Innovative, government-led education initiatives in other countries have been successful at helping maintain a skilled healthcare workforce to meet universal health coverage requirements, according to a study published in Health Affairs. But the study argues while these initiatives offer insights that can potentially be used in the U.S., more research is needed to determine long-term impact.
For the study, researchers examined various initiatives in Thailand, Brazil and India.
In Thailand, the studied initiatives involved training and retaining physicians in rural areas of the country. Researchers said the country's Collaborative Project to Increase Production of Rural Doctors and the One District One Doctor program have been successful in terms of improving rural retention rates as well as the clinical and community-oriented competencies of medical school graduates.
In Brazil, researchers looked at the country's Family Health Strategy nationwide federal program, which is designed to improve primary care access through training of community health workers. They said the Family Health Strategy has been successful, extending primary care access to a large majority of the country's residents and decreasing infant and child mortality.
In India, researchers looked at the country's Nurse Practitioner in Primary Health Care program, which launched last year and involves a postgraduate diploma program in primary care for nurses. They said it is too early to fully assess the program's impact but noted "the strategy of shifting primary care responsibilities to nurses may be particularly cost-effective in the Indian context."
Even though these initiatives have had some successes, the study notes the long-term impact is not yet known.
"Further research is needed to assess the impact of such initiatives on the long-term retention of workers — particularly doctors — and the adequacy of the training offered to lower-skilled workers to effectively plug medical personnel gaps. Systematic monitoring of program affordability and cost-effectiveness over time must be prioritized, alongside efforts to disseminate lessons learned," the study's authors wrote.
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