WHO/WONCA Rural Pathways Checklist
This is a tool to assess the current status of a health care system within 8 action areas that have been proven to increase the size of the rural healthcare workforce in low to middle income countries. Together these domains form a pathway toward training and sustaining adequate numbers of competent health care workers in non-urban areas. The KSMA, KSMIRCME and STLI would like your opinions about how Kyrgyzstan's health care system is performing in these areas. We will summarize the collated information in a journal article listing the priority action areas to support the development of a robust rural healthcare workforce. Policy makers will be encourage to read this article. Individual responses will be kept confidential.

Please answer the questions from the perspective of the overall health care system, with the "we" in each question referring to the health care system as you experience it. Two of the initial fill-in-the-blank questions allow you to explain what type of rural health care problem you are most concerned about and what type of health care worker(s) are needed to address this problem.  Please answer all the multiple choice sections use the following scale to rank the country's progress in each area:  0=not started, 1=minimal progress, 2=mild, 3=moderate, and 4=strong progress.  Simply click on the circle in the column of the number that expresses your opinion.   If you wish to remain anonymous, it is fine to leave out your name.  Be sure to click "Submit" at the end of the form once you have finished.

This checklist is a draft developed by WONCA and sponsored by the WHO and they are invested in getting feedback on it prior to its planned release. The final 6 questions of the survey are designed to evaluate the usefulness of the checklist.  You should have receive an explanatory statement regarding this process with your initial invitation.  By submitting the survey below, you are allowing your de-identified data to be used to help the WHO validate this survey tool in addition to helping with the journal article described in the first paragraph.
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Name and title (optional)
Position
Clear selection
Organization
Office Location
Clear selection
Do you primarily work outside of Bishkek?
Role
What is/are the rural healthcare problem/s you are addressing?
Are there any particular health workers (and/or skills) that you need to address this problem and where are they needed?
A.
0
1
2
3
4
We are working with rural communities to define priorities and involve them in solutions for this problem.
We have scanned the national policies and plans for rural health and considered any new policies which would support us to implement a rural pathway for this problem
We have got partners who can technically/financially support us to implement rural pathways to address this problem.
Clear selection
Discuss context, barrier and enablers for section A about community needs, rural policies and partners.
B.
0
1
2
3
4
We have identified the skills and qualifications/training needed for the demands of the role
We have identified the factors motivating and/or inhibiting workers in this area at the moment
Clear selection
Discuss context, barrier and enablers for section B about existing workers and their scope.
C.
0
1
2
3
4
We are selecting motivated people from the rural community who will be suitable for this role if they get education and training
Our current selection process for these workers includes criteria about the person’s connection and motivation for working in the areas we want to address
We have decided an appropriate entry-level standard for the training
We have considered financial support needed for helping rural people to participate in the training
Clear selection
Discuss context, barrier and enablers for section C about selection of health workers.
D.
0
1
2
3
4
There are relevant bridging courses and step-wise qualifications available for people in the rural community to access all levels of required training
The curriculum includes rural practice elements for the scope and complexity of skills required in the rural community
Relevant theoretical and practical components of the course are delivered in or near the rural areas where we want the workers to end up
Real-time face to face and virtual supervision is available to support learning by rural trainees and workers in the areas we are addressing
Local government, community and champions have been engaged to support the rural training
Clear selection
Discuss context, barrier and enablers for section D about education and training.
E.
0
1
2
3
4
People who trained in the community can get jobs in the areas where they trained
Trainees and workers are routinely orientated to the community and workplace when they arrive
There are enough people on the rosters to make the workload sustainable
Infrastructure and clinical resources are available in the area so that the trainees and workers can practice at the top of their skills
We have put steps in place so that health workers feel safe 4
We are giving the workers enough time off
Clear selection
Discuss context, barrier and enablers for section E about working conditions for recruitment and retention.
F.
0
1
2
3
4
Graduates who complete the training are formally recognised by a qualification
Graduates have a career path and can use the qualification in a range of settings, not just in the location/s where they trained
People with qualifications are paid appropriately for being qualified to practice in the rural area
Clear selection
Discuss context, barrier and enablers for section F about accreditation and recognition.
G.
0
1
2
3
4
Senior clinician support and supervision is available for ongoing professional development by trainees and junior workers in the rural area
Peer support, professional meetings and practice discussions are available and relevant for the trainees and workers 5
Information systems are available for the trainees and workers in the rural area
Rural workers can access refresher courses, workshops and/or research projects they may want to do
Clear selection
Discuss context, barrier and enablers for section G about professional support and up-skilling.
H.
0
1
2
3
4
The measures we will use to monitor the effect of training and support strategies have been identified
We are collecting data to test the training and support strategies we are using
We are reporting data about the implementation and outcomes of the strategies we used
Clear selection
Discuss context, barrier and enablers for section H about monitoring and evaluation.
Thank you for completing the self-evaluation tool!  Please also give us feedback on the tool itself by responding these last few questions.
not at all
slightly
moderately
very
1. How applicable was the Checklist for your situation?
Clear selection
2. Did it help to identify the gaps in Kyrgyzstan's efforts to promote rural healthcare? Please describe.
3. Did it help to identify the strengths in Kyrgyzstan's efforts to promote rural healthcare? Please describe.
4. What do you plan to work on now that you have assessed Kyrgyzstan's efforts to promote rural healthcare? Please describe.
5. Do you have any other feedback about the checklist?
6. Do you have examples of rural pathways in your area to train and support rural health workers that could be good examples for others? If yes, please describe the objectives, actions and results.
Submit
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