Improving Medical Specialist Service in District Hospitals: Increasing the Number of Medical Specialist and Nurse Diploma IV

1Anna Kurniati, 2Ferry Efendi, 1Nurul Aidil Adhawiyah
1Center for Planning and Management of Human Resources for Health
Ministry of Health, The Republic of Indonesia
Jl. Hang Jebat Raya F3, Kebayoran Baru Jakarta, 12120
2Faculty of Nursing Airlangga University Indonesia
Jl. Mulyorejo Kampus C Unair Surabaya 60115

Abstract
In overcoming the HRH crisis, the Kampala Declaration (KD) and the Agenda for Global Action (AGA) in year 2008 had set up some indicators to help countries in monitoring the progress of actions taken. Indonesia is including 57 countries categorized suffering HRH crisis. The shortage of HRH occur in most of category health workers, particularly medical specialist, doctors, dentist, midwives, nutritionist and public health.
The district hospitals play important roles in the referral system. However, most district hospitals do not meet the national minimum standard, especially the availability of basic medical specialists (child health, internist, surgery and obstetric gynecology) and other supporting specialists. In line with the KD/AGA on scaling up health worker education and training, starting from year 2008, the Ministry of Health have provided scholarship for medical doctors and dentist who are willing to attend medical specialist training, and scholarship for nurses to upgrade their education level to Diploma IV (specialist training). In return, they have to pay for service for certain period depending on the hardship level of the working locations. Implementation of this program requires strong coordination among MoH, MONE (particularly through medical schools and nursing schools), MOF and the local government both in the province and district levels.
This paper will describe the experience of Indonesia in monitoring the implementation of strategy to improve the access of community to quality health services, especially through increasing the number of medical specialist and nurse Diploma IV for the district hospitals.

Keywords: scholarship, district hospitals, coordination.

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