The Production, Transportation, and Performance of Physicians, Nurses, and Midwives in Indonesia : An Update
Indonesia launched the national health insurance program - Jaminan Kesehatan National (JKN), on January 1, 2014, and aims to achieve universal health coverage (UHC) by 2019. Achieving UHC means not only increasing the number of people covered but a...
| Main Authors: | , , , |
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| Format: | Working Paper |
| Language: | English en_US |
| Published: |
World Bank Group, Washington, DC
2014
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2014/09/20286298/production-transportation-performance-physicians-nurses-midwives-indonesia-update http://hdl.handle.net/10986/20729 |
| Summary: | Indonesia launched the national health
insurance program - Jaminan Kesehatan National (JKN), on
January 1, 2014, and aims to achieve universal health
coverage (UHC) by 2019. Achieving UHC means not only
increasing the number of people covered but also expanding
the benefits package and ensuring financial protection.
Although the JKN benefits package is comprehensive, a key
challenge related to the capacity to deliver the promised
services is ensuring the availability, distribution, and
quality of human resources for health (HRH). Of
Indonesia's 33 provinces, 29 do not have the WHO
recommended ratio of 1 physician per 1,000 population,
although Indonesia regularly produces 6,000 to 7,000 new
physicians annually. The shortage of nurses in hospitals and
health centers (puskesmas) is noticeable despite the large
number of graduates. The government's health worker
contract policy (PTT [Pegawai Tidak Tetap]) was the main
policy lever to improve the distribution of physicians and
midwives; it offered a shorter contract and higher monetary
benefits for rural and remote postings. Nevertheless,
evolution of the policy over more than two decades of
implementation indicates that the outcome has not been
totally satisfactory and that distribution problems remain.
Physician maldistribution has been particularly affected by
the number and concentration of hospitals in urban areas, as
well as by government's policy of allowing dual
practice. Aside from HRH production and distribution
figures, key information on the quality of Indonesian
physicians, nurses, and midwives is limited. The latest data
from the 2007 Indonesia Family Life Survey (IFLS) vignettes,
which measured diagnostic and treatment ability, showed low
average scores across these three integral health worker
categories. Indonesia is addressing the quality issue by
improving the quality assurance system of health
professional education through school accreditation and
graduate certification and by strengthening health
professional registration and recertification systems. With
these issues in mind, if Indonesia is to attain UHC by 2019,
significant and concerted effort to improve the
availability, distribution, and quality of human resources
for health is required. |
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