Abstract
The World Health Organization has recognised two key strategies in tackling preventable blindness: improving human resources for health in under-served areas, and task-shifting. The relationship between task-shifting in eye care and the recruitment and retention of eye care workers in under-served areas, and whether these strategies are compatible, is unknown.Aim:
To improve access to eye care in under-served areas by analysing the relationship between task-shifting in rural areas of Scotland and Ghana and the recruitment and retention of mid-level providers in eye care.
Methods:
A literature review was conducted relating to task-shifting and recruitment and retention of eye health workers using the lens of work motivation theory. Semi-structured interviews with 19 optometrists with experience of remote and rural practice were conducted: nine in Ghana and ten in Scotland. Framework analysis was used to analyse interviews and create recommendations for policy.
Results:
Interviews demonstrated the main motivational factors for optometrists in Ghana and Scotland which were categorised into motivational, demotivational and hygiene factors for recruitment, retention and task-shifting. Results from Ghana and Scotland were compared and contrasted for contextual implications.
Conclusions:
Improving access to eye care is not as simple as hiring more staff. Staff need to be incentivised to take up positions in underserved areas, motivated to remain in those positions and given the appropriate resources to be productive. Task-shifting also requires incentivisation, motivation and resources. Many of the motivational factors influencing recruitment and retention and task-shifting are similar, suggesting they are compatible strategies in improving access to eye care, although some factors are culture- and context-specific. Motivation theory can help policy makers understand these motivational factors and plan health services accordingly.
| Date of Award | 2024 |
|---|---|
| Original language | English |
| Awarding Institution |
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| Supervisor | Niall Strang (Supervisor) & Sven Jonuscheit (Supervisor) |