Top

Human Resources for Health

Published in:

01-12-2021 | Research

Factors associated with the rural and remote practice of medical workforce in Maluku Islands of Indonesia: a cross-sectional study

Authors: Farah Noya, Sandra Carr, Sandra Thompson, Rhonda Clifford, Denese Playford

Published in: Human Resources for Health | Issue 1/2021

Abstract

Background

Many factors contribute to engagement in rural and remote (RR) medical practice, but little is known about the factors associated with rural and remote medical practice in such remote locations as the Maluku Province of Indonesia. This study describes factors associated with actual RR practice, preferred RR practice, and intention to remain practice in Maluku Province.

Methods

An online survey of work-related experience and intentions for future rural work was administered to 410 doctors working in the Maluku province of Indonesia. Participant characteristics were described using descriptive statistics, associations between the independent variables with the location of the workforce, intention to remain practice in Maluku, preference for future RR practice in Maluku were analysed using Chi-square tests and logistic regression.

Results

A total of 324 responses (79% response rate) were recorded, comprising 70% females and 30% Pattimura University graduates of doctors employed in Maluku. Doctors working in RR areas were more likely to be a GP (OR 3.49, CI 1.03–11.8), have a monthly salary of more than IDR 6 million (OR 11.5, CI 4.24–31.1), and have no additional practice (OR 2.78, CI 1.34–5.78). Doctors intended to stay practice in Maluku were more likely to be born in Maluku (OR 7.77, CI 3.42–17.7) and have graduated from Pattimura University (OR 3.06, CI 1.09–8.54), and less likely to be a temporary employee (OR 0.24, CI 0.10–0.57). Doctors who prefer future RR practice in Maluku were more likely to experience rural living (OR 2.05 CI 1.05–3.99), have a positive indication of the impact of community exposure during medical schools on their current practice (OR 2.08, CI 1.06–4.09), currently practising in RR Maluku (OR 8.23, CI 3.27–20.8); and less likely to have bigger take-home pay (OR 0.30, CI 0.13–0.70).

Conclusion

This study indicates that special attention should be given to recruiting doctors with a rural background and ongoing support through attractive opportunities to build a sustainable RR workforce. Since a regional medical school helps supply doctors to the RR areas in its region, a sustained collaboration between medical schools and local government implementing relevant strategies are needed to widen participation and improve the recruitment and retention of RR doctors.

Available only for authorised users

Strasser R, Andre-Jacques N. Context counts: training health workers in and for rural remote areas. Bull World Health Organ. 2010;88:777–82.PubMedPubMedCentralCrossRef

Versteeg M, du Toit L, Couper I. Building consensus on key priorities for rural health care in South Africa using the Delphi technique. Glob Health Action. 2013;6:119–26. https://doi.org/10.3402/gha.v6i0.19522.CrossRef

Thompson SC, Cheetham S, Baxi S. The enablers, barriers and preferences of accessing radiation therapy facilities in the rural developed world—a systematic review. BMC Cancer. 2017;17:794.PubMedPubMedCentralCrossRef

Efendi F. Health worker recruitment and deployment in remote areas of Indonesia. Rural Remote Health. 2012;12(2):[about 6 p].

World Health Organization. Country cooperation strategy at a glance. Indonesia. 2018. https://apps.who.int/iris/rest/bitstreams/609150/retrieve.

World Health Organization. The 2018 update, Global Health Workforce statistics. Geneva: World Health Organization; 2018.

Head of the Central Statistic Agency. Regulation of The Head of The Central Statistic Agency Number 37 of The Year 2010 concerning Classification of Urban and Rural in Indonesia. In: Central Statistic Agency, editor. Book 3 Bali, Nusa Tenggara, Kalimantan, Sulawesi, Maluku, and Papua. Jakarta; 2010.

The Ministry of Health of the Republic of Indonesia. Data and information: Indonesia health profile 2017. Jakarta: The Ministry of Health of the Republic of Indonesia; 2017.

World Health Organization. Maternal mortality. 2019. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality. Accessed 12 June 2021.

10.

United Nations Children's Fund. Child survival and the SDGs. 2020. https://data.unicef.org/topic/child-survival/child-survival-sdgs/. Accessed 12 June 2021.

11.

The Ministry of Finance of the Republic of Indonesia. APBN 2018. 2018. https://www.kemenkeu.go.id/apbn2018. Accessed 23 Sept 2018.

12.

Herawati, Franzone R, Chrisnahutama A. Universal health coverage: tracking Indonesia’s progress. Jakarta: Perkumpulan PRAKARSA; 2020.

13.

President of Republic of Indonesia. Presidential regulation number 131 of the year 2015 regarding the determination of underdeveloped areas for the year 2015–2019. Jakarta: Ministry of State Secretariat; 2015.

14.

President of Republic of Indonesia. Presidential decree number 6 of the year 2017 concerning the determination of the outermost small islands. Jakarta: The Secreatariat of Cabinet of The Republic of Indonesia; 2017.

15.

Minister of Health of the Republic of Indonesia. Regulation of the Minister of Health of the Republic of Indonesia number 6 of the year 2013 concerning the criteria for remote, very remote, and unattractive health care facilities. Jakarta: Ministry of Health of The Republic of Indonesia; 2013.

16.

Chomitz KM, Setiadi G, Azwar A, Ismail N, Widiyarti A. What do doctors want? developing incentives for doctors to serve in Indonesia’s rural and remote areas. Washington DC: World Bank Development Research Group; 1998.

17.

Laksono AD, Ridlo IA, Ernawaty E. Distribution analysis of doctors in Indonesia. Indones J Health Adm. 2020;8(1):11. https://doi.org/10.20473/jaki.v8i1.2020.29-39.CrossRef

18.

Minister of Health of the Republic of Indonesia. Regulation of the Minister of Health of the Republic of Indonesia number 33 of the year 2018 concerning special assignment for health workers for Nusantara Sehat Program. Jakarta: Ministry of Health of the Republic of Indonesia; 2018.

19.

Narpiti D, Hasabasri M, Meliala A. Analysis of factors influenced retention of doctors and dentists in underserved areas. Yogyakarta: Universitas Gajah Mada; 2015.

20.

Indonesian Centre Bureau of Statistic. Indonesian population profile based on SUPAS 2015. Jakarta: Indonesian Centre Bureau of Statistic; 2015.

21.

Strasser R, Neusy AJ. Context counts: training health workers in and for rural and remote areas. Bull World Health Organ. 2010;88(10):777–82.PubMedPubMedCentralCrossRef

22.

Wakerman J. Defining remote health. Aust J Rural Health. 2004;12(5):210–4. https://doi.org/10.1111/j.1440-1854.2004.00607.x.CrossRefPubMed

23.

Strasser R. Social accountability and the supply of physicians for remote rural Canada. CMAJ. 2015;187(11):791–2.PubMedPubMedCentralCrossRef

24.

Noya F, Freeman K, Carr S, Thompson S, Clifford R, Playford D. Approaches to facilitate improved recruitment, development, and retention of the rural and remote medical workforce: a scoping review protocol. Int J Health Policy Manag. 2021;10(1):22–8. https://doi.org/10.34172/ijhpm.2020.27.CrossRefPubMed

25.

McGrail MR, Russell DJ, Campbell DG. Vocational training of general practitioners in rural locations is critical for the Australian rural medical workforce. Med J Aust. 2016;205(5):216–21.PubMedCrossRef

26.

Beauchamp J, Belanger M, Schofield A, Bordage R, Donovan D, Landry M. Recruiting doctors from and for underserved groups: Does new brunswick’s initiative to recruit doctors for its linguistic minority help rural communities? Can J Public Health. 2013;104(6 SUPPL.1):S44–8.PubMedPubMedCentralCrossRef

27.

Matsumoto M, Inoue K, Kajii E. Policy implications of a financial incentive programme to retain a physician workforce in underserved Japanese rural areas. Soc Sci Med. 2010;71(4):667–71.PubMedCrossRef

28.

Ray RA, Woolley T, Gupta TS. James Cook University’s rurally orientated medical school selection process: quality graduates and positive workforce outcomes. Rural Remote Health. 2015;15(4):3424.PubMed

29.

Rabinowitz HK, Diamond JJ, Markham FW, Santana AJ. The relationship between entering medical students’ backgrounds and career plans and their rural practice outcomes three decades later. Acad Med. 2012;87(4):493–7.PubMedCrossRef

30.

Hogenbirk JC, McGrail MR, Strasser R, Lacarte SA, Kevat A, Lewenberg M. Urban washout: How strong is the rural-background effect? Aust J Rural Health. 2015;23(3):161–8. https://doi.org/10.1111/ajr.12183.CrossRefPubMed

31.

Runge CE, MacKenzie A, Loos C, et al. Characteristics of Queensland physicians and the influence of rural exposure on practice location. Intern Med J. 2016;46(8):981–5.PubMedCrossRef

32.

Playford DE, Evans SF, Atkinson DN, Auret KA, Riley GJ. Impact of the Rural Clinical School of Western Australia on work location of medical graduates. Med J Aust. 2014;200(2):104–7. https://doi.org/10.5694/mja13.11082.CrossRefPubMed

33.

Crump WJ, Fricker RS, Ziegler CH, Wiegman DL. Increasing the Rural Physician Workforce: a potential role for small rural medical school campuses. J Rural Health. 2016;32(3):254–9. https://doi.org/10.1111/jrh.12156.CrossRefPubMed

34.

Playford D, Ngo H, Gupta S, Puddey IB. Opting for rural practice: the influence of medical student origin, intention and immersion experience. Med J Aust. 2017;207(4):154–8. https://doi.org/10.5694/mja16.01322.CrossRefPubMed

35.

Kwan MMS, Kondalsamy-Chennakesavan S, Geetha R, Toombs MR, Nicholson GC. The rural pipeline to longer-term rural practice: general practitioners and specialists. PLoS ONE. 2017;12(7):e0180394.PubMedPubMedCentralCrossRef

36.

Fuglestad A, Prunuske J, Regal R, Hunter C, Boulger J, Prunuske A. Rural family medicine outcomes at the University of Minnesota Medical School Duluth. Fam Med. 2017;49(5):388–93.PubMed

37.

McGrail MR, O’Sullivan BG, Russell DJ. Rural training pathways: the return rate of doctors to work in the same region as their basic medical training. Hum Resour Health [Electronic Resource]. 2018;16(1):56.CrossRef

38.

Campbell DG, McGrail MR, O’Sullivan B, Russell DJ. Outcomes of a 1-year longitudinal integrated medical clerkship in small rural Victorian communities. Rural Remote Health. 2019;19(2):4987. https://doi.org/10.22605/RRH4987.CrossRefPubMed

39.

Playford DE, Mercer A, Carr SE, Puddey IB. Likelihood of rural practice in medical school entrants with prior tertiary experience. Med Teach. 2019;41(7):765–72. https://doi.org/10.1080/0142159x.2019.1570099.CrossRefPubMed

40.

McGirr J, Seal A, Barnard A, et al. The Australian Rural Clinical School (RCS) program supports rural medical workforce: evidence from a cross-sectional study of 12 RCSs. Rural Remote Health. 2019;19(1):4971. https://doi.org/10.22605/rrh4971.CrossRefPubMed

41.

Woolley T, Sen Gupta T, Murray R, Hays R. Predictors of rural practice location for James Cook University MBBS graduates at postgraduate year 5. Aust J Rural Health. 2014;22(4):165–71. https://doi.org/10.1111/ajr.12106.CrossRefPubMed

42.

Matthews C, Bagg W, Yielder J, Mogol V, Poole P. Does Pukawakawa (the regional-rural programme at the University of Auckland) influence workforce choice? N Z Med J. 2015;128(1409):35–43.PubMed

43.

Petrany SM, Gress T, Poole D. A free clinic continuity experience during residency is associated with practice in underserved areas. J Grad Med Educ. 2017;9(5):595–9.PubMedPubMedCentralCrossRef

44.

O’Sullivan B, McGrail M, Russell D, et al. Duration and setting of rural immersion during the medical degree relates to rural work outcomes. Med Educ. 2018;52(8):803–15.PubMedCrossRef

45.

Playford DE, Nicholson A, Riley GJ, Puddey IB. Longitudinal rural clerkships: increased likelihood of more remote rural medical practice following graduation. BMC Med Educ. 2015;15:55.PubMedPubMedCentralCrossRef

46.

Shires L, Allen P, Cheek C, Wilson D. Regional universities and rural clinical schools contribute to rural medical workforce, a cohort study of 2002–2013 graduates. Rural Remote Health. 2015;15(3):3219.PubMed

47.

Woolley T, Gupta TS, Murray R. James Cook University’s decentralised medical training model: an important part of the rural workforce pipeline in northern Australia. Rural Remote Health. 2016;16(1):3611–21.PubMed

48.

Moore M, Burgis-Kasthala S, Barnard A, Hall S, Marks S. Rural clinical school students do come back: but it may take time. Aust J Gen Pract. 2018;47(11):812–4. https://doi.org/10.31128/ajgp-02-18-4505.CrossRefPubMed

49.

Myhre DL, Bajaj S, Woloschuk W. Practice locations of longitudinal integrated clerkship graduates: a matched-cohort study. Can J Rural Med. 2016;21(1):13–6.PubMed

50.

Berita Maluku Online. Far Far: the population of Maluku is in accordance with WHO standards. Berita Maluku Online. 2015.

51.

Minister of Health of the Republic of Indonesia. Regulation of the Minister of Health of the Republic of Indonesia number 2052 of the year 2011 concerning license of practice and implementation of medical practices. Jakarta: Indonesia MoHotRo; 2011.

52.

Jamieson JL, Kernahan J, Calam B, Sivertz KS. One program, multiple training sites: does site of family medicine training influence professional practice location? Rural Remote Health. 2014;14(1):1–12.

53.

Putri LP, Russell DJ, O’Sullivan BG, Kippen R. Factors associated with working in remote Indonesia: a national cross-sectional study of early-career doctors. Front Med (Lausanne). 2021;8:594695. https://doi.org/10.3389/fmed.2021.594695.CrossRef

54.

Handoyo NE, Rahayu GR, Claramita M, Ash J, Schuwirth LW. Personal resilience and rural doctors retention: a study in Indonesia. Rural Remote Health. 2020;20:6097. https://doi.org/10.22605/RRH6097.CrossRefPubMed

55.

Shires L, Allen P, Cheek C, Deb W. Regional universities and rural clinical schools contribute to rural medical workforce, a cohort study of 2002 to 2013 graduates. Rural Remote Health. 2015;15(3):3219.PubMed

56.

Mian O, Hogenbirk JC, Warry W, Strasser RP. How underserviced rural communities approach physician recruitment: changes following the opening of a socially accountable medical school in northern Ontario. Can J Rural Med. 2017;22(4):139–47.PubMed

57.

Gupta TS, Woolley T, Murray R, Hays R, McCloskey T. Positive impacts on rural and regional workforce from the first seven cohorts of James Cook University medical graduates. Rural Remote Health. 2014;14:2657.PubMed

58.

Easterbrook M, Godwin M, Wilson R, et al. Rural background and clinical rural rotations during medical training: effect on practice location. CMAJ Can Med Assoc J. 1999;160(8):1159–63.

59.

Playford D, Ngo H, Puddey I. Intention mutability and translation of rural intention into actual rural medical practice. Med Educ. 2021;55(4):496–504. https://doi.org/10.1111/medu.14404.CrossRefPubMed

60.

The Health Office of Maluku Province. Maluku health profile 2014. Ambon: The Health Office of Maluku Province; 2014.

61.

Dowell J, Norbury M, Steven K, Guthrie B. Widening access to medicine may improve general practitioner recruitment in deprived and rural communities: survey of GP origins and current place of work. BMC Med Educ. 2015;15:165. https://doi.org/10.1186/s12909-015-0445-8.CrossRefPubMedPubMedCentral

62.

Puddey IB, Mercer A, Playford DE, Riley GJ. Medical student selection criteria and socio-demographic factors as predictors of ultimately working rurally after graduation. BMC Med Educ. 2015;15:74.PubMedPubMedCentralCrossRef

63.

Puddey IB, Playford DE, Mercer A. Impact of medical student origins on the likelihood of ultimately practicing in areas of low vs high socio-economic status. BMC Med Educ. 2017;17(1):1.PubMedPubMedCentralCrossRef

64.

Adendorff J, Sutherland D, Nielsen N. The implications of an affirmative action student selection process for the rural medical workforce. In: 6th National Rural Health conference. Canberra, Australian Capital Territory, Australia. 2001.

65.

Brown T, Liu JX, Scheffler RM. Does the under- or overrepresentation of minority physicians across geographical areas affect the location decisions of minority physicians? Health Serv Res. 2009;44(4):1290–308. https://doi.org/10.1111/j.1475-6773.2009.00978.x.CrossRefPubMedPubMedCentral

66.

Grasreiner D, Dahmen U, Settmacher U. Specialty preferences and influencing factors: a repeated cross-sectional survey of first- to sixth-year medical students in Jena, Germany. BMC Med Educ. 2018;18(1):103. https://doi.org/10.1186/s12909-018-1200-8.CrossRefPubMedPubMedCentral

67.

Buddeberg-Fischer B, Klaghofer R, Abel T, Buddeberg C. Swiss residents’ speciality choices—impact of gender, personality traits, career motivation and life goals. BMC Health Serv Res. 2006;6(1):137. https://doi.org/10.1186/1472-6963-6-137.CrossRefPubMedPubMedCentral

68.

Kaliyadan F, Amin T, Qureshi H, Al WF. Specialty preferences of 1st year medical students in a Saudi Medical School—factors affecting these choices and the influence of gender. Avicenna J Med. 2015;5(4):134–9. https://doi.org/10.4103/2231-0770.165120.CrossRefPubMedPubMedCentral

69.

MacDowell M, Glasser M, Hunsaker M. A decade of rural physician workforce outcomes for the Rockford Rural Medical Education (RMED) Program, University of Illinois. Acad Med. 2013;88(12):1941–7. https://doi.org/10.1097/acm.0000000000000031.CrossRefPubMed

70.

Woolley T, Sen Gupta T, Bellei M. Predictors of remote practice location in the first seven cohorts of James Cook University MBBS graduates. Rural Remote Health. 2017;17(1):3992.PubMed

71.

Thabrany H, Setiawan E, Puteri GC, et al. Evaluation study of the implementation of graded referral system in the era of JKN-KIS (Indonesian National Health Insurance). Research summary of JKN-KIS. 2017;3(October).

72.

Henderson LN, Tulloch J. Incentives for retaining and motivating health workers in Pacific and Asian countries. Hum Resour Health. 2008;6(1):18. https://doi.org/10.1186/1478-4491-6-18.CrossRefPubMedPubMedCentral

73.

Cuesta-Briand B, Coleman M, Ledingham R, et al. Understanding the factors influencing junior doctors’ career decision-making to address rural workforce issues: testing a conceptual framework. Int J Environ Res Public Health. 2020;17(537):1–12. https://doi.org/10.3390/ijerph17020537.CrossRef

74.

Matsumoto M, Inoue K, Kashima S, Takeuchi K. Characteristics of physicians, their migration patterns and distance: a longitudinal study in Hiroshima, Japan. Rural Remote Health. 2012;12(2):2027.PubMed

75.

Minister of Health of the Republic of Indonesia. Regulation of the Minister of Health of The Republic of Indonesia number 53 of the Year 2013 concerning specialist educational assistance program for medical doctors and dentists. Jakarta: Ministry of Health of The Republic of Indonesia; 2013.

76.

Boonluksiri P, Tumviriyakul H, Arora R, Techakehakij W, Chamnan P, Umthong N. Community-based learning enhances doctor retention. Educ Health Change Learn Pract. 2018;31(2):114–8. https://doi.org/10.4103/efh.EfH_153_17.CrossRef

77.

Morken C, Bruksch-Meck K, Crouse B, Traxler K. Factors influencing rural physician retention following completion of a rural training track family medicine residency program. WMJ. 2018;117(5):208–10.PubMed

78.

Glasser M, MacDowell M, Hunsaker M, et al. Factors and outcomes in primary care physician retention in rural areas. S Afr Fam Pract. 2010;52(4):336–40.CrossRef

79.

Orda U, Orda S, Gupta TS, Knight S. Building a sustainable workforce in a rural and remote health service: a comprehensive and innovative Rural Generalist training approach. Aust J Rural Health. 2017;25(2):116–9.PubMedCrossRef

80.

Robinson M, Slaney GM. Choice or chance! The influence of decentralised training on GP retention in the Bogong region of Victoria and New South Wales. Rural Remote Health. 2013;13(1):1–12.

81.

Straume K, Sondena MS, Prydz P. Postgraduate training at the ends of the earth—a way to retain physicians? Rural Remote Health. 2010;10(2):1356.PubMed

82.

Straume K, Shaw DM. Effective physician retention strategies in Norway’s northernmost county. Bull World Health Organ. 2010;88(5):390–4.PubMedPubMedCentralCrossRef

83.

Pena S, Ramirez J, Becerra C, Carabantes J, Arteaga O. The Chilean rural practitioner programme: a multidimensional strategy to attract and retain doctors in rural areas. Bull World Health Organ. 2010;88(5):371–8 (French).PubMedPubMedCentralCrossRef

84.

Kehlet K, Aaraas IJ. “The Senja Doctor”: developing joint GP services among rural communities in Northern Norway. Rural Remote Health. 2015;15(3):1–6.

85.

Arora R, Chamnan P, Nitiapinyasakul A, Lertsukprasert S. Retention of doctors in rural health services in Thailand: impact of a national collaborative approach. Rural Remote Health. 2017;17(3):4344.PubMedCrossRef

86.

MacVicar R, Clarke G, Hogg DR. Scotland’s GP Rural Fellowship: an initiative that has impacted on rural recruitment and retention. Rural Remote Health. 2016;16(1):3550.PubMed

87.

Gorsche RG, Woloschuk W. Rural physicians’ skills enrichment program: a cohort control study of retention in Alberta. Aust J Rural Health. 2012;20(5):254–8. https://doi.org/10.1111/j.1440-1584.2012.01298.x.CrossRefPubMed

88.

Martin P, Gupta TS, Bond D, Douyere J, Mills K. Rural competencies in emerging medical practitioners: beyond clinical skills. Aust J Rural Health. 2019;27(5):427–32.PubMedCrossRef

89.

Cristobal F, Worley P. Can medical education in poor rural areas be cost-effective and sustainable: the case of the Ateneo de Zamboanga University School of Medicine. Rural Remote Health. 2012;12(1):1–7.

90.

Greenhill JA, Walker J, Playford D. Outcomes of Australian rural clinical schools: a decade of success building the rural medical workforce through the education and training continuum. Rural Remote Health. 2015;15(3):2991.PubMed

91.

Chopra A. JCU medical graduates’ preparedness for remote practice. Rural Remote Health. 2015;15(4):3202.PubMed

92.

Sen Gupta T, Murray R, Hays R, Woolley T. James Cook University MBBS graduate intentions and intern destinations: a comparative study with other Queensland and Australian medical schools. Rural Remote Health. 2013;13(2):2313.PubMed

93.

Hogenbirk JC, French MG, Timony PE, Strasser RP, Hunt D, Pong RW. Outcomes of the Northern Ontario School of Medicine’s distributed medical education programmes: protocol for a longitudinal comparative multicohort study. BMJ Open. 2015;5(7):e008246.PubMedPubMedCentralCrossRef

94.

Halili S Jr, Cristobal F, Woolley T, Ross SJ, Reeve C, Neusy AJ. Addressing health workforce inequities in the Mindanao regions of the Philippines: tracer study of graduates from a socially-accountable, community-engaged medical school and graduates from a conventional medical school. Med Teach. 2017;39(8):859–65.CrossRef

95.

Playford D, Puddey IB. Interest in rural clinical school is not enough: participation is necessary to predict an ultimate rural practice location. Aust J Rural Health. 2017;25(4):210–8. https://doi.org/10.1111/ajr.12324.CrossRefPubMed

96.

World Health Organization. WHO guideline on health workforce development, attraction, recruitment and retention in rural and remote areas. Geneva: World Health Organization; 2021.

97.

The European Union, The Food and Agriculture Organization of the United Nations (FAO), The International Labour Office (ILO), The Organization for Economic Co-operation and Development (OECD), United Nations Human Settlements Programme (UN-Habitat), The World Bank. A recommendation on the method to delineate cities, urban and rural areas for international statistical comparisons. New York: United Nation Statistical Commission; 2020.

Title: Factors associated with the rural and remote practice of medical workforce in Maluku Islands of Indonesia: a cross-sectional study
Authors: Farah Noya
Sandra Carr
Sandra Thompson
Rhonda Clifford
Denese Playford
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: Human Resources for Health / Issue 1/2021
Electronic ISSN: 1478-4491
DOI: https://doi.org/10.1186/s12960-021-00667-z

At a glance: The STEP trials

Springer Medicine

Factors associated with the rural and remote practice of medical workforce in Maluku Islands of Indonesia: a cross-sectional study

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2021

Global accreditation practices for accelerated medically trained clinicians: a view of five countries

Barriers and facilitators to online medical and nursing education during the COVID-19 pandemic: perspectives from international students from low- and middle-income countries and their teaching staff

An analysis of the services provided by community health workers within an urban district in South Africa: a key contribution towards universal access to care

Assessment of training and mentoring for DR-TB care decentralization in Tanzania

Situational analysis and reflections on the introduction of advanced practice nurses in Brazilian primary healthcare

Reflecting on the current scenario and forecasting the future demand for medical doctors in South Africa up to 2030: towards equal representation of women