New Insights Into the Provision of Health Services in Indonesia: A Health Workforce StudyOver the past decade, Indonesia has implemented significant health sector reforms that include decentralizing responsibilities for service delivery, designing incentives for health providers, increasing the supply of midwives in remote areas, and analyzing demographic and epidemiological transitions causing changes in the patterns of disease prevalence. Financial protection against catastrophic expenditures has improved substantially, and legislation has been enacted to improve the quality of physician training and patient care.Despite the progress, substantial challenges remain and include comparatively low resources for the health sector, limitations in the supply of providers at the primary and hospital levels, inefficient payment systems, shortcomings in the quality of maternal and child and adult care, lack of oversight and effective licensing in an expanding private health sector, and ineffective planning for and recruitment and retention of health workers.Given the slow pace in improving health outcomes and limited evidence linking health performance and the health workforce, the need to make more information available about past experiences to inform future policy changes is pressing. Few studies have been undertaken to measure the actual impact of the reforms and the remaining challenges. 'New Insights into the Provision of Health Services in Indonesia: A Health Workforce Study' begins the process, providing real time evidence-based inputs to facilitate the Government of Indonesia's comprehensive health sector review. The authors' analysis of panel data from households and health providers will assist the government's assessment of the impact of past health work force policies and its consideration of policy changes. |
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3rd quintile 4th quintile accreditation adult curative Askeskin/Jamkesmas average Banten capita expenditure Central Java Change in number child curative child curative care curative care vignette decentralization diagnostic ability diagnostic and treatment district fixed effects doctors dual practice errors in brackets Gadjah Mada University health care providers health facilities health outcomes health providers health services health workers health workforce hemoglobin hospital http://www.rand.org/labor/FLS/IFLS IFLS improve incentives increase Indonesia Family Jakarta Java and Bali Model number of midwives number of physicians number of private PODES population practitioners prenatal care private physicians private practice private sector private services Provinces public and private public health puskesmas puskesmas and pustu quality of health R-squared remote areas rural areas Siaga Source South Kalimantan South Sulawesi South Sumatra Standard errors Sumatra supply of health Susenas Trained in 12 treatment ability urban areas utilization vignette score village World Bank