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"Indonesia masih mengalami kesulitan terkait akses masyarakat terhadap layanan kesehatan serta kurangnya tenaga kesehatan, terutama di wilayah perdesaan dan terpencil. Berdasarkan data Sistem Informasi Sumber Daya Manusia Kesehatan (SISDMK), terdapat kekurangan tenaga kesehatan, khususnya dokter, yang ditandai dengan masih banyaknya jumlah Puskesmas tanpa dokter. Provinsi Maluku adalah salah satu Provinsi yang memiliki persentase Puskesmas tanpa dokter tertinggi yaitu 17,6% dan Puskesmas tersebut mayoritas terletak di wilayah perdesaan dan terpencil yang ditetapkan oleh pemerintah. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan motivasi dokter untuk bekerja di daerah perdesaan dan terpencil di Provinsi Maluku. Desain penelitian ini adalah cross-sectional menggunakan kuesioner online yang disebarkan kepada 344 dokter yang bekerja di Provinsi Maluku. Hasil penelitian menunjukkan bahwa dari 192 (56%) dokter yang mengisi kuesioner, faktor pengalaman di perdesaan dan terpencil (p=0,032), peluang karir (p=0,000), peluang pengembangan pendidikan dan profesional (p=0,010) dan kondisi kehidupan (p=0,016) merupakan faktor-faktor yang berhubungan dengan motivasi dokter untuk bekerja di daerah perdesaan dan terpencil di Provinsi Maluku. Sementara faktor yang paling dominan berhubungan adalah peluang karir (AOR=4,32 95% CI 1,43-11,76 95% CI) dan pengalaman di perdesaan dan terpencil 1-5 tahun (AOR=4,30 95% CI 1,24-14,70 95% CI). Penelitian ini menunjukkan bahwa dalam membuat kebijakan untuk mengatasi kekurangan dokter di daerah perdesaan dan terpencil khususnya di Provinsi Maluku, pemerintah harus memberikan perhatian khusus terhadap peluang pengembangan pendidikan dan profesional, kondisi kehidupan, dan terutama kebijakan terkait peluang kemajuan karir dokter serta kebijakan yang menunjang dokter agar memiliki pengalaman praktik di perdesaan dan terpencil.

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Indonesia is still experiencing difficulties related to community access to health services and the need for more health workers, especially in rural and remote areas. Based on data from the Health Human Resources Information System (SISDMK), there is a shortage of health workers, especially doctors, as indicated by the large number of Public Health Centers that are without doctors.  Maluku Province is one of the provinces with the highest percentage of Public Health Centers without doctors, at 17.6%, and most of these are located in rural and remote areas designated by the government. This study aims to determine the factors that associated with doctors' motivation to work in rural and remote areas in Maluku Province. The design of this study was cross-sectional, using an online questionnaire distributed to 344 doctors working in Maluku Province. The results showed that of 192 (56%) partisipants who filled out the questionnaire, the factors of experience in rural and remote areas (p=0.032), career opportunities (p=0.000), educational and professional development opportunities (p=0.010), and living conditions (p=0.016) were factors associated with doctors' motivation to work in rural and remote areas in Maluku Province. While the most dominant factors associated are career opportunities (AOR = 4.32 95% CI 1.43-11.76 95% CI) and experience in rural and remote areas 1-5 years (AOR=4,30 95% CI 1,24-14,70 95% CI). This study suggests that in making policies to overcome the shortage of doctors in rural and remote areas, especially in Maluku Province, the government should consider the following factors such as educational and professional development opportunities, living conditions, and primarily policies related to opportunities for career advancement of doctors and policies that support doctors to have practice experience in rural and remote areas."

"Penelitian ini bertujuan menggali lebih dalam ketersediaan dokter spesialis serta upaya yang dilakukan untuk memenuhi kebutuhan tenaga dokter spesialis pada Rumah Sakit Umum Kelas C milik Pemerintah di daerah terpencil. Penelitian kualitatif dilakukan dengan pendekatan studi kasus di Rumah Sakit Umum Daerah Haji Abdoel Madjid Batoe (RSUD HAMBA) Kabupaten Batanghari Provinsi Jambi dan RSUD Malingping Kabupaten Lebak, Provinsi Banten. Hasil penelitian menunjukkan bahwa ketersediaan dokter spesialis baik di RSUD HAMBA maupun RSUD Malingping masih belum memadai. Kedua RS masih kekurangan tenaga spesialis baik dari segi jenis dan jumlah, sehingga mengakibatkan belum optimalnya pelayanan kesehatan. Berbagai upaya dilakukan oleh Pemerintah Daerah (Pemda) setempat, namun masih terdapat kendala, antara lain letak geografis, kondisi infrastruktur dan perekonomian daerah yang masih belum memadai, kurangnya kompensasi baik yang bersifat finansial maupun non finansial, selain tentunya kebijakan dan komitmen Pemda setempat, yang masih perlu ditingkatkan. Kesimpulan penelitian ini adalah suasana kerja yang nyaman serta kebijakan dan komitmen Pemda sangat berperan terhadap peningkatan motivasi dan retensi dokter spesialis di daerah. Perlu dirumuskan kebijakan dan regulasi yang spesifik mengenai standar pola rekrutmen, penempatan, serta hak dan kewajiban dokter spesialis secara komprehensif.

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This research aims to explore an availability of medical doctor specialist and the pulfillment efforts of medical doctor specialist of the C Class Hospital (CCH) in remote areas. This qualitative research has been conducted within case studies approach in both Haji Abdoel Madjid Batoe General Hospital (HAMBA GH) of the Batanghari Regency in Muara Bulian, Jambi Province and Malingping General Hospital (Malingping GH) of the Banten Province located at Malingping District as well. In fact, both in HAMBA GH and Malingping GH there are limited medical doctor specialist permanently. Meanwhile, there are so many factors that influence availability of medical doctor specialist in remote areas, specifically in Batanghari Regency and Malingping District, including geographical position, conditions of the remote area, availability of infrastructures and public facilities, economic factor, work environment, financial and non-financial compensation and also the government commitment and policy to support all efforts of medical doctor spescialist's pulfillment in remote areas. This research concludes that work environment, compensation, government policies and regulations are dominantly influenced pulfillment efforts of medical doctor specialist in CCH in remote areas. It needs to design particular policies and regulations about standard of recruitment pattern, placement allocation, budgeting, also medical doctor specialist's rights and responsibilities comprehensively, to solve this crucial problem."

"Studi ini mengevaluasi performa turbin air Turgo skala piko dengan memanfaatkan batok kelapa sebagai sudu, khususnya meneliti pengaruh sudut masuk dan keluar sudu terhadap efisiensi turbin. Latar belakang studi ini adalah kebutuhan mendesak untuk sumber energi terbarukan yang ramah lingkungan di daerah terpencil dan tidak terjangkau listrik di Indonesia. Pemanfaatan potensi hydropower dengan instalasi pembangkit listrik tenaga air skala piko (< 5 kW) di daerah 3T (Tertinggal, Terdepan, Terluar) menjadi solusi potensial. Penggunaan bahan alami seperti batok kelapa sebagai sudu turbin Turgo menawarkan keunggulan ekonomi dan keberlanjutan, mengatasi masalah material dan pemeliharaan di daerah sulit akses. Turbin Turgo yang dirancang dalam studi ini diuji pada ketinggian jatuh air 4 meter dengan variasi sudut serang nosel. Pengujian d ilakukan melalui perhit ungan analit ik d an simulasi numerik unt uk menentukan sudut masuk nosel relatif, kecepatan relatif aliran air, sudut keluar relatif, kecepatan fluida keluar, dan efisiensi hidrolik teoritis. Tiga jenis turbin dengan sudut serang nosel berbed a d iuji: Turbin A (48.28°), Turbin B (19.03°), d an Turbin C (26.28°). Hasil studi menunjukkan bahwa sudut serang nosel optimal berada dalam kisaran 10°- 30°, dimana hasil perhitungan teoritis Turbin C menghasilkan efisiensi hidrolik tertinggi sebesar 74%, diikuti oleh Turbin B sebesar 52%, dan Turbin A sebesar 50%. Hal ini menunjukkan bahwa sudut serang nosel yang tepat dapat meningkatkan efisiensi turbin dengan mengoptimalkan perpindahan momentum aliran air. Penggunaan batok kelapa sebagai sudu turbin menunjukkan potensi besar dalam pengembangan pembangkit listrik tenaga air yang ramah lingkungan dan berbiaya rendah di daerah terpencil. Dengan demikian, inovasi ini dapat berkontribusi pada peningkatan rasio elektrifikasi nasional dan pengurangan emisi gas rumah kaca, sejalan dengan komitmen Indonesia terhadap Perjanjian Paris.

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The rapid growth of the global population and advancements in civilization have led to an exponential increase in energy demand. Despite the unsustainable nature of fossil fuels and their severe environmental and health issues, fossil fuels, particularly petroleum, remain the primary energy source. Greenhouse gases (GHGs) such as methane, carbon dioxide, and nitrous oxide are released in large quantities during the combustion of fossil fuels, contributing to climate crises, rising sea levels, and extreme weather conditions threatening coastal communities. According to the IPCC's Sixth Assessment Report (2023), the world is on a path to dangerous climate risks by the end of the 21st century, even under 1.5°C or 2°C warming scenarios. Indonesia's commitment to the Paris Agreement requires a 29% reduction in GHG emissions by 2030. However, strategies to decarbonize effectively need reevaluation, as the current deforestation emission reduction schemes only prevent 3% of the required total. With an increase in global surface temperature and a rapid rise since 1970, Indonesia is focusing on increasing its renewable energy share. Hydropower, with a potential of 94.6 GW and an installed capacity of only 6.1 GW, presents a significant opportunity, especially for electrifying remote areas through small-scale solutions like pico hydropower systems. This study aims to investigate the performance of a pico-scale Turgo water turbine using coconut shell spoon blades, focusing on the effects of the inlet and outlet blade angles. Analytical calculations were based on conditions at the fluid mechanics laboratory of the Mechanical Engineering Department, using a head of 4 meters, 8 blades, and a nozzle- to-turbine distance of 100 mm. The water speed calculated was 8.59 m/s, with runner speed at 4.03 m/s, resulting in a water power of 16.9 W. Three turbine types (A, B, and C) with different attack angles were tested analytically for relative velocity, fluid exit speed, and hydraulic efficiency. Analytical results showed that Turbine C had the highest efficiency at 74%, followed by Turbine B at 52% and Turbine A at 50%. Turbines B and C fell within the optimal jet angle range for Turgo and Pelton turbines. Turbine C's superior performance was attributed to a better alignment of water momentum transfer due to its blade angles, minimizing flow separation and stall."