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Investigating physician leadership competencies in rural and remote areas of the province of Aceh, Indonesia
  1. Fury Maulina1,2,
  2. Mubasysyir Hasanbasri3,
  3. Fedde Scheele4,5,
  4. Jamiu O Busari6,7
  1. 1School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
  2. 2Department of Public Health, Faculty of Medicine, Universitas Malikussaleh, Lhokseumawe, Aceh, Indonesia
  3. 3Department of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Yogyakarta, Indonesia
  4. 4Athena Institute for Transdisciplinary Research, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
  5. 5Research in Education, Amsterdam UMC Locatie VUmc, Amsterdam, the Netherlands
  6. 6Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
  7. 7Department of Pediatrics, Dr Horacio E Oduber Hospital, Oranjestad, Aruba
  1. Correspondence to Fury Maulina, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht 6229 ER, Netherlands; f.maulina{at}


Backgrounds Globally, 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.

Methods We 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.

Results We 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.

Conclusions Local 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.

  • medical leadership
  • doctor
  • competencies
  • primary care
  • health system

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  • Correction notice This article has been corrected since it first published. Affiliation has been updated in 'Correspondence to' section.

  • Contributors FM and JB developed study idea. FM recruited participants and performed data collection. All authors performed data interpretation and analysis. JB, FS and MH provided manuscript revisions. All authors contributed to the edits to the manuscript. All authors provided their final approval for publishing of the manuscript and are responsible for the overall content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.