Motivation of Strategic Health Workers to Work in Remote, Border, and Outer Island Areas (RBOIA) of Indonesia

Health worker maldistribution has become a global issue due to health workers' preference to work in urban areas and stay away from the Remote, Border, and Outer Island Areas (RBOIA). This study aimed to analyze the motivation of health workers to stay and work in remote areas. A systematic review was conducted on scientific articles published in several scientific journals that describe findings from Jambi, Sumbawa, and Papua, which fulfill the inclusion criteria. These studies were then enriched qualitatively through in-depth interviews. Triangulation was also performed for Jambi and Sumbawa. In Jambi, the main factors influencing motivation to work in specific areas are comfortable working atmospheres and environments and opportunities to improve careers and competencies. In Sumbawa, devotion as the native people of the region considerably affects the retention of health workers, with a significance that is similar to the material incentives. In Papua, the opportunity to be recruited as civil servants is the strongest factor influencing the decision regarding preferred work areas. Hence, it can be concluded that material incentives are not the primary factors that affect retention of health workers in RBOIA, as it is more dominantly motivated by non-material aspects. Local governments need to consider specific situations when developing comprehensive local policies that include personal, organizational, and socioeconomic factors to improve retention of health workers.