staff, indigenous health workers, pharmacists, medical doctors and others. It is also viewed that the number of workforce is inversely proportional to the accessibility of the location. Areas viewed as remote usually have few medical workers (Francis, Bowman & Redgrave, 2002). Each year new vacancies in all groups of the medical profession are advertised (AIHW 2003).
It has generally been observed that there is a very big shortage of medical staff in rural health centres. Research has shown that most medical staffs view rural populations as being socially, culturally and economically less empowered. They have a general perception that setting up a medical practice in rural areas is not viable for business. They also state that lack of access to relief, collegiate support, and few carrier opportunities also influence their decisions about practising in rural area (Best 2000).
Research has also shown that the number of skilled nurses is declining at an alarming rate and worst hit area being rural health. Generally the reasons cited from nurses as being the factors which hinder or affect their decision are similar to those raised by doctors. The government in its effort to address this came up with a task force which was mandated to investigate and provide recommendations on how to tackle the nurses’ shortage (Smith, 2004).
Key issues in rural health
Medical staffs who work in rural areas have a very wide scope of practice which is usually brought about by lack of enough specialists. They are also unable to access educational resources to improve their qualifications (Wilkinson and Blue, 2002). Medical workers in rural areas need to have good skills and also posses a wide knowledge base with the capability of working with minimal resources and should expect little or no collegiate support (Cramar, 2000). Some of the staff also raised issues about their safety and security; this has had a negative impact on the existing work force as well as potential recruits. Those already in rural service are eager to leave while the same time discouraging new graduates from taking up positions in rural health care (AARN 2004). Other key issues that affect the work force include poor wages and salaries, poor distribution of work force, lack of resources and equipment and migration of health workers in search of greener pastures (Dunbabin & Levitt 2003).
 
Strategies for addressing the workforce issues in rural health
            The work force can be encouraged to stay in rural areas through incentives such as the scholarship programs being financed by the Australian government; some of the examples include John Flynn medical scholarship and the postgraduate and undergraduate remote nurses scholarship schemes (Strasser, 2002). The government has also encouraged the establishment of rural health department in various universities. The government should encourage hiring of more medical staff with incentives to work in rural health.
Conclusion
            Drastic measures have to be put in place to constantly check the work force levels in rural health so as to overcome future shortages of workers. The government should come up with appropriate incentives program that will encourage new young graduates to set up their practice in rural settings.
 

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