Fiscal Capacity, Geographical Conditions, and Demography as Contribution Factors to the Availability of Medical Specialist in Public Hospitals in a Remote Area of Banten Province

Meeting the shortage of medical specialist in remote areas is a challenge for local governments in the era of decentralization. Many factors such as the socio-economic, geographic, and demographic conditions contribute to this challenge. This research analyzes the various factors that influence the availability of medical specialist in the Malingping District Hospital in a remote area of Banten Province. A qualitative approach was taken, employing in-depth interviews and research observations in Malingping District Hospital. Malingping is a remote and underdeveloped area in Banten Province. The research revealed that the availability of medical specialist in Malingping District Hospital was inadequate, both in terms of number and type. Difficult geographical conditions and inadequate infrastructure cause there are limited means of transportation for reaching Malingping, which greatly affects the flow of people and goods. Remote location and heavy terrain with curving, uphill and downhill contours makes access to Malingping so difficult. The size and growth of the population is relatively stagnant. Moreover, development tends to be slow, and the economy of the region is still underdeveloped. Many medical specialist do not want to visit, work, and settle in Malingping. Based on this study, it can be concluded that the motivation of medical specialist to work in a region, particularly a remote area, is greatly influenced by the location, geographical condition, economic development, population number, and significant growth. Concrete efforts are needed to provide access to remote areas, as are efforts that strive toward regional development that directly affects the regional economy, attracting professionals including medical specialist to work in these regions.