INTRODUCTION:
Health workers are crucial to healthcare systems, and equitable distribution is vital for quality care. The WHO predicts a global shortage of 18 million health workers by 2030, with low- and middle-income countries facing the greatest deficits. Southeast Asia is expected to experience the largest shortfall, with a deficit of 6.9 million health professionals (1). Retaining health workers in rural areas is particularly challenging due to shortages, uneven distribution, and high turnover. This systematic review examines the perspectives of health workers on barriers and facilitators to retention in rural and underserved areas of Southeast Asia, to inform strategies to enhance retention and improve healthcare delivery.

METHODS:
The review focused on health workers’ views on retention in rural Southeast Asia. Studies published before 22 March 2025 were identified through MEDLINE, Web of Science, and EMBASE databases via the LSHTM Library. Peer-reviewed articles on health workforce retention in rural areas of the WHO South-East Asia Region were included.

RESULTS:
The initial search identified 660 publications, with 514 unique records. After screening, 498 articles were excluded, and 16 full-text articles were reviewed. Five studies from Bangladesh, India, Indonesia, and Nepal met the inclusion criteria. Four studies used qualitative methods, and one used a mixed-methods approach. All studies met CASP quality standards. Findings indicate that retention is influenced by financial and non-financial incentives, career development opportunities, working conditions, community support, and professional recognition. Poor infrastructure and limited career progression are significant barriers.

CONCLUSIONS:
Retention in rural areas depends on incentives, career opportunities, and community support. Addressing barriers like poor infrastructure and career stagnation, while enhancing recognition and community ties, is crucial to improving retention and healthcare delivery.