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Table 4 Stakeholder positions on policies and implementation considerations

From: Stakeholder perspectives on proposed policies to improve distribution and retention of doctors in rural areas of Uttar Pradesh, India

Supportive

Reservations about the policy

Opposed

Policy 1: Increase opportunities for students from rural backgrounds to enter medical college in the public sector, through providing state sponsored training for the NEET for students from rural areas.

Department of Medical Education, regulators, training institutions, doctors’ association, AYUSH association, medical officers, district-level administration

Medical officers, Private sector hospital association, (personal opinion, did not represent association)

 

Policy 2: Develop and enforce a compulsory rural posting policy requiring that all newly hired doctors spend a minimum of 3 years in an underserved community (priority districts/under-served rural facilities)

Private sector hospital association, rural medical practitioners association, national level agencies, civil society

Doctors’ associations (leadership was personally supportive)

Frontline medical officers, district-level administrator, regulators

Policy 3: Allow home district posting for clinical cadres (RETAIN)

Doctor’s associations, nurses’ association, medical officers,

national-level stakeholders

 

District-level administration

Policy 4: Living conditions – Improve staff housing infrastructure and security in rural facilities. (RETAIN)

All stakeholders

  

Policy 5: Working conditions - Increase coordination across health departments and agencies to ensure that health workers have appropriate inputs and supports to do their job including the availability of functioning equipment, electricity, drugs and other supplies. (RETAIN)

Most stakeholders

Health systems expert

 

Policy 6: Permit private practice for government doctors and develop a policy that regulates hours and conditions under which private practice can occur and remove the non-private practice allowance. (RETAIN)

Medical officers

District-level administration, doctors association

National-level stakeholders; civil society

Policy 7(a) Support the shifting of tasks from MBBS to AYUSH doctors in rural settings through:

i. Assess the clinical competence of AYUSH doctors in the provision of services previously provided by MBBS

ii. Additional on-the-job and short-term training to AYUSH doctors

Supportive supervision to AYUSH doctors

Directorate of Medical Education, AYUSH association, rural medical practitioners association, national-level heath agencies

Medical officers

Doctors’ association, district-level administration

Policy 7(b) Explore further task shifting options from MBBS to nurses (community health officers)

Nurses associations, national level health agencies, frontline health workers, Department of Medical Education, civil society organization

Doctors’ association

 
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BMC Health Services Research

ISSN: 1472-6963

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