Indonesia shifts toward local training to address health worker shortages
Indonesia is putting greater emphasis on educating people to work in their home regions, moving beyond temporary deployments to address persistent gaps in health care staffing. The effort includes tuition-free hospital-based specialist training that gives priority to doctors from areas with severe shortages.
Building a workforce closer to home
Temporary assignments have been a central part of Indonesia's response for a decade. Since its launch in 2015, the Ministry of Health's Special Assignment Program has sent 21,105 health workers to 3,630 community health centers, known as puskesmas, in 331 districts and cities. But the ministry says fixed-term postings leave remote centers dependent on successive recruitment rounds rather than a permanent workforce.
Access to education is another obstacle. Ministry data released during the 2024 rollout of the hospital-based specialist medical residency program, or PPDS, showed that 67 percent of specialist residency participants came from Java and Bali. Kalimantan accounted for just 2 percent and eastern Indonesia for 1 percent. Java and Bali also hosted 52 percent of training centers. The ministry warned that a continuation of this pattern would leave eastern Indonesia with virtually no specialist candidates from its own communities.
The hospital-based program supplements, rather than replaces, university-based residency training. Its initial intake placed 52 residents at six teaching hospitals. Residents have employee status at their training hospitals and do not pay tuition, with priority given to doctors from regions facing severe specialist shortages.
A peer-reviewed policy review published in JMIR Medical Education on September 9, 2026, described that intake as a pilot. It received 412 applications and filled all 52 places, an acceptance rate of 12.6 percent. Training covered six high-need specialties: ophthalmology, cardiology, pediatrics, orthopedics, neurology, and oncology.
According to the review, hospital-based residents sign an integrity pact committing them to return to their regions of origin after graduation, and the Indonesia Endowment Fund for Education, or LPDP, fully covers tuition. The review also reported that the Ministry of Finance allocated 1,000 funded residency positions in 2024, with a target of 5,000 specialists within two years.
The government has since authorized 25 additional study programs, taking the total to 31, while prioritizing doctors from underdeveloped, frontier, and outermost regions. Broader financial support includes 8,484 scholarships recorded by the Ministry of Health between 2022 and 2025 through joint ministry and LPDP schemes. The emphasis is on preparing local professionals for long-term service, not only filling current vacancies.
Staffing gaps extend from clinics to hospitals
Ministry figures for August 2026 put the staffing deficit at puskesmas at 6,927 workers, with 38 percent of centers missing at least one of nine core personnel categories. Deputy Health Minister Benjamin Paulus Octavianus presented the figures in late October at the second National Forum of the Indonesian Health Council, or KKI.
The required categories are doctors, dentists, nurses, midwives, public health officers, environmental health specialists, medical laboratory technologists, nutritionists, and pharmacists. Incomplete teams limit the centers' ability to provide comprehensive health promotion and preventive care. Ministry data from May 2026 identified dentists as the category most commonly missing.
WHO Indonesia cited a separate ministry figure on November 3, 2026: roughly 37 percent of puskesmas lacked the full set of nine priority personnel categories. It also reported that about 41 percent of regional public hospitals at the regency or city level had not met qualification requirements for the seven core medical specialties.
Some community centers have no doctor at all. Citing ministry data on October 22, 2026, Kompas reported that approximately 400 of the country's 10,300 puskesmas were in that position.
To identify where staff are needed, the ministry is using its Health Human Resources Information System to map the workforce and forecast requirements. Areas with limited access, including Papua, East Nusa Tenggara, and Maluku, receive priority.
Specialist training faces a large backlog
A joint Ministry of Health-WHO health labor market analysis identified specialists as the most serious staffing bottleneck: available specialists met only about half of estimated demand. Presented at a Jakarta policy dialogue on July 15-16, 2026, the analysis put Indonesia's overall health workforce at approximately 41 workers per 10,000 people, compared with a Western Pacific regional average of 82.7. Its findings will inform Indonesia's 2026-2035 Health Human Resources Blueprint.
Kompas reported, against WHO benchmarks, that Indonesia had about 150,000 general practitioners compared with an ideal 280,000. It cited shortages of roughly 130,000 general practitioners and 30,000 specialists. A separate ministry projection warns that, without faster action, the specialist deficit could reach nearly 65,000 by 2032.
The JMIR Medical Education review put the specialist workforce at 51,443 as of January 2025. That represented 0.18 specialists per 1,000 people, below the national planning target of 0.28. Nearly 59 percent were concentrated in Java and major urban centers.
The review also described the limits of the existing training capacity. Universities produce about 2,700 specialists annually; at that rate, addressing a deficit of roughly 30,000 would require at least a decade, without allowing for retirements or additional demand as the population ages.
Practical skills and support for remote staff
At the KKI forum, Benjamin said workforce planning must match demand with the right competencies, professional fields, and equitable distribution. He called for continuing professional development to emphasize usable skills rather than simply collecting credit points, including proficiency in artificial intelligence, telemedicine, and electronic health records.
For workers in remote, border, island, and other health-disadvantaged areas, the ministry identified online courses, blended learning, and mentoring by referral hospitals as ways to build skills. Data-based staffing plans and fair disciplinary enforcement were also among six directives issued at the forum.
Regional talks address a global shortage
Indonesia's staffing challenges also featured at the Asia Pacific Action Alliance on Human Resources for Health, or AAAH, conference in Bali in early November. The meeting drew 200 policymakers, educators, and development partners from 22 countries. Established in 2005 with 10 member states, the alliance now spans 22 countries.
WHO projects a worldwide shortage of about 11 million health workers by 2030. In September, it warned that aging populations and an aging health workforce could make the gap larger. AAAH Chair Anna Kurniati, who also serves as secretary of the ministry's Directorate General of Pharmaceuticals and Medical Devices, highlighted growing pressures from noncommunicable diseases, emerging infections, climate change, and population aging. WHO also cited persistent underinvestment in health education and training.
The Bali discussions centered on leadership and governance, quality education and worker welfare throughout a career, and inclusive digital transformation. Benjamin called for countries to prioritize investment in health workers and reaffirmed Indonesia's readiness for regional cooperation. WHO Western Pacific Regional Director Saia Ma'u Piukala, a former surgeon, stressed decent working conditions, career development, and well-being.
The conference aimed to produce recommendations on workforce planning, staff safety and welfare, and digital innovation, with the resulting guidance expected to serve as a benchmark for member countries.