Population Growth and the Urology Workforce in West Java, Indonesia: A Distribution and Projection Study

Aaron Tigor Sihombing,1,2 Antonia Kartika,3,4 Antoninus Hengky1,2 1Department of Surgery, Division of Urology, Universitas Padjajaran, Sumedang, West Java, Indonesia; 2Hasan Sadikin General Hospital, Bandung, West Java, Indonesia; 3Department of Ophthalmology, Universitas Padjajaran, Sumedang, West Java, Indonesia; 4National Eye Center, Cicendo Eye Hospital, Bandung, West Java, IndonesiaCorrespondence: Aaron Tigor Sihombing, Department of Surgery, Division of Urology, Universitas Padjadjaran, Jl. Raya Bandung Sumedang, Sumedang Regency, West Java, 45363, Indonesia, Tel +62 813 2132 9126, Email [email protected]: West Java, Indonesia’s most populous province, faces escalating urological healthcare demands due to rapid population growth and an aging demographic. This study evaluates the adequacy and distribution of the urology workforce in West Java and examines whether current workforce trends are sufficient to meet projected population needs.Patients and Methods: A cross-sectional study utilized secondary data from the Indonesian Central Bureau of Statistics (BPS), the Indonesian Urology Collegium, and the Indonesian Urology Association (West Java section). The distribution of urologists, urologist-to-population ratios, age structure, and workforce growth trends from 2009 to 2023 were analyzed. Descriptive statistics, ratio calculations, and spatial analysis were employed to assess workforce adequacy and distribution disparities.Results: Urologists were heavily concentrated in urban centers, particularly Bandung City, with marked shortages in rural and suburban regions. The overall urologist-to-population ratio remained far below levels considered adequate for specialist care. Although the annual growth of urologists exceeded population growth, the absolute number remained insufficient. Projections indicated a future decline in the proportion of urologists aged 30– 45 years, suggesting an impending workforce gap. A strong positive correlation was observed between urologist availability and the West Java Health Index.Conclusion: West Java faces a substantial mismatch between urological healthcare needs and workforce availability. Uneven distribution and projected shortages threaten equitable access to care. Strategic workforce planning, expansion of specialist training capacity, targeted deployment policies, and telemedicine integration are essential to ensure sustainable and equitable urological services in this rapidly growing province.Keywords: urologist distribution, healthcare, urology workforce shortage, population growth