Retention strategies & incentives for health workers in rural & remote areas: what works? (full report)

The factors that impact upon labour turnover and workforce retention, particularly in rural and remote areas, are complex and require a multi-sector response. While there exists considerable literature on workforce turnover, significantly less attention has focused on how length of stay of health workers varies according to profession, location of employment, workplace activity and nature of organisation. Nor has there been significant rigorous evaluation of the effectiveness of retention measures and incentives on improved length of stay of health workers outside of the private sector. The need for more systematic research on workforce retention and the effectiveness of measures designed to minimise avoidable workforce turnover has only relatively recently been fully appreciated. In Australia, the most significant contribution to health workforce retention research has been undertaken by researchers from rural and remote research units, where the need to base interventions and incentives upon a sound understanding of what triggers poor workforce retention is most fully appreciated. This research encompasses a comprehensive systematic review and critical appraisal of the literature, building on both conceptual and empirical investigations. Professor John Humphreys, Professor John Wakerman and Dr Dennis Pashen investigated what sorts of retention strategies and incentives have been implemented to entice health workers to take-up and remain in practice in rural and remote areas. Furthermore, they looked at what workforce retention strategies have proven to be effective in attracting health workers, increasing length of stay and reducing avoidable turnover in rural and remote areas.The research reported in this paper is a project of the Australian Primary Health Care Research Institute, which is supported by a grant from the Australian Government Department of Health and Ageing under the Primary Health Care Research, Evaluation and Development Strategy