Indonesia has made impressive gains in expanding the reach of health services over the past 25 years, contributing to significant improvements in certain health outcomes. However, some health indicators remain low, indicating improvements in the quality of health workers are still needed. The Health Professional Education Quality Project will contribute to better progress in achieving key health outcomes in Indonesia by ensuring higher value health care by improving the quality of the health care providers: the doctors, dentists, nurses, and midwives. The project is addressing this by strengthening the accreditation and certification institutions which will lead to improved quality of the education of these health professionals.
Each year, around 5,000 doctors, 1,350 dentists, 34,000 nurses and 10,000 midwives graduate from Indonesia’s 70 medical schools, 23 dental schools, almost 600 midwifery school and over 500 nursing schools; all categorized as higher education institutions under the jurisdiction of the Ministry of National Education and Culture. Quality of the schools varies widely, where many newly established institutions still have poor education quality. Evidence shows little improvement in quality of doctors, nurses and midwives during the period of 1997-2007. Quality of training is among the contributing factors to poor health services. Recent reforms have laid the foundation for improvement in health professional education but implementation of these reforms is only just starting.
Component 1: Strengthening policies and procedures for school accreditation.
The component is supporting the government in developing a valid, transparent, credible and internationally competitive accreditation system for medical, dental, nursing, and midwifery education.
Component 2: Certification of graduates using a national competency-based examination
This component supports the strengthening of competence-based examinations for doctors, dentists, nurses, and midwives by: (i) establishing an independent national competence examination agency; (ii) improving the methodology and management of the examination; and (iii) developing an item bank networking system.
Component 3: Results based financial assistance package for medical schools
Building on the agreements on accreditation and certification, the project has allocated financial assistance packages for selected medical schools to meet the accreditation standards.
The project is currently working with 42 universities throughout Indonesia.
The project has been approved since November 2009 and planned to end in December 2014. A number of results have been achieved until now include:
- The involvement of health professional associations in the development of quality assurance framework for health professional education have at least two benefits: increased capacity of those organizations, and improved relationship and communication between professions and also with the Government.
- The Grand Design of professional education for each of health professional involved in the Project is developed.
- The concept of inter-professional education is discussed and strengthened through the project
- 22 Computer Based Test Centers have been established all over Indonesia with the support from the Project. The CBT network is expanded with more Centers and also the number of workstations has more than doubled due to the contribution from the training institutions.
International Bank for Reconstruction and Development US$74,972 million
World Bank is working with the Ministry of National Education and Culture and Ministry of Health to implement the project. Other stakeholders involved in the project are health professional organizations, associations of health professional education institutions, National Accreditation Body for Higher Education, Indonesian Medical Council and Indonesian Health Professional Council.
Toward the Future
There are growing interests among other professions to replicate the development of quality assurance system including accreditation of training institutions and competency-based certification supported by this project.