After success in health service quantity, Indonesia now addresses quality.

April 6, 2012

  • Indonesia has made impressive gains in improving the coverage of health services, but quality still needs to be addressed.
  • The government has made initiatives to address competencies of health workers but improvements still needed.
  • The World Bank is working with the government to help ensure that health workers graduate with the same competency standard throughout Indonesia.

Jakarta, April 6, 2012 – Indonesia has been able to make great progress in increasing the coverage of health services. A significant reason behind this is the thousands of new health workers graduating from schools annually. However, quality of new graduates still needs to be addressed and focusing on the education they receive is vital.

As a nursing student studying at Gadjah Mada University, one of the most established academic institution in Indonesia, Maria Leonar feels confident that the education she is receiving will help her provide good health service for the public. "I have easy access to good learning materials, and the lecturers here are very experienced. Students in other nursing schools may not be as fortunate," she said illustrating the disparity among schools.

Quality of the schools varies widely, where quality of newly established education institutions remain poor. Evidence shows little improvement in quality of doctors, nurses and midwives during the period of 1997-2007. The Medical Practice Act in 2004 supported the establishment of the Indonesian Medical Council, which produced standards for physician competencies and medical education in 2006. However, given the varying capacities of Indonesian medical schools, the standards are not implemented consistently. As a consequence, large and growing variation in quality exists among schools and their graduates.

Health Professional Education Quality Project
Since 2009, the World Bank has been working with the Indonesian government to implement the Health Professional Education Quality project to help ensure that doctors, nurses, dentists and midwives graduate with the same level of competency. “The first step to improve the standard of schools is knowing what to improve, and this will be done through a new accreditation system we are currently developing,” said Illah Sailah from the Ministry of National Education and Culture. "The main purpose of having a better accreditation system is not to rank schools but as an external feedback to let schools know how they can improve," she added.

" The first step to improve the standard of schools is knowing what to improve, and this will be done through a new accreditation system we are currently developing "

Illah Sailah

Ministry of National Education and Culture

At present, the Indonesian Higher Education National Accreditation Agency still uses a single form to base its assessment for all fields of studies. "This one form cannot provide a comprehensive assessment on quality of schools since it is too general. For example, schools for doctors and economists should not be assessed in the same manner," said Titi Prihatiningsih, Dean of Gadjah Mada University medical school.

One critical factor to determine graduates meet the required competency standard for health workers is putting a good examination system in place. A national examination, including a competency assessment, is being developed under the project, and will be mandatory in addition to existing exams currently held at the faculty level. Twenty-two computer-based exam centers have now been established and are being tested. "I understand an extra examination at the national level can be more difficult, but it will certainly help make the standard of health workers more equal throughout Indonesia,” said Endang, a medical school student at Gadjah Mada University.

To help new universities improve, under the project one established university becomes a mentor for two developing universities. University of Indonesia in Jakarta, for example, is helping University of Riau and Tanjungpura University, both located in Sumatra. “In practice, this is actually not a mentoring activity since the more established universities also learn from the process,” said Bambang Trijaya a faculty member from University of Indonesia. “My colleagues have gained new knowledge about diseases that are more common in Sumatra,” giving one example.