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MANAJEMEN SDM

KESEHATAN

Piramida Populasi Indonesia

Impact of the population transformation


Change of the diseases pattern

Nakes sebagai
Faktor Kritis Mencapai Target2 KES
Paling signifikan dalam pencapaian
pembangunan kesehatan (berkontribusi 80%
terhadap keberhasilan)

Anand S, Brnighausen T. Health workers and vaccination coverage in developing countries: an


econometric analysis. The Lancet, 2007, 369: 12771285.
Speybroeck N et al. Reassessing the relationship between human resources for health, intervention
coverage and health outcomes. Background paper prepared for The world health report 2006. Geneva,
World Health Organization, 2006 (http://www.who.int/hrh/documents/reassessing_relationship.pdf).

Sayangnya seringkali diabaikan:


Lemah dalam

Sistem produksi nakes


Perencanaan dan penyediaannya
Rekrutmen dan penempatan
Diklat-penilaian pekerjaan-sistem insentif
Pemantauan-pengendalian dan sistem informasi SDM

Adang Bachtiar, CCF Indonesia, 2009

No
Type of
health
personnel

1
Specialist

2
Total
Ratio
per
PHC

109
0,01

Medical doctor
11,86
5
1.39

3
Dentist
5,278
0.62

4
Nurse
55,19
4
6.46

5
Dental Nurse
3,107
0.36

6
Midwife
57,48
9
6.73

Source : MoH, Indonesia, 2008


7
Pharmacist
192
0.02

8
Ass. of
Pharmacist
2,029
0.24

9
Public Health
(S1)
2,955
0.35

10
Public Health
(S2)
128
0.01

11
Sanitarian
7,540
0.88

12
Nutritionist
6,106
0.71

13

Physiotherapist

89

0.01

14
Med. Technician
2,830
0.33

3.05

Ratio medical doctor to Puskesmas


3
by province in 2008
0.23
0.42
0.66
0.67
0.88
0.94
0.96
0.97
1.05
1.07
1.08
1.10
1.15
1.20
1.20
1.24
1.27
1.31
1.35
1.38
1.38
1.39
1.57
1.61
1.66
1.73
1.73
1.76
1.86
2.02
2.03
2.23
2.43

Maluku
MalukuUtara
Sulawesi Tenggara
Papua
KalimantanTengah
KalimantanBarat
Sulawesi Barat
NusaTenggaraTimur
Gorontalo
KalimantanTimur
NusaTenggaraBarat
Lampung
Sulawesi Selatan
Sulawesi Tengah
NAD
JawaBarat
PapuaBarat
SumateraSelatan
SumateraBarat
JawaTimur
KalimantanSelatan
Indonesia
Jambi
Sulawesi Utara
DKI Jakarta
Bengkulu
Banten
BangkaBelitung
SumateraUtara
Riau
JawaTengah
Bali
D.I. Yogyakarta
KepulauanRiau

Health Workforce in Public Health Care Center


in Indonesia

current hrh situation


(RATIO PER 100.000 POPULATION)
TYPE OF HRH

TARGET
YEAR 2010

ACHIEVED
YEAR 2008

7,73

Physician

30

26,30

Dentist

11

7,70

158

157,75

75

43,75

Medical Specialist

Nurse
Midwife
Source: BDEHRH, MOHRI Year 2010

HRH DEVELOPMENT
STRATEGIC ISSUES
1. HRH maldistribution and low motivation of
HRH especially in remote areas;
2. Lack of appropriate regulation and low
commitment to implement regulation.
3. HRH planning is not adequately supported by
HRH information system;
4. Mismatch between HRH
education/production and HRH requirement.
5. Lack of HRH control and supervision

Working Lifespan of Health


Workforce and Health Service
Performance
Workforce
Performance

Entry
Planning
Education
Recruitment

Exit
Migration
Career
Choice
Retirement
Health &
safety

Compensation
Management
Continuing
education
System support,
environment
Worker Motivation

Health Service
Performance
Access/availability,
Responsiveness
Competence, Productivity

Labor Market Conditions

Private sector opportunities in


health sector
Public Sector HR Policies
Alternative Job Markets (domestic,
overseas)

Akiko Maeda,
2011

Government Policies

Health sector policies


Education policies
Public administration regulations
Labor policies

Major problem of the health


workforce

Health
workforce
(especially
specialists) do
not like to go to
remote and
underserved
areas

Source : WHO, 2010, adapted from Henderson LN, Tulloch J. Incentives for retaining
and motivating health workers in Pacific and Asian countries. Human Resources for