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Attracting, Recruiting, and Retaining Medical Workforce: A Case Study in a Remote Province of Indonesia

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MDPI
DOI: 10.3390/ijerph20021435

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medical workforce shortage; rural and remote; recruitment and retention; sustainable rural medical workforce; medical school initiatives

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Indonesia has faced a chronic medical workforce shortage and has implemented some WHO-recommended strategies for recruitment and retention. However, there are still challenges in implementation, and nationwide government intervention is needed to strengthen the impact of regional medical school initiatives and re-evaluate and reinforce relevant programs.
Indonesia, one of the Asia Pacific low-and middle-income countries (LMICs), has suffered from a chronic medical workforce shortage. However, there are limited published studies describing the approaches implemented by the Indonesian government regarding the recruitment and retention of the medical workforce. This case study aimed to understand the current practices for recruitment and retention of the medical workforce in Indonesian rural and remote provinces. We conducted a case study of the Maluku Province of Indonesia with a document analysis and key informant interviews with officials responsible for medical workforce recruitment and retention. We used the World Health Organization's (WHO) guidelines as an analytical matrix to examine the recruitment and retention practices under the four domains of (i) educational, (ii) regulatory, (iii) financial, and (iv) professional and personal development and classified them into either University/Medical School level or Government/Non-government level. Our findings suggest that Indonesia implemented most of the WHO-recommended medical workforce recruitment and retention strategies. However, implementation is still problematic; hence, the aim of establishing an adequate, sustainable medical workforce has not been reached. Nationwide government intervention in educational aspects is important to magnify the impact of regional medical school initiatives. Relevant programmes must be re-evaluated and re-enforced concerning significance, comprehensiveness, and effectiveness for a sustainable rural and remote medical workforce.

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