Purnamasari Indriya, Ayuningtyas Dumilah, Sutrisnawati Ni Nyoman Dwi
Department of Health Administration and Policy, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia.
Iran J Public Health. 2019 Jul;48(7):1270-1277.
Indonesia as an archipelagic country, makes the efforts to fulfill the needs of medical specialists in remote areas are not easy tasks. This study aimed to explore the availability and the needs fulfillment efforts of medical specialist in remote areas; and to know whether the availability of medical specialists have met the hospital needs, and how the authorities efforts to fulfill them, also the factors that affect the effort.
This qualitative research was conducted with case study approach in Haji Abdoel Madjid Batoe District Hospital (RSUD HAMBA) Batanghari Jambi and Malingping District Hospital (RSUD Malingping) in Lebak Banten. In-depth interviews were conducted with various stakeholders.
The availability of medical specialist in both hospitals in number and type are inadequate. This fact indicates low retention and motivation of medical specialists to work in remote area. The major factor in both hospitals is inadequate salaries, difficult access, lack of medical equipment, also the difficulty to develop a career. However, these factors in both area ultimately boil down to the lack of government policies that support medical specialist fulfillment.
The important factors that affect the lackness of effort in fulfilling medical specialists' placement in remote areas are inadequate of infrastructures, competence and career development contraints, and the coordination between national and regional policies. The commitment of central and regional government to improve the infrastructures, competence and career developments, and regulations with respect to medical specialists in remote areas.
印度尼西亚作为一个群岛国家,要满足偏远地区对医学专家的需求并非易事。本研究旨在探讨偏远地区医学专家的可获得性以及满足需求的努力情况;了解医学专家的可获得性是否满足医院需求,以及当局为满足这些需求所做的努力,还有影响这些努力的因素。
本定性研究采用案例研究方法,对占碑省巴唐哈里的哈吉·阿卜杜勒·马吉德·巴托医院(RSUD HAMBA)和万丹省勒巴克的马林坪区医院(RSUD Malingping)进行研究。对不同利益相关者进行了深入访谈。
两家医院医学专家的数量和类型都不足。这一事实表明医学专家在偏远地区工作的留任意愿和积极性较低。两家医院的主要因素是薪资不足、交通不便、医疗设备缺乏以及职业发展困难。然而,这两个地区的这些因素最终都归结为政府缺乏支持医学专家配置的政策。
影响偏远地区医学专家配置工作不力的重要因素包括基础设施不足、能力和职业发展受限以及国家和地区政策之间的协调问题。中央和地区政府应致力于改善偏远地区医学专家的基础设施、能力和职业发展以及相关法规。