The Hindu : National : Doctors serve rural areas mainly due to geographical factor, says survey

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Monday, Jun 14, 2010
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Doctors serve rural areas mainly due to geographical factor, says survey

Aarti Dhar

NEW DELHI: A medical practitioner's decision to join service in rural and remote areas is widely influenced by geographical affinities and familial associations.

Preferential admission to higher education after serving in a rural place was also cited as a reason though by few doctors.

According to a qualitative research on ‘Factors Influencing Decisions of Doctors to Serve in Rural and Remote Areas of Chhattisgarh State,' doctors' decision to remain in rural and remote areas over periods of time were driven by a combinations of factors, including geographical affinities, personal values of service, professional interests and ambitions, strong relationships with colleagues and in the case of contractual doctors, the anticipation of obtaining a regular position.

Working conditions evoke a mix of responses among doctors, some revelling in the experience and finding opportunities in the challenge of adversity, and others confronting an eroding knowledge base and decline in professional confidence and capabilities, said the survey. It was conducted by the Public Health Foundation of India, the National Health Systems Resource Centre and the State Health Resource Centre, Chhattisgarh.

Many respondents, particularly contractually employed practitioners, perceived that their presence in their respective locations was not of their free will.

They were simply assigned there by the government's placement process.

Some respondents even touched upon the alleged role of nepotism and, in some instances, active corruption in the allocation of postings, suggesting that remote and less-preferred locations were assigned to those who did not have personal or pecuniary influence to bear on authorities.

On the other hand, a number of practitioners had also actively sought to work in the area of their present locations.

Geographical and ethnic affinities were cited by a majority of practitioners as a reason for serving in a remote area.

Motivating factor

Values of service and the importance of a social return from government-funded medical education were also cited by a few doctors, as a motivating factor for joining a position in a rural or backward area.

A few respondents indicated that they had joined government jobs in rural areas due to policies linking conduct of rural service with eligibility for or preferential admission to postgraduate degree course.

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