Published date: May 17 2018

Journal Title: KnE Life Sciences

Issue title: The 2nd International Meeting of Public Health 2016 (IMOPH) – Part I

Pages: 319–329

DOI: 10.18502/kls.v4i4.2291

I Purnamasariindriya_rahmadi@yahoo.co.id

D Ayuningtyas

N N Dwi Sutrisnawati

Meeting the shortage of medical specialist in remote areas is a challenge for local governments in the era of decentralization. Many factors such as the socio-economic, geographic, and demographic conditions contribute to this challenge. This research analyzes the various factors that influence the availability of medical specialist in the Malingping District Hospital in a remote area of Banten Province. A qualitative approach was taken, employing in-depth interviews and research observations in Malingping District Hospital. Malingping is a remote and underdeveloped area in Banten Province. The research revealed that the availability of medical specialist in Malingping District Hospital was inadequate, both in terms of number and type. Difficult geographical conditions and inadequate infrastructure cause there are limited means of transportation for reaching Malingping, which greatly affects the flow of people and goods. Remote location and heavy terrain with curving, uphill and downhill contours makes access to Malingping so difficult. The size and growth of the population is relatively stagnant. Moreover, development tends to be slow, and the economy of the region is still underdeveloped. Many medical specialist do not want to visit, work, and settle in Malingping. Based on this study, it can be concluded that the motivation of medical specialist to work in a region, particularly a remote area, is greatly influenced by the location, geographical condition, economic development, population number, and significant growth. Concrete efforts are needed to provide access to remote areas, as are efforts
that strive toward regional development that directly affects the regional economy, attracting professionals including medical specialist to work in these regions.

Keywords: medical specialist, availability, external factors, remote areas.

[1] Ayuningtyas, Dumilah, 2014, Health Policy: Fundamental and Practice, Rajawali Pers, Jakarta


[2] Banten Provincial Government 2015, Decree of Banten Governor Number 28 Year 2015 on Standard Unit Price Banten Province Year 2015


[3] Cabinet Secretary of the Republic Indonesia, 2012, Presidential Decree Number 72 year 2012 on National Health System


[4] Dieleman, M and Harnmeijer, J. W., 2006, Improving Health Worker Performance: in Search of Promising Practices, Evidence and Information for Policy, KIT-Royal Tropical Institute of the Netherlands, WHO, Geneva, Switzerland


[5] Directorate General Higher Education for Republic of Indonesia, Ministry of Health and Education (Ditjen Dikti Kemendikbud), 2010, A picture of the availability and needs of medical personnel in Indonesia, Health Professional Education Quality (HPEQ) Project, Jakarta


[6] Directorate General of Public Health Efforts, 2015, Hospital Record and Report System (SP2RS), Jakarta


[7] Ilyas, Yaslis, 2006, Determinants Distribution Specialist Doctors in the City / Regency Indonesia, Health Care Management Journal Volume 09, No. 3, Jakarta


[8] Malingping District Hospital, 2015, Malingping District Hospital Service Profile Year 2015, Malingping, Lebak Regency, Banten Province


[9] Malingping District Hospital, 2014, Malingping District Hospital Service Profile Year 2014, Malingping, Lebak Regency, Banten Province


[10] Ministry of Health Republic of Indonesia, 2015, Minister of Health Regulation No. 44 Year 2015 on Medical Specialist Education Program Grants/ Orthodontist Specialist Program


[11] Ministry of Health Republic of Indonesia, 2014, Minister of Health Regulation No. 56 Year 2014 on Classification and Hospital Licensing


[12] Ministry of Health Republic of Indonesia, 2013, Minister of Health Regulation No. 6 Year 2013 on Criterion of Health Service Facilities in Remote Areas, Distant Areas, and Unfavorable Health Services Facility.


[13] Ministry of Health Republic of Indonesia, 2013, Minister of Health Regulation No. 7 Year 2013 on Guidelines for appointing and assigning Doctors and Midwives as a variable-hour employees.


[14] Ministry of Health Republic of Indonesia, 2013, Minister of Health Regulation No. 9 Year 2013 on Special Assignment of Health Manpower


[15] Ministry of Health Republic of Indonesia, 2011, Minister of Health Regulation No. 2052 Year 2011 on Practitioner License and Medicine Practice.


[16] Ministry of Health Republic of Indonesia, 2007, Minister of Health Regulation No. 1235 Year 2007 on Allocating Incentives for Health Manpower under Resident Special Assignment.


[17] Ministry of the State Secretariat Republic of Indonesia, 2014, Act Number 23 Year 2014 on Regional Government, State Gazette of the Republic of Indonesia Year 2014 Number 244, Additional State Gazette of the Republic of Indonesia Number 5587


[18] Ministry of the State Secretariat Republic of Indonesia, 2014, Act Number 36 Year 2014 on Health Manpower, State Gazette of the Republic of Indonesia Year 2014 Number 298


[19] Ministry of the State Secretariat Republic of Indonesia, 2009, Act Number 36 Year 2009 on Health Care, State Gazette of the Republic of Indonesia Year 2009 Number 144


[20] Ministry of the State Secretariat Republic of Indonesia, 2009, Act Number 44 Year 2009 on Hospital, State Gazette of the Republic of Indonesia Year 2009 Number 153


[21] Ministry of the State Secretariat Republic of Indonesia, 2004, Act Number 29 Year 2004 on Medicine Practice, State Gazette of the Republic of Indonesia Year 2004 Number 116


[22] Ministry of the State Secretariat Republic of Indonesia, 2010, Republic of Indonesia Decree Number 53 Year 2010 on Civil Servant Practice, State Gazette of the Republic of Indonesia Year 2010 Number 74


[23] National Development Planning Agency (BAPPENAS), 2005, Reports Health Manpower Planning Policy Studies, Directorate of Public Health and Nutrition, Deputy Health manpower and Culture, Jakarta


[24] National Agency on Statistics (BPS) Banten Province, 2015, Serang Banten


[25] National Agency on Statistics (BPS) Lebak District, 2015, Rangkasbitung, Banten Province


[26] Nojima, Yoshiaki et al, 2014, Job and Life Satisfaction and Preference of Future Practice Locations of Physicians on Remote Islands in Japan, Human Resources for Health in 2015, downloaded via http://www.human-resources-health.com/content/13/ 01/39 17 November 2015


[27] The Board of Health Manpower for Health Empowerment and Development (BPPSDM Kesehatan), 2007, Jakarta


[28] The Center on Planning and Employment of Health Manpower. Data on Planning and Health Manpower Needs 2012-2015, Jakarta


[29] The Research and Health Development Institution (BALITBANGKES), 2010, Jakarta


[30] World Health Organization (WHO), 2010, Increasing Access to Health Workers in Remote and Rural Areas Through Improved Retention : Global Policy Recommendations, WHO Press, Geneva, Switzerland


[31] World Health Organization (WHO), 2010, Models and Tools for Health Workforce Planning and Projections (Human Resources for Health Observer, 3), WHO Press, Geneva, Switzerland


[32] World Health Organization (WHO), 2009, Monitoring the Geographical Distribution of The Health Workforce in Rural and Underserved Areas, retrieved from http://www.who.int/entity/workforcealliance/knowledge/resources/ monitoring_geodistribution/en/ on November 18, 2015.


[33] Zurn, Pascal et al, 2004, Imbalance in the Health Workforce, retrieved from http: //www.human-resources-health.com/content/2/1/13 on November 26, 2015