Workforce Availability, Accessibility, and Availability of Healthcare Facilities in Archipelagic Regions: A Literature Review
Keywords:
Health Workforce Availability; Accesibility; Facility Availability; Health Setvice Utilization; Public Health Center.Abstract
The utilization of health services in border areas still faces various obstacles that lead to low utilization rates of Community Health Centers (Puskesmas), even though these facilities are physically available. The main challenges stem from limited geographic accessibility, unequal distribution of health workers, and the lack of adequate health facilities. Border communities living in connecting or display areas of a region often have to travel long distances with difficult transportation conditions, which ultimately impacts low visits to formal health facilities. This study aims to examine and synthesize the findings of various previous studies that highlight the relationship between accessibility, quality of health services, workforce availability, and facility availability on the level of health service utilization, particularly in border areas. The method used is a literature review of 23 scientific articles published between 2020 and 2025 and obtained from reliable sources and national journal portals. Data were analyzed descriptively and thematically. The study results indicate that accessibility is the most significant factor influencing people's decisions in using health services, followed by the uneven availability of health workers, and the quality and completeness of facilities that do not meet minimum service standards. These findings are consistent with Andersen's behavioral model, which positions accessibility as an enabling factor in service utilization. Furthermore, the study results also reinforce the urgency of improving health infrastructure and regional-based health worker redistribution policies.
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