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Rural Road to Health

Jan 30, 2024

Dr Cath Cosgrave is a rural change-maker, strategic advisor, trainer, coach, presenter and evaluator.  She has more than 25 years of experience  working with rural communities developing community-centred, strength-based strategies to effectively address local health and community service issues.

Attract Connect Stay website -


Episode summary:

00.55  Dr Cosgave shares how she became involved in rural health

06.15  What are the challenges facing rural communities when trying to retain a health workforce? 

08.30  What is the attract, connect, stay framework?

20.50  How does the framework work at a practical implementation level?  

22.50  The community connector program

36.15  What has the community response been to this approach?

40.45  What have the key learnings been?

45.20  Is the framework transferable to other countries?


Key messages:

What influences decisions to stay or decisions to leave a rural community? 

Attraction of health workers is a major barrier. 

Nursing is a bit better as training happens locally.  Doctors tend to be from out of area.

Life stage, career stage and degree of familiarity with rural living/place - the three main factors influencing recruitment and retention.

Health professionals start to weigh up if they will leave or stay around the 12 months into a new position.

Early careers are interested in career development and support

Middle life, family stage, flexible career opportunities are important.

Senior professionals, interested in leaving a legacy and have fewer family commitments. 

Support needed for healthcare workers to settle and connect with the community. 

The framework focuses on three areas: 1) Friendly and supportive workplace. 2) Building career pathways in the local region.  3) Social connections and sense of belonging.  All three need to be addressed.

Retention is different depending on life stage, if you are getting two years out of early career professionals that is very good.  Life stage is the most important determinant for decision making.

Very difficult to attract mid-career professionals as everything needs to be tailored to the whole family. 

Community connector program- to help the professional and their family integrate well with the community.  

The community connector is always recruited from the local community and use their knowledge of the local area and their social connections to help support the health professional and their family.

Lack of funding is often a barrier to implementing new initiatives. 

People experience rural communities as warm and friendly but not as inclusive.  Rural communities need to look at ways to modernize to support diversity.

How well does the person fit and how well can the community support them? This is important to ask and think about. 

The need to be patient, it is a cultural change program at organizational change and community level.  

Ensuring that it is sustainable.

Key stakeholders need to learn to work well together.


  • My most relevant papers are:

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 Health17(8), 2698.

Cosgrave, C., Malatzky, C., & Gillespie, J. (2019) Social determinants of rural health workforce retention: A scoping review. International Journal of Environmental Research and Public Health 16(3) 314.

Cosgrave, C., Maple, M., & Hussain, R. (2018) An explanation of turnover intention among early-career nursing and allied health professionals working in rural and remote Australia: Findings from a grounded theory study, Rural and Remote Health, 18: 4511. doi: 10.22605/RRH4511

  • People can follow me/ Attract Connect Stay developments /resources







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