- Amanatul Firdaus1,
- Ferry Efendi1,2,
- Setho Hadisuyatmana1,2,
- Gading Ekapuja Aurizki1 and
- Khatijah Lim Abdullah3
The aim of this study was to analyse the factors associated with the intention of Indonesian nursing students to work in rural areas. This was a cross-sectional study. The instrument used was a self-developed questionnaire consisting of 13 questions. The data were analysed using the ?2statistics test and binary logistic regression with a level of significance <0.05. The study was conducted at a public nursing school located in urban Surabaya, East Java, Indonesia, in December 2017. A total of 714 nursing students from four different programmes were involved. This study found that almost 60% of nursing students were reluctant to work in rural areas. Of the three variables which were significant in the ?2 analysis, only two were significant following the logistic regression test, namely the class programmes of undergraduate regulars (OR=2.274; 95% CI 1.326 to 3.900), profession regulars (OR=2.262; 95% CI 1.110 to 4.607) and rural place of origin (OR=1.405; 95% CI 1.036 to 1.906). The education programme and place of origin were associated with the intention of nursing students to work in rural areas. Therefore, the recruitment of prospective nurses should consider these factors by considering the local context.
- A. Kurniatia, 1,
- E. Rosskamb, , 2, ,
- M.M. Afzalc, 3,
- T.B. Suryowinotod, 4,
- A.G. Muktie, 5
- aHRH Planning Division, Center for Planning and Management of Human Resources for Health, BDEHRH, Ministry of Health, Indonesia
- bWebster University, Geneva, Switzerland
- cGlobal Partnerships, Global Health Workforce Alliance, WHO, Geneva, Switzerland
- dMinistry of Health, Indonesia
- eGadjah Mada University, Yogyakarta, Indonesia
Received 14 July 2014, Revised 6 April 2015, Accepted 15 April 2015, Available online 30 May 2015
Indonesia faces critical challenges pertaining to human resources for health (HRH). These relate to HRH policy, planning, mismatch between production and demand, quality, renumeration, and mal-distribution. This paper provides a state of the art review of the existing conditions in Indonesia, innovations to tackle the problems, results of the innovations to date, and a picture of the on-going challenges that have yet to be met.
Reversing this crisis level shortage of HRH requires an inclusive approach to address the underlying challenges. In 2010 the government initiated multi-stakeholder coordination for HRH, using the Country Coordination and Facilitation approach. The process requires committed engagement and coordination of relevant stakeholders to address priority health needs. This manuscript is a formative evaluation of the program using documentary study and analysis.
Consistent with Indonesia’s decentralized health system, since 2011 local governments also started establishing provincial multi-stakeholder committees and working groups for HRH development. Through this multi-stakeholder approach with high level government support and leadership, Indonesia was able to carry out HRH planning by engaging 164 stakeholders. Multi-stakeholder coordination has produced positive results in Indonesia by bringing about a number of innovations in HRH development to achieve UHC, fostered partnerships, attracted international attention, and galvanized multi-stakeholder support in improving the HRH situation. This approach also has facilitated mobilizing technical and financial support from domestic and international partners for HRH development.
Applying the multi-stakeholder engagement and coordination process in Indonesia has proved instrumental in advancing the country’s work to achieve Universal Health Coverage and the Millennium Development Goals by 2015. Indonesia continues to face an HRH crisis but the collaborative process provides an opportunity to achieve results. Indonesia’s experience indicates that irrespective of geographical or economic status, countries can benefit from multi-stakeholder coordination and engagement to increase access to health workers, strengthen health systems, as well as achieve and sustain UHC.
- Health workers;
- Health systems strengthening;
- Health policy;
- Multi-stakeholder coordination;
- Universal health coverage
doi:10.1016/j.puhe.2015.04.012Get rights and content