By: Anna Kurniati (BPPSDMK, Kemenkes RI)
Indonesia is an archipelago country consisting of more than 17.000 islands. The country has land border with Malaysia, Papua New Guinea and Timor Leste. Community in this area have close relationship with the community in the border of the neighbour country in term of culture, social and economic. In the health sector, people cross the country border to seek health services suited their needs.
One of Indonesia’s priority development is for areas in the country border. As these areas reflect the outward looking, an entrance for economic activities, and crucial in the aspects of prosperity, security, and unity. Health development for country border areas have been prioritised in Indonesia such as through improvement of health services in health centers. To meet the demand of community in these areas, health centers have been being completed with some beds, equipment and qualified health workers in adequate number.
The decentralization policy that has been implemented since year 1999 provides more authority to the local government in health sector. The status of health workers in the public sector that used to be placed by the central government have been transferred to the local government. Once they transferred into the one region, it will be difficult to move to other region without approval from both local governments. Consequently, many of health workers request to move to their home town or close to their place of origin before their status being transferred. Thus the less attractive, remote, border country areas suffer from lacking of health workers, and difficult to recruit certain health workers from other regions.
The Ministry of Health of Indonesia have some programs to improve the availability of qualified health workers in these areas through placement of contract doctors, dentist and midwifes. However it has some constraints such as lack of quantity, absenteeism, and continuity as the contract only for 6 – 12 months unless there is contract renewal or in time replacement.
This paper will present the current health situation and health workers who work in health centers in the remote country border areas in the eastern part of Indonesia i.e East Kalimantan province, East Nusa Tenggara province and Papua province. These three provinces have different characteristic in health problems in their border areas.