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What do doctors want? developing incentives for doctors to serve in Indonesia's rural and remote areas

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Author Info
Chomitz, Kenneth M.
Setiadi, Gunawan
Azwar, Azrul
Ismail, Nusye
Widiyarti
Abstract

Like many large countries, Indonesia has difficulty attracting doctors to service in rural and remote areas. To guide the creation of incentives for service in these areas, the authors analyze two sets of data about physicians: 1) the locations chosen by graduating medical students before and after a major change in the incentive system, and 2) survey data on choices among hypothetical assignments differing in compensation, career prospects, and amenities at various locations. Their findings suggest that: a) The current policy of offering specialist training is incentive enough to make doctors from Java willing to serve in remote areas. (It is not necessary to also offer a civil service appointment.) But providing specialist training as an incentive to work in remote areas is not only expensive, but potentially inefficient, since specialist practice and rural public health management require different skills and attitudes. b) Moderately (but not extremely) remote areas can be staffed using modest cash incentives. c) Doctors from the Outer Islands are far more willing to serve in remote areas than their counterparts from Java. So, it may be worthwhile increasing the representation of Outer Island students in medical schools (perhaps through scholarships and assistance in pre-university preparation).

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Paper provided by The World Bank in its series Policy Research Working Paper Series with number 1888.

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Date of creation: 31 Mar 1998
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Handle: RePEc:wbk:wbrwps:1888

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Keywords: Health Systems Development&Reform; Public Health Promotion; Health Monitoring&Evaluation; Teaching and Learning; Information Technology; Health Monitoring&Evaluation; Airports and Air Services; Information Technology; Economic Theory&Research; Teaching and Learning;

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References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. J Hurley, 1990. "Simulated Effects of Incomes-based Policies on the Distribution of Physicians," Centre for Health Economics and Policy Analysis Working Paper Series 11, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada. [Downloadable!]
  2. Chesher, Andrew & Santos Silva, J M C, 2002. "Taste Variation in Discrete Choice Models," Review of Economic Studies, Blackwell Publishing, vol. 69(1), pages 147-68, January.
  3. Cummings, Ronald G & Harrison, Glenn W & Rutstrom, E Elisabet, 1995. "Homegrown Values and Hypothetical Surveys: Is the Dichotomous Choice Approach Incentive-Compatible?," American Economic Review, American Economic Association, vol. 85(1), pages 260-66, March.
  4. Carson, Richard T. & Hanemann, W. Michael, 2006. "Contingent Valuation," Handbook of Environmental Economics, in: K. G. Mäler & J. R. Vincent (ed.), Handbook of Environmental Economics, edition 1, volume 2, chapter 17, pages 821-936 Elsevier. [Downloadable!] (restricted)
  5. Adamowicz W. & Louviere J. & Williams M., 1994. "Combining Revealed and Stated Preference Methods for Valuing Environmental Amenities," Journal of Environmental Economics and Management, Elsevier, vol. 26(3), pages 271-292, May. [Downloadable!] (restricted)
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  1. Gauri, Varun, 2001. "Are incentives everything? payment mechanisms for health care providers in developing countries," Policy Research Working Paper Series 2624, The World Bank. [Downloadable!]
  2. Chaudhury, Nazmul & Hammer, Jeffrey S., 2003. "Ghost doctors - absenteeism in Bangladeshi health facilities," Policy Research Working Paper Series 3065, The World Bank. [Downloadable!]
  3. Klemick, Heather & Leonard, Kenneth L. & Masatu, Melkiory C., 2008. "Defining Access to Health Care: Evidence on the Importance of Quality and Distance in Rural Tanzania," Working Papers 6178, University of Maryland, Department of Agricultural and Resource Economics. [Downloadable!]
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