Indonesia

The Toolkit is adapted from the WHO WISN Manual. WISN has traditionally been in a top down approach with limited success, particularly when applying it within the context of a decentralized government system. It was recognized that a more innovative approach was required to implement the methodology successfully at decentralized levels. [from author]

This article describes a systematic process to develop and implement two strategic action plans focussing on competence development based on specific job descriptions. The approach was a change from only focussing on training, to a broader, long term approach to human resource development for comprehensive TB control. [adapted from abstract]

This report presents the consolidated findings from the desk review and the in-country assessment, as well as recommendations for interventions that could strengthen the role private health care providers can play in achieving health sector objectives. [from summary]

Recent years have seen growing awareness of the importance of human resources for health in health systems and with it an intensifying of the international and national policies in place to steer a response. This paper looks at how governments and donors in five countries: Cameroon, Indonesia, Malawi, Rwanda and Tanzania, have translated such policies into action. [from abstract]

Since the early 1990s Indonesia has attempted to increase the level of skilled attendance at birth by placing rural midwives in every village in an effort to reduce persistently high levels of maternal mortality. Yet evidence suggests that there remains insufficient incentive to ensure an equal distribution across areas while the poor in all areas continue to access skilled attendance much less than those in richer groups.

The objective of this article is to determine the stock of human resources for health in 15 districts, their service status and primary place of work. It also assesses the effect of decentralization on management of human resources and the implications for the future. [from abstract]

This paper discusses the current health situation in eastern Indonesia and the problems facing health workers at health centers in the remote country border areas of that region. [adapted from abstract]


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This website contains brief country reports on HRH development activities in 2008 from nations belonging to the Asia-Pacific Action Alliance on HRH.

Care for most women before, during and after delivery can be provided within a well equipped primary care setting. Since the 1980s Indonesia has attempted to improve women’s access to maternal health care by assigning professional midwives to each village. Despite an increase in the number of midwives, maternal mortality remains high compared to other countries with similar Gross Domestic Product per capita. [from introduction]

This brief describes PATH’s project to implement supportive supervision techniques to improve health worker training in Indonesia.

The government of Indonesia launched the village-based midwife program to place a skilled birth attendant in every village to provide antenatal and perinatal care, family planning, other reproductive health services, and nutrition counseling. The attendants were also to facilitate basic primary health-care services, including immunization and nutrition interventions.

This study assessed whether the strategy of “a midwife in every village” in Indonesia achieved its aim of increasing professional delivery care for the poorest women. [from abstract]

In 1989, the government of Indonesia launched the Midwife in the Village programme. Its purpose was to reduce maternal death by assigning a resident midwife to each village in the country. By definition, she would live in the village and be part of the community she served. In 2005, Immpact examined the effect of the programme on the health and survival of mothers in two districts in Java. [from author’s description]

This cost analysis is based on QAP research on the effectiveness of two interventions (self-assessment and peer review) in sustaining or increasing the effectiveness of interpersonal communications training that midwives had taken. The research had measured the effectiveness of the interventions in terms of the number of utterances midwives made during family planning consultations, and this case study followed on, measuring the cost of each intervention in terms of the number of utterances generated. Activities/tools: Sample provider self-assessment form, sources of costs, evaluation of marginal benefit.

This study tested two low-cost alternatives to supervision-self-assessment and peer review-that may reinforce providers’ skills after training, in this case training in interpersonal communication and counseling (IPC/C). There were three study groups: the control group received no reinforcement after training, a “self-assessment” (SA) group performed SA exercises for 16 weeks after training, and a SA and peer review group also performed SA exercises for 16 weeks and met in small groups to peer review and guide each other in their efforts to improve their IPC/C skills. These reinforcement strategies taught providers how to work more efficiently so that they could shorten consultations yet provide high quality interactions with clients. An analysis of the cost-effectiveness of each intervention is included. [publisher’s description]

This case study documents Indonesia’s family planning experience with a view to understanding the factors and conditions that led to the remarkable growth in the private sector’s role in delivering family planning services. [from abstract]

The nurse program for foreign countries in Indonesia has been carried out since 1996. In the beginning, this program attempted to solve the false ‘surplus’ problem of nurses in Indonesia. Recently, however, the MOH has developed serious concerns with this program. There have been several efforts to promote the nurse program for foreign countries starting with the improvement of education, recruitment and other mechanisms related to nurses for foreign countries. Some achievements, strengths, weaknesses, potentials and threats are discussed in this paper. Alternative policy inputs for future improvement of this program have also been submitted.

In line with government initiatives, this series of studies was undertaken to establish the training and development needs of nurses and midwives working within a variety of contexts in Indonesia, with the ultimate aim of enhancing care provision within these domains. [from abstract]

The current study was part of a review of the existing complex system of midwifery training in Indonesia and the development of a coherent program of continuing professional development, tighter accreditation regulations and clearer professional roles.

This study aimed to establish the occupational profiles of each grade of nurse in Indonesia, identify their training and development needs and ascertain whether any differences existed between nurses working in different regions or within hospital or community settings. [from abstract]

In Indonesia responsibility for immunizations is placed on local government health centres and on the nurses who provide the immunizations at each centre. An on-the-job peer training programme for these nurses, which was designed to improve the immunization performance of poorly performing health centres in terms of coverage and practice in Maluku province, was evaluated. [from abstract]

This review examines the systemic and individual causes of multiple job holding (MJH) and evidence on its prevalence. MJH should be seen as resulting initially from underlying system-related causes. These include overly ambitious efforts by governments to develop and staff extensive delivery systems with insufficient resources. Governments have tried to use a combination of low wages, incentives, exhortations to public service, and regulation to develop these systems. In many countries, these strategies are not sufficient to outweigh the motivations of and incentives faced by individual health workers in mixed public private labour markets.