Designing financial-incentive programmes for return of medical service in underserved areas of sub-Saharan Africa

In many countries in sub-Saharan Africa health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practice for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through two mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentive from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. While financial-incentive programmes are an attractive option to increase the supply of health workers to medically underserved areas – they offer students who otherwise would not have the means to finance a health care education an opportunity to do so, establish legally enforceable commitments to work in underserved areas, and work without compulsion – these programmes may be difficult to implement.Disease, control, global health, financial-incentive programs, Africa.

Non-college-bound English learners as the underserved third: How students graduate from high school without being college- or career-ready

Not all high school students go to college. Yet, because there is currently such a dominant emphasis on “college for all,” preparing non-college-bound students for career-readiness has received short shrift. This issue is particularly important for English learners (ELs) because close to half of high school ELs do not advance to postsecondary education. Through a longitudinal ethnography of two underperforming, non-college-bound ELs, I examine how and why a relatively well-resourced school allowed these students to graduate without college- and career-readiness. I argue that although there were substantial structural inequalities that led to the under-education of the two ELs, educators at the school were largely unaware of such barriers and attributed the ELs’ underachievement to the students’ own deficits. I counter this institutional deficit orientation with alternative stories of student assets that illuminate the substantial strengths and talents that the focal ELs possessed, which, if recognized and integrated into their education, could have led to career-readiness.Accepted manuscrip

Conducting Research with Community Groups

Nurse scientists are increasingly recognizing the necessity of conducting research with community groups to effectively address complex health problems and successfully translate scientific advancements into the community. While several barriers to conducting research with community groups exist, community based participatory research (CBPR) has the potential to mitigate these barriers. CBPR has been employed in programs of research that respond in culturally sensitive ways to identify community needs and thereby address current health disparities. This manuscript presents case studies that demonstrate how CBPR principles guided the development of: (a) a healthy body weight program for urban, underserved African-American women, (b) a reproductive health educational intervention for urban, low-income, underserved, ethnically diverse women, and (c) a pilot anxiety/depression intervention for urban, low-income, underserved, ethnically diverse women. These case studies illustrate the potential of CBPR as an orientation to research that can be employed effectively in non-research intensive academic environments

Financial incentives for return of service in underserved areas: a systematic review

Of the 42 reviewed studies 33 investigated financial-incentive programs in the US. The remaining studies evaluated programs in Japan (five studies), Canada (two), New Zealand (one) and South Africa (one). The programs started between 1930 and 1998. We identified five different types of programs (service-requiring scholarships, educational loans with service requirements, service-option educational loans, loan repayment programs, and direct financial incentives). Financial incentives ranged from year-2000 United States dollars 1,358 to 28,470. All reviewed studies were observational. The random-effects estimate of the pooled proportion of all eligible program participants who had either fulfilled their obligation or were fulfilling it at the time of the study was 71% (95% confidence interval 60-80%). Seven studies compared retention in the same underserved area between program participants and non-participants. Six studies found that participants were less likely to remain in the same underserved area (five studies reported the difference to be statistically significant, while one study did not report a significance level); one study did not find a significant difference in retention in the same area. Twelve studies compared provision of care/retention in any underserved area between participants and non-participants. Ten studies found that participants were more likely to continue to practice in any underserved area (eight studies reported the difference to be statistically significant, while two studies did not provide the results of significance tests); two studies found that program participants were significantly less likely than non-participants to remain in any underserved area. Seven studies investigated the satisfaction of participants with aspects of their enrolment in financial-incentive programs; three studies examined the satisfaction of members of participants’ families with their lives in the undeserved area.Financial incentives, underserved areas,review

A systematic literature review of undergraduate clinical placements in underserved areas.

Context: The delivery of undergraduate clinical education in underserved areas is increasing in various contexts across the world in response to local workforce needs. A collective understanding of the impact of these placements is lacking. Previous reviews have often taken a positivist approach by only looking at outcome measures. This review addresses the question: What are the strengths and weaknesses for medical students and supervisors of community placements in underserved areas? Methods: A systematic literature review was carried out by database searching, citation searching, pearl growing, reference list checking and use of own literature. The databases included MEDLINE, EMBASE, PsycINFO, Web of Science and ERIC. The search terms used were combinations and variations of four key concepts exploring general practitioner (GP) primary care, medical students, placements and location characteristics. The papers were analysed using a textual narrative synthesis. Findings: The initial search identified 4923 results. After the removal of duplicates and the screening of titles and abstracts, 185 met the inclusion criteria. These full articles were obtained and assessed for their relevance to the research question; 54 were then included in the final review. Four main categories were identified: student performance, student perceptions, career pathways and supervisor experiences. Conclusions: This review reflects the emergent qualitative data as well as the quantitative data used to assess initiatives. Underserved area placements have produced many beneficial implications for students, supervisors and the community. There is a growing amount of evidence regarding rural, underserved areas, but little in relation to inner city, deprived areas, and none in the UK

How the Diversity of Curriculum Prepares Future Physician Assistants (PA\u27s) to Provide Healthcare for Underserved Populations

How the Diversity of Curriculum Prepares Future Physician Assistants (PA\u27s) to Provide Healthcare for Underserved Populations Jessica Lim-Wilson, Depts. of Health, Physical Education & Exercise Science and Psychology, with Dr. Christine Booker, Dept. of Kinesiology and Health Sciences This research project was conducted to explore the availability of the diverse curriculum in Physician Assistant programs by region as well as the scope of PA responsibility across the United States. Using the information collected, the association between Physician Assistant curriculum and underserved population health outcomes by region was examined. In conclusion, this research has assisted in understanding the relationship between PA education and health outcomes.https://scholarscompass.vcu.edu/uresposters/1321/thumbnail.jp

Squeeze Play

As they go to bat for their underserved clients, legal clinics must balance responsibilities for educating students and upholding the public trust

Promising Practices: The Importance of Outreach to Underserved Populations

Underserved groups have been handicapped by barriers that have resulted in low participation rates in the job market, especially if they have a physical or mental disability. It is often times difficult to get the attention of these underserved groups without making extraordinary efforts to reach out to their communities. Understanding the barriers that cause the low participation in our programs is the first step in removing these barriers. This overview is not intended to be all-inclusive, but simply to discuss a few of the barriers that have caused this lack of participation and how specific projects have taken steps to address them

Buffalo\u27s Community Health Centers: Healthcare for People with Low Incomes

Community health centers are non-profit, community-oriented healthcare providers. Generally, they are a subset of Federally Qualified Health Centers, institutions that receive special funding because they provide medical care to underserved populations. They offer preventative and primary healthcare, including physical exams, routine testing and screening, immunizations, dental care, pediatrics, women’s health, prenatal care, and nutritional services. These clinics are open to all, but designed to reach out to underserved populations, especially low-income individuals, racial and ethnic minorities, recent immigrants, and rural populations. The National Association of Community Health Centers estimates that nationally, their clinics provide health services for over 23 million people, and this number is increasing. To give one example from Buffalo, the Jericho Road Family Practice serves more than 30,000 people each year

Philanthropy's Role in Creating a Connected America

Outlines how foundations can support capacity building and expanding broadband access to underserved communities by leveraging the federal Broadband Infrastructure and Broadband Technologies Opportunity Programs through matching grants and partnerships