Model of rotation and efficient distribution of rural doctors in the La Troncal health district
Abstract
The objective of this research was to design an efficient model for the rotation and redistribution of medical personnel in rural health centers in the canton of La Troncal, Ecuador. A non-experimental design and mixed approach were used, combining analysis of administrative records, surveys of rural doctors, and semi-structured interviews with health authorities. The results revealed a predominance of young and female personnel, temporary contracts, insufficient or uncoordinated rotation, limitations in infrastructure and logistical support, and a perceived impact on continuity and work motivation. In conclusion, the organization and distribution of medical personnel in rural centers in La Troncal faces challenges such as job instability, resource shortages, and ineffective rotation, which affect the continuity and quality of care. Comprehensive human talent management is required, with strategic planning, balanced workloads, professional development, incentives, and sustainability of rural care.
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References
Baker, O., Horvitz-Lennon, M., & Yu, H. (2024). Clinician Distribution and Type in Rural and Urban Areas of the National Health Services Corps. JAMA Network, 1-5. https://n9.cl/4gk8ir
Barreto, T., Jetty, A., Eden, A., Petterson, S., Bazemore, A., & Peterson, L. (2020). Distribution of Physician Specialties by Rurality. The Journal of Rural Health, 714-722. https://n9.cl/wkzr2
Bascolo, E., Houghton, N., Del Riego, A., & Fitzgerald, J. (2020). A renewed framework for the essential public health functions in the Americas. Pan American Journal of Public Health, 1-8. https://n9.cl/36v11
Cosgrave, C. (2020). The Whole-of-Person Retention Improvement Framework: A Guide for Addressing Health Workforce Challenges in the Rural Context. International Journal of Environmental Research and Public Health, 1-14. https://n9.cl/39so1a
Hernández, R., Fernández, C., & Baptista, M. (2014). Metodología de la Investigación. México D. F.: McGRAW-HILL / INTERAMERICANA EDITORES, S.A. DE C.V.
Moncho, M., Aparisi, S., Defez, B., Davol, A., & Peris, G. (2022). Health care in rural areas: proposal of a new telemedicine program assisted from the reference health centers, for a sustainable digitization and its contribution to the carbon footprint reduction. Heliyon, 1-6. https://n9.cl/h8c56
Pan American Health Organization. (2023). Strengthening the health workforce in the Americas: Focusing on critical shortages, distribution and quality. Pan American Journal of Public Health, 1-2. https://n9.cl/4ycwj
Punzalan, J., Guingona, M., Punzalan, M., Cristobal, F., Frahsa, A., & Liwanag, H. (2023). The Integration of Primary Care and Public Health in Medical Students’ Training Based on Social Accountability and Community-Engaged Medical Education. International Journal of Public Health, 1-12. https://n9.cl/1o5ju
Registro Oficial Órgano de la República del Ecuador. (24 de febrero de 2023). Registro Oficial Órgano de la República del Ecuador. https://n9.cl/pj918
Rodríguez, A., & Pérez, A. (2017). Métodos científicos de indagación y de construcción del conocimiento. Revista Escuela de Administración de Negocios, 1-26. doi: https://doi.org/10.21158/01208160.n82.2017.1647
Sanz, E., & Oliva, J. (2021). La percepción local del acceso a los servicios de salud en las áreas rurales. El caso del pirineo navarro. Anales del Sistema Sanitario de Navarra, 44(2), 185-194. Epub. https://n9.cl/csdcb
Stewart, R. (2023). Building a rural and remote health workforce: an overview of effective interventions. The Medical Journal of Australia, S3-S4. https://n9.cl/ibp24
Tamayo, C., Roca, M., & Nápoles, G. (2017). La modelación científica: algunas consideraciones teórico-metodológicas. Santiago, 79-90. https://n9.cl/e4a1a
Vera, L., Cuadros, C., & Zambrano, M. (2022). Impacto de las políticas públicas de salud en zonas rurales ecuatorianas. Revista Estudios del Desarrollo Social: Cuba y América Latina, 10(2), . Epub. https://n9.cl/ev0vr
Wheat, J. (2025). Twenty-five years of Alabama’s Rural Health Leaders Pipeline: what difference has it made? Frontiers in Medicine, 1-11. https://n9.cl/3wlkr
Young, J. (2025). How Private Equity Undermines Rural Health Equity. AMA Journal of Ethics, 369-375. https://n9.cl/d2r0zc.
Zhu, P., Xu, X., Zhai, C., He, C., Su, Y., Yuan, H., Tang, Z. (2025). Turnover intentions among rural-oriented medical students in Western China: a constructivist grounded theory study. Primary Health Care Research & Development, 1-7. https://n9.cl/236jn
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