Effects of decentralisation and health system reform on health workforce and quality-of-care in Indonesia, 1993–2007

Diana, Aly, Hollingworth, Samantha A. and Marks, Geoffrey C. (2014) Effects of decentralisation and health system reform on health workforce and quality-of-care in Indonesia, 1993–2007. International Journal of Health Planning and Management, 30 1: E16-E30. doi:10.1002/hpm.2255


Author Diana, Aly
Hollingworth, Samantha A.
Marks, Geoffrey C.
Title Effects of decentralisation and health system reform on health workforce and quality-of-care in Indonesia, 1993–2007
Journal name International Journal of Health Planning and Management   Check publisher's open access policy
ISSN 1099-1751
0749-6753
Publication date 2014-01-01
Year available 2014
Sub-type Article (original research)
DOI 10.1002/hpm.2255
Volume 30
Issue 1
Start page E16
End page E30
Total pages 15
Place of publication Chichester, West Sussex, United Kingdom
Publisher John Wiley & Sons
Language eng
Abstract The impact of decentralisation, socioeconomic changes and healthcare reforms in Indonesia on type and distribution of healthcare providers and quality-of-care has been unclear. We examined workforce trends for healthcare facilities from 1993 to 2007 using the Indonesian Family Life Surveys. Each included a sample of public and private healthcare facilities, used standardised interviews for numbers and composition of staffing, and quality-of-care vignettes. There was an increase in multiprovider facilities and shift in profile of solo providers—increasing proportions of midwives and drop in doctors in rural areas (including facilities with doctors) and nurses in urban areas. Quality-of-care scores were low, particularly for nurses as solo providers. Despite increased numbers of healthcare workers and growth of the private sector, outer Java-Bali and rural areas continued to be disadvantaged in workforce capacity and quality-of-care. The results have implications for accreditation and in-service training requirements, the legal status of nurses and private sector regulation.
Keyword Decentralisation
Health workforce
Human resources
Quality assessment
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print 14 May 2014

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Public Health Publications
School of Pharmacy Publications
 
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Created: Thu, 19 Jun 2014, 23:04:24 EST by Samantha Hollingworth on behalf of School of Pharmacy