Review Article
The effectiveness of continuing education programmes for health workers in rural and remote areas: a systematic review and meta-analysis
AUTHORS
#Yanan Wu1 Masters Degree, Student
#Xuefeng Wei2 Masters Degree, Student
Liying Zhou3 Masters Degree, Student
Fenfen E4 Masters Degree, Student
Yiliang Zhu5 Dr, Professor
Meng Xu6 Masters Degree, Student
Nan Chen7 Masters Degree, Student
Xue Shang8 Masters Degree, Student
Kangle Guo9 Masters Degree, Student
Yanfei Li10 Masters Degree, Student
Kehu Yang11 Dr, Professor
Xiuxia Li12 Dr, Professor *
#Contributed equally
AFFILIATIONS
1, 2, 3, 4, 6, 7, 8, 10, 11, 12 Health Technology Assessment Center/Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China; Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China; and Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China
5 School of Medicine, University of New Mexico, Albuquerque, NM 87107, USA
9 Gansu Provincial Hospital, Lanzhou, 730000, China
ACCEPTED: 18 July 2023
early abstract:
Introduction: Health workers in rural and remote areas shoulder heavy responsibilities of rural residents. This systematic review aims to assess the effectiveness of continuing education programmes for health workers in rural and remote areas.
Methods: Eight electronic databases were searched on November 28, 2021. Randomized controlled trials (RCTs) and quasi-experimental studies evaluating the effectiveness of continuing education for health workers in rural and remote areas were included. The quality of the studies was assessed using the risk of bias tool provided by Effective Practice and Organization of Care (EPOC). A meta-analysis was performed for eligible trials, and the other findings were presented as a narrative review due to inconsistent study types and outcomes.
Results: A total of seventeen studies were included, four of which were RCTs. The results of the meta-analysis showed that compared to no intervention, continuing education programmes significantly improved the knowledge awareness rate of participants (OR = 4.09, 95% CI: [2.51, 6.67], P < 0.05). Qualitative analysis showed that twelve studies reported on the level of knowledge of participants, with all showing positive changes. Eight studies measured the performance of health workers in rural and remote areas, with 87.50% (n=7) finding improved performance. Two studies reported on the impact of continuing education programmes for health workers in rural and remote areas on patient health, with only one showing a positive change. One study from India measured the health of communities, which showed a positive change.
Conclusions: The results of this study showed that continuing education programmes were an effective way to address the lack of knowledge and skills among health workers in rural and remote areas. Few studies have examined the effectiveness of education programmes for health workers in rural and remote areas in improving patient health outcomes. It is not yet known whether the delivery of health worker continuing education programmes in rural areas has a positive impact on patient and community health. Future attention should continue to be paid to the impact on these outcomes.