Factors affecting retention in the Philippine National Rural Physician Deployment Program from 2012 to 2019: a mixed methods study. 2021

Erika Louise L Flores, and Edric Matthew R Manahan, and Miguel Paulo B Lacanilao, and Isabella Ma Beatriz T Ladaw, and Mico Martin B Mallillin, and Nikolai Thadeus Q Mappatao, and Juan Alfonso Leonardia, and Veincent Christian F Pepito
School of Medicine and Public Health, Ateneo de Manila University, Ortigas Ave., Pasig City, Philippines.

BACKGROUND To address the maldistribution of healthcare providers and the shortage of physicians in geographically isolated and disadvantaged areas of the Philippines, the Philippine National Rural Physician Deployment Program, or more commonly known as the Doctors to the Barrios (DTTB) program was established in 1993. However, as of 2011, only 18% of the DTTBs chose to stay in their assigned municipalities after their two-year deployment, termed retention. This study aims to identify the individual, local, work, national, and international factors affecting the retention of DTTBs in their assigned communities after their two-year deployment. METHODS A descriptive, mixed-methods, explanatory design was used. For the quantitative part, the modified and updated Stayers Questionnaire was given to all current DTTBs present in a Continuing Medical Education session in the Development Academy of the Philippines. Descriptive statistics were then presented. For the qualitative part, individual, semi-structured key informant interviews were conducted in-person or via phone with current and alumni DTTBs from 2012 to 2019. Proceedings of the interviews were transcribed, translated, and analyzed thematically. RESULTS 102 current DTTBs participated in the quantitative part of our study, while 10 current and former DTTBs participated in the interviews. Demographic factors and location, personal beliefs, well-being, friends and family dynamics, and perceptions about work were the individual factors identified to affect retention. Social working conditions, career development, and infrastructure, medical equipment, and supplies were among the work factors identified to affect retention. Geography, living conditions, local social needs, and technology were among the local factors identified to affect retention. Compensation, the recently signed Universal Healthcare Law, and Safety and Security were identified as national factors that could affect retention. International factors did not seem to discourage DTTBs from staying in their communities. CONCLUSIONS A host of individual, work-related, local, national, and international factors influence the DTTB's decision to be retained in different, complex, interconnected, and dynamic ways. We also identified implementation issues in the DTTB program and suggested interventions to encourage retention.

UI MeSH Term Description Entries
D010679 Philippines A country in southeastern Asia, archipelago between the Philippine Sea and the South China Sea, and east of Vietnam. The capital is Manila. Philipines,Phillipines,Phillippines
D010820 Physicians Individuals licensed to practice medicine. Physician
D004502 Education, Medical, Continuing Educational programs designed to inform physicians of recent advances in their field. Medical Education, Continuing,Continuing Medical Education,Education, Continuing Medical
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012424 Rural Population The inhabitants of rural areas or of small towns classified as rural. Rural Residence,Rural Communities,Rural Spatial Distribution,Communities, Rural,Community, Rural,Distribution, Rural Spatial,Distributions, Rural Spatial,Population, Rural,Populations, Rural,Residence, Rural,Rural Community,Rural Populations,Rural Residences,Rural Spatial Distributions
D019035 Rural Health Services Health services, public or private, in rural areas. The services include the promotion of health and the delivery of health care. Health Services, Rural,Rural Health Center,Services, Rural Health,Center, Rural Health,Centers, Rural Health,Health Center, Rural,Health Centers, Rural,Health Service, Rural,Rural Health Centers,Rural Health Service,Service, Rural Health

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