Remarks

• This recommendation has been adapted and integrated from the updated 2021 WHO guideline on health workforce development, attraction, recruitment and retention in rural and remote areas (280).
• Recommendations from the above source guideline (abridged) addressing education, regulation, incentives and support include the following.
• Education: Use targeted admission policies to enrol students who live or have spent some childhood years in rural areas in health worker education programmes, and locate teaching and learning institutions closer to rural areas; expose students of a wide array of health worker disciplines to rural and remote communities and rural clinical practices; include rural health topics in health worker preservice and in-service training of health workers; and design and enable access to continuing education and professional development programmes that meet the needs of rural health workers to support their retention.
• Regulation: Introduce and regulate enhanced scope of practice for health workers in rural and remote areas; introduce different types of health workers to rural practices to meet the needs of communities, based on people-centred service delivery models; respect the rights of health workers when compulsory service in rural and remote areas exists, with fair, transparent and equitable management, support and incentives; and provide scholarships, bursaries or other education subsidies to health workers in return for service in rural and remote areas.
• Incentives: Employ a package of fiscally sustainable financial and nonfinancial incentives to influence health workers’ decisions to relocate to and remain in rural and remote areas.
• Support: Invest in rural infrastructure and services to ensure decent living conditions for health workers and their families; ensure a safe and secure working environment for health workers; provide decent work that respects the fundamental rights of health workers; foster the creation of health workforce support networks for health workers in rural and remote areas; develop and strengthen career development and advancement programmes, and career pathways for health workers in rural and remote areas; support the development of networks, associations and journals for health workers in rural and remote areas to facilitate knowledge exchange; and adopt social recognition measures at all levels for health workers in rural and remote areas to raise the profile of rural health workers.