Accepted for/Published in: JMIR Research Protocols
Date Submitted: Sep 21, 2023
Date Accepted: Nov 9, 2023
Overview of Retention Strategies for Medical Doctors in Low- and Middle-income Countries (LMICs) and Their Effectiveness: A Scoping Review Protocol
ABSTRACT
Background:
The global shortage and maldistribution of healthcare workers, especially medical doctors, pose a significant threat to achieving the United Nations Sustainable Development Goal 3 (SDG3) of ensuring well-being and healthy lives for all. Low- and middle-income countries (LMICs) are disproportionately affected by this crisis with a high rate of brain drain from rural to urban areas, as well as to high-income developed countries. In response, various retention strategies have been implemented in different settings and organisations. However, their effectiveness remains underexplored, especially in LMICs.
Objective:
The objective of this study is to review the available retention strategies for medical doctors in LMICs and to determine the effectiveness of the various strategies. This review aims to compile relevant research findings on this issue to generate a thorough summary of all the retention strategies practised in LMICs and more importantly, to provide a current state of evidence of the effectiveness of these strategies in retaining medical doctors in countries with limited resources and high disease burden.
Methods:
The structured framework by Arksey and O'Malley will serve as the basis for conducting this scoping review. A comprehensive search strategy will be conducted across four electronic databases (PubMed, EBSCOHost, Scopus, and ScienceDirect). A systematic approach following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews (PRISMA-ScR) guidelines will be executed to search, screen, review, and extract data from studies that meet predefined inclusion criteria. Data encompassing bibliographical information, study location, retention strategies, influencing factors, and outcomes (effectiveness) will be obtained from the selected studies using a standardised data extraction. Endnote software and Microsoft Excel will be used for reference management and removal of duplicate studies. A narrative synthesis will be performed after categorising and analysing all the extracted data to identify recurrent themes.
Results:
This ongoing review will generate a comprehensive compilation of retention strategies implemented in LMICs aimed at preventing brain drain among medical doctors. Data extraction is currently in progress and completion is expected by the end of 2023. Themes with regard to types of strategies, influencing factors, and outcomes will be synthesised. Findings will highlight effective retention strategies and challenges in implementation, as well as gaps for the benefits of future research. By identifying common barriers and facilitators, this review will contribute insights into enhancing the policies and initiatives for doctor retention in LMICs.
Conclusions:
This scoping review explores the retention strategies for doctors practised in LMICs and attempts to identify effective strategies from existing research. By evaluating the barriers and challenges influencing the effectiveness of these strategies, policymakers and healthcare leaders can strive to obtain a balanced and optimal health human resource in their respective organisations and countries. Clinical Trial: NMRR ID-23-01994-OGW; https://nmrr.gov.my/research-directory/ac4f5b88-8619-4b2b-b6c7-9abcef65fdcd
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Copyright
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