Beyond the Paycheck: A Realist Synthesis of Mechanisms Influencing Retention of Medical Doctors in Rural Sudan

الملخص

Sudan faces a persistent shortage and severe urban–rural maldistribution of medical doctors, undermining progress toward Universal Health Coverage. Despite long standing reliance on compulsory service and financial incentives, rural areas continue to experience high turnover, and existing studies offer limited explanation of why retention interventions succeed or fail. This realist synthesis develops an explanatory program theory of rural doctor retention in Sudan by examining how outcomes arise from interactions between contextual conditions and underlying mechanisms.