title: Analysis of context factors in compulsory and incentive strategies for improving attraction and retention of health workers in rural and remote areas: a systematic review.
abstract: BACKGROUND
  Current literature systematically reports that interventions to attract and retain health workers in underserved areas need to be context specific but rarely defines what that means. In this systematic review, we try to summarize and analyse context factors influencing the implementation of interventions to attract and retain rural health workers.
  
  
  METHODS
  We searched online databases, relevant websites and reference lists of selected literature to identify studies on compulsory rural service programmes and financial incentives. Forty studies were selected. Information regarding context factors at macro, meso and micro levels was extracted and synthesized.
  
  
  RESULTS
  Macro-level context factors include political, economic and social factors. Meso-level factors include health system factors such as maldistribution of health workers, growing private sector, decentralization and health financing. Micro-level factors refer to the policy implementation process including funding sources, administrative agency, legislation process, monitoring and evaluation.
  
  
  CONCLUSIONS
  Macro-, meso- and micro-level context factors can play different roles in agenda setting, policy formulation and implementation of health interventions to attract and retain rural health workers. These factors should be systematically considered in the different stages of policy process and evaluation.
authors.affiliation: China Centre for Health Development Studies, Peking University, Mailbox box 505, 38 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China. xliu@bjmu.edu.cn.
authors.forename: Xiaoyun
authors.initials: X
authors.lastname: Liu
authors.affiliation: Center for Woman and Child's Health, China Center for Disease Control and Prevention, Beijing, China. lillydou@126.com.
authors.forename: Lixia
authors.initials: L
authors.lastname: Dou
authors.affiliation: China Centre for Health Development Studies, Peking University, Mailbox box 505, 38 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China. nancyzhang0224@163.com.
authors.forename: Huan
authors.initials: H
authors.lastname: Zhang
authors.affiliation: School of Political Science and Public Administration, Wuhan University, 299 Bayi Road, Wuchang District, Wuhan, China. yangsun@whu.edu.cn.
authors.forename: Yang
authors.initials: Y
authors.lastname: Sun
authors.affiliation: China Centre for Health Development Studies, Peking University, Mailbox box 505, 38 Xueyuan Road, Haidian District, Beijing, 100191, People's Republic of China. beibeiyuan@bjmu.edu.cn.
authors.forename: Beibei
authors.initials: B
authors.lastname: Yuan
mesh_terms: D003695:Delivery of Health Care; D006282:Health Personnel; D006801:Humans; D037141:Mandatory Programs; D008507:Medically Underserved Area; D009042:Motivation; D010560:Personnel Selection; D010563:Personnel Turnover; D019035:Rural Health Services; D012424:Rural Population; D000078329:Workforce