Motivation and Retention of Health Workers in Rural, Remote, and Border Areas: A Mixed-Methods Systematic Review
DOI:
https://doi.org/10.32493/JJSDM.v10i1.60157Keywords:
Retention Intention, Motivation, Remote Areas, Rural, Border AreasAbstract
The unequal distribution of health workers across rural, remote, and border areas remains a global challenge because it directly affects equitable access to and sustainability of health services. This study aims to synthesize factors influencing the motivation and retention intention of health workers in underserved areas. A mixed-methods systematic review was conducted using the PRISMA 2020 reporting guideline and the Joanna Briggs Institute convergent integrated approach. The literature search was performed in Scopus and was limited to English-language, open-access journal articles published between 2015 and 2026. The final search was conducted on 5 April 2026. Of 42 records identified, 26 studies met the inclusion criteria and were synthesized thematically. The review shows that health workforce retention is a multilevel phenomenon shaped by individual and place-based determinants, financial and non-financial incentives, organizational conditions, career development, workforce governance, and digital capability. Financial incentives remain important for initial recruitment, but long-term retention depends more strongly on housing, workplace facilities, supportive supervision, professional learning, community attachment, and transparent career pathways. Rural, remote, and border settings also differ in their workforce challenges; therefore, retention policies require contextualized and multicomponent designs. This review contributes by integrating motivational theories, evidence from discrete choice experiments, organizational retention pathways, and digital support mechanisms into a unified framework for health workforce retention in underserved areas.
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