Compulsory rural service – a step towards achieving universal health coverage?

Abstract

Universal Health Coverage is being adopted on a larger dimension globally. One of the important components for effective implementation of Universal Health Coverage is adequately trained human resources at every level of healthcare. The production and retention of trained human resources is a huge on-going challenge. Several state governments in India have devised a strategy of compulsory rural posting for undergraduates and postgraduates from government institutes, ensuring the availability of medical professionals in rural and tribal areas. The present study was planned with the objective of assessing the understanding of postgraduate and super speciality course students regarding the compulsory rural posting against a financial bond, and evaluate the factors influencing the completion of the bond. The aim was to provide suggestions to improve the compliance towards compulsory rural posting. The study revealed that increased duration of the medical course due to inclusion of bond, career pathway being unclear, lack of incentives in the form of increased salary or extra marks during postgraduate admission, effect on pursuing higher studies, social and personal life were major deterrents in completion of the compulsory rural posting. We also propose measures such as educational reforms, policy level reforms and consideration of social issues so as to make the implementation of this strategy a successful model in taking Universal Health Coverage forward.