Abstract：
OBJECTIVE: To assist policy-makers in improving access to eye care in under-served areas by analysing the relationship between motivational factors affecting the uptake of task-shifting in eye care and the recruitment and retention of optometrists in remote and rural areas.
BACKGROUND: The World Health Organization recommends two key strategies in tackling preventable blindness in under-served areas: improving human resources for health and task-shifting. The relationship between task-shifting and recruitment and retention of eye care workers in under-served areas is unknown. Ghana and Scotland are two countries from different levels of economic development that have notably expanded the roles of optometrists and struggle with rural recruitment and retention.
METHODS: Motivation was explored through semi-structured interviews with 19 optometrists in Ghana and Scotland with experience in remote and rural practice. Framework analysis was used to analyse interviews, explore the relationship between task-shifting and recruitment and retention and create recommendations for policy.
RESULTS: The main motivational considerations included altruism, quality of life, learning and career opportunities, fulfilling potential, remuneration, stress of decision-making and collaboration. Motivational and demotivational factors for task-shifting and recruitment/retention shared many similar aspects.
CONCLUSIONS: Recruitment and retention in remote and rural areas require staff be incentivised to take up those positions, motivated to remain and given the adequate resources for personal and professional fulfilment. Task-shifting also requires incentivisation, motivation to continue and the resources to be productive. Many motivational factors influencing recruitment/retention and task-shifting are similar suggesting these two strategies can be compatible and complementary in improving access to eye care, although some factors are culture and context specific. Understanding optometrists\' motivation can help policy-makers improve rural recruitment and retention and plan services.
BACKGROUND: The World Health Organization recommends two key strategies in tackling preventable blindness in under-served areas: improving human resources for health and task-shifting. The relationship between task-shifting and recruitment and retention of eye care workers in under-served areas is unknown. Ghana and Scotland are two countries from different levels of economic development that have notably expanded the roles of optometrists and struggle with rural recruitment and retention.
METHODS: Motivation was explored through semi-structured interviews with 19 optometrists in Ghana and Scotland with experience in remote and rural practice. Framework analysis was used to analyse interviews, explore the relationship between task-shifting and recruitment and retention and create recommendations for policy.
RESULTS: The main motivational considerations included altruism, quality of life, learning and career opportunities, fulfilling potential, remuneration, stress of decision-making and collaboration. Motivational and demotivational factors for task-shifting and recruitment/retention shared many similar aspects.
CONCLUSIONS: Recruitment and retention in remote and rural areas require staff be incentivised to take up those positions, motivated to remain and given the adequate resources for personal and professional fulfilment. Task-shifting also requires incentivisation, motivation to continue and the resources to be productive. Many motivational factors influencing recruitment/retention and task-shifting are similar suggesting these two strategies can be compatible and complementary in improving access to eye care, although some factors are culture and context specific. Understanding optometrists\' motivation can help policy-makers improve rural recruitment and retention and plan services.
摘要：
目标：通过分析影响眼科护理任务转移的动机因素与偏远和农村地区验光师的招募和保留之间的关系，协助政策制定者改善服务不足地区的眼科护理服务。
背景：世界卫生组织建议在服务不足地区应对可预防失明的两个关键战略：改善卫生人力资源和任务转移。在服务不足的地区，任务转移与招聘和保留眼科医生之间的关系尚不清楚。加纳和苏格兰是两个经济发展水平不同的国家，它们显着扩大了验光师的作用，并在农村招聘和保留方面进行了斗争。
方法：通过对加纳和苏格兰19名具有偏远和农村实践经验的验光师进行半结构化访谈，探索了动机。框架分析用于分析访谈，探索任务转移与招聘和留用之间的关系，并提出政策建议。
结果：主要的动机考虑包括利他主义，生活质量,学习和职业机会，履行潜力，薪酬,强调决策和合作。任务转移和招聘/保留的动机和动机因素有许多相似的方面。
结论：偏远和农村地区的招聘和保留要求激励员工担任这些职位，有动力留下来，并为个人和职业实现提供足够的资源。任务转移也需要激励，继续的动力和生产力的资源。许多影响招募/保留和任务转移的动机因素是相似的，表明这两种策略可以兼容和互补，以改善获得眼部护理。虽然有些因素是文化和背景的具体情况。了解验光师的动机可以帮助政策制定者改善农村招聘和保留以及计划服务。
背景：世界卫生组织建议在服务不足地区应对可预防失明的两个关键战略：改善卫生人力资源和任务转移。在服务不足的地区，任务转移与招聘和保留眼科医生之间的关系尚不清楚。加纳和苏格兰是两个经济发展水平不同的国家，它们显着扩大了验光师的作用，并在农村招聘和保留方面进行了斗争。
方法：通过对加纳和苏格兰19名具有偏远和农村实践经验的验光师进行半结构化访谈，探索了动机。框架分析用于分析访谈，探索任务转移与招聘和留用之间的关系，并提出政策建议。
结果：主要的动机考虑包括利他主义，生活质量,学习和职业机会，履行潜力，薪酬,强调决策和合作。任务转移和招聘/保留的动机和动机因素有许多相似的方面。
结论：偏远和农村地区的招聘和保留要求激励员工担任这些职位，有动力留下来，并为个人和职业实现提供足够的资源。任务转移也需要激励，继续的动力和生产力的资源。许多影响招募/保留和任务转移的动机因素是相似的，表明这两种策略可以兼容和互补，以改善获得眼部护理。虽然有些因素是文化和背景的具体情况。了解验光师的动机可以帮助政策制定者改善农村招聘和保留以及计划服务。
