Abstract
The problem of shortage of human resource for health (HRH) in remote areas has been concerned for decades. Providing financial and non-financial incentives is one of the effective solutions. The objectives of this study include (1) to indicate incentives and quality of life of HRH working on remote areas and (2) to develop policies for motivating HRH to be willing to working in remote areas. The quantitative and qualitative research has been used. We used qualitative method for development of attributes and response level for an analysis of Discrete Choice Experiment (DCE). The DCE was conducted into two groups: group 1 - physicians, dentists and pharmacists; and group 2 - nurses and multidisciplinary team. The thematic analysis and conditional logit regression model were used for qualitative research and DCE, respectively. Regarding results from qualitative analysis, the attributes influencing decision making of HRH working in remote areas include income, workload, self development, working in hometown, horizontal relationship, good facilities (e.g. electricity, water supply, especially the internet that is important for work and recreational activities), having a safe and convenient house, being instilled as government official, clean environment and family issues. The results from conditional logit regression model determine that workload, convenient stores, and private accommodation are important incentives, however, the most important attribute was income. It was found that if they got income a 40% higher than friends working in urban areas, they had 4.2 times more chance to work in remote areas; If a 60% higher, 8.3 times more chance to work in remote areas. For Nurses and multidisciplinary team, workload, self development, working in hometown, living in private accommodation, being instilled as government official, especially income are important incentives. It was confirmed that income is the most important incentive to motivate HRH working in remote areas. The current incentive policy of providing subsidy for HRH working remote areas should be remained. Another policy to be considered is providing scholarship to local students to work in their hometown as well as providing private accommodation to meet requirement of workers. This policy can be managed at the level of provinces and regions.
