Investigating physician leadership competencies in rural and remote areas of the province of Aceh, Indonesia

Abstract

BackgroundsGlobally, the most rural healthcare systems are lagging behind those of urban healthcare systems. Especially in rural and remote areas, the essential resources to provide principal health services are inadequate. It is purported that physicians have an important role in healthcare systems. Unfortunately, there is a paucity of studies on physician leadership development in Asia, especially on how to enhance physician leadership competencies in rural and remote low-resource settings. This study aimed to investigate doctors’ perceptions of existing and needed physician leadership competencies based on their experiences in primary care settings in low-resource rural and remote areas are in Indonesia.MethodsWe performed a qualitative study with a phenomenological approach. Eighteen primary care doctors, who worked in rural and remote areas of Aceh, Indonesia, purposively selected, were interviewed. Prior to the interview, participants were asked to select the top-five skills they deemed most essential for their work based on the five domains of the ‘Lead Self’, ‘Engage Others’, ‘Achieve Results’, ‘Develop Coalitions’ and ‘Systems Transformation’ (LEADS) framework. We then performed a thematic analysis of the interview transcripts.ResultsWe identified the following qualities a good physician leader in low-resource rural and remote settings should possess: (1) cultural sensitivity skills; (2) a strong character that includes courage and determination; and (3) creativity and flexibility skills.ConclusionsLocal cultural and infrastructural factors create a need for several different competencies within the LEADS framework. A profound amount of cultural sensitivity was considered the most important in addition to the ability to be resilient, versatile and ready for creative problem-solving.

Educación remota y liderazgo educativo. Una experiencia postpandemia COVID-19

“…2. un carácter fuerte que incluye coraje y determinación; y 3. habilidades de creatividad y flexibilidad (Maulina et al 2023b).…”

Primary care doctors’ perceived needs for physician leadership development in rural and remote settings of Aceh province, Indonesia

“…In light of the above-mentioned findings, we propose that medical schools embed specialised leadership training in their curricula that focus on learning about the cultures and local wisdom of rural and remote societies. Our previous study24 provides some examples such as when rural primary care doctors could build bridges between religious beliefs and medical practices, they succeed in inviting religious leaders to promote the vaccination programme (many people refuse to be vaccinated because of forbidden and permitted issues). Another example, doctors who could communicate in the local language were better welcomed by rural and remote communities because they could easily approach society and had a deep emotional relationship with them, and eventually, people from rural and remote areas wanted to participate in primary care activities.…”

The impact of an educational intervention on physician leadership competencies among rural and remote primary care doctors in Aceh, Indonesia

“…The preferred leadership training format was a workshop facilitated by a lecturer from the faculty of medicine. Training sessions should ideally last for two days on average and should be evaluated using pre-and post-tests. As cultural difficulties present major and robust challenges to leadership in the rural health-care system, the intervention should be culturally sensitive (Maulina et al , 2022). Indeed, Edmonstone already pointed out in his study that the development of leadership and management skills in non-Western societies must be acculturated; to ensure their user-friendly application, these skills must be conveyed and transferred across cultural boundaries (Edmonstone, 2018).…”