The Needs Fulfillment of Medical Specialist in General Hospital Type C in Remote Areas

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.