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Primary care doctors’ perceived needs for physician leadership development in rural and remote settings of Aceh province, Indonesia
  1. Fury Maulina1,2,
  2. Mubasysyir Hasanbasri3,
  3. Jamiu O Busari4,5,
  4. Fedde Scheele6,7
  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. 4Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
  5. 5Pediatrics, Dr Horacio E Oduber Hospital, Oranjestad, Aruba
  6. 6Department of Obstetrics and Gynaecology, OLVG, Amsterdam, The Netherlands
  7. 7Department of Medical Education, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Fury Maulina, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6229 ER Maastricht, Limburg, The Netherlands; f.maulina{at}


Background Globally, rural/remote health systems fall short of optimal performance. Lack of infrastructure, resources, health professionals and cultural barriers affect the leadership in these settings. Given those challenges, doctors serving disadvantaged communities must develop their leadership skills. While high-income countries already had learning programmes for rural/remote areas, low-income and middle-income countries (LMICs), such as Indonesia, are lagging behind. Through the lens of the LEADS framework, we examined the skills doctors perceived as most essential to support their performance in rural/remote areas.

Methods We conducted a quantitative study, including descriptive statistics. Participants were 255 rural/remote primary care doctors.

Results We discovered that communicating effectively, building trust, facilitating collaboration, making connections and creating coalitions among diverse groups were most essential in rural/remote communities. When rural/remote primary care doctors serve in such cultures, may need to prioritise harmony within the community and social order values.

Conclusions We noted that there is a need for culture-based leadership training in rural or remote settings of Indonesia as LMIC. In our view, if future doctors receive proper leadership training that focuses on being competent rural physicians, they will be better prepared and equipped with the skills that rural practice in a specific culture requires.

  • medical leadership
  • doctor
  • primary care
  • development

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  • Contributors FM and JOB developed the study concept. FM recruited participants and collected data. Data interpretation and analysis were performed by all authors. JOB, FS and MH revised the manuscript. The manuscript was edited by all of the authors. All authors provided final approval for the manuscript’s publication 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.