AB159. Rural physician deployment programs in five Southeast Asian countries: a narrative review

Abstract: Access to healthcare is a known challenge in rural populations globally, driven by an imbalance of physician distribution between urban and rural areas. This disparity is particularly pronounced in Southeast Asia, where physician deployment programs have been implemented to address it. This narrative review examined the structure, incentives, retention outcomes, and impact of such programs in Thailand, Malaysia, Indonesia, the Philippines, and Vietnam. Results showed that approaches varied across countries: Thailand and Malaysia adopted compulsory service models, while Indonesia, the Philippines, and Vietnam opted for optional or semi-compulsory approaches. All programs used financial incentives and career benefits to attract physicians. Thailand’s program demonstrated the highest retention rates—52.5% in the regular track and 78.2% in the special track—compared to the Philippines’ 18%, while specific data for Indonesia, Malaysia, and Vietnam were limited. Nonetheless, during the periods of implementation, improvements in rural healthcare access and service coverage were reported in Thailand, Indonesia, Malaysia, and Vietnam. Malaysia’s program, however, has not been thoroughly evaluated. Overall, the evidence suggested a positive association between rural physician deployment programs and improved health service metrics in underserved regions. However, data on long-term retention and direct impacts on rural health indicators are lacking and warrant further research. These findings underscore the importance of continuous evaluation to optimize the effectiveness of such programs across Southeast Asia.

Keywords: Rural health services; rural physician deployment; health workforce; Southeast Asia; rural health policy