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

.Abstract: Indonesia, one of the Asia Pacific 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 document analysis and key informant interviews with officials responsible for medical workforce recruitment and retention. We used the WHO’s guidelines as an analytical matrix to examine the recruitment and retention practices under four domains, i) educational, ii) regulatory, iii) financial, and iv) professional and personal development, and classified them into University/Medical School level and Government/Non-government level. Our findings suggest that Indonesia has 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 the regional medical school initiatives. Relevant programs must be re-evaluated and re-enforced concerning significance, comprehensiveness and effectiveness for sustainable rural and remote medical workforce.