This is study will be prone to selection, recall, social desirability and compliance biases due to the non-random sampling method (survey) and non-participation of some medical doctors.
18.104.22.168 Selection bias
Selection bias is defined as an error brought in when the study population is not representative of the targeted population (60). It can occur during the recruitment of study participants or during the course of retaining the research subjects (61). Although this survey intends to recruit all the eligible medical doctors from the graduate years 2013-15, it is possible that some participants may withdraw, not respond or never be contacted despite several attempts resulting in non-response bias.
Bias will also be introduced if those doctors who do not participate in the study or non-responders have different socio-demographic and work-related characteristics from those who will participate leading to ‘compliance bias’ (61). The participants who are less likely to respond in this study may be the medical doctors who do not attend the conference and those working with the MOH in administrative positions relating to the deployment duties, such as DHOs, because of conflict of interest. However, from the design stage of the study, the SMD and MOH have been engaged to ensure that they help with pre-contacting all the medical doctors to participate in the research. In addition, follow up will be made by phone calls and emails to ensure an increased response rate (46). The medical doctors who may have migrated abroad after their internship will be contacted through emails as the SMD has all their contact details. Furthermore, it is expected that the notification letters from the MOH to all the DHOs on the study will motiv...
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...potential factors which need to be addressed in order to improve deployment policies in Malawi. Furthermore, a comparison of the study findings and the related studies in other countries will be made.
Recommendations will be drawn based on the findings from the study to inform policy makers in the country. For example, if the some characteristics are found to have a significant effect on the deployment process, it will necessitate action by the Ministry of Health in aligning the deployment policies according to the suggestions.
Despite the study aiming to provide data on the deployment of the medical doctors in the short term, overall, it is expected to stimulate debate on the existing policies with the goal of improving health outcomes in Malawi. The findings can be extrapolated to similar settings and countries facing challenges with deployment of health workers.
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