Pump it up: A man has his blood pressure checked at a community health center (Puskesmas) in Pancoran, South Jakarta. Health Minister Endang Rahayu Sedyaningsih wants to boost the quality of services at Puskesmas across the nation to meet the Millennium Development Goals. JP/R. Berto Wedhatama
The government is planning to empower community health centers across the country to help provide medical treatment for people in rural areas and promote the importance of healthcare.
This will form part of efforts to meet the Millennium Development Goals (MDGs) set for 2015.
Health Minister Endang Rahayu Sedyaningsih acknowledged on Monday that healthcare services had not been equally enjoyed by people, partly because of the uneven distribution of health workers.
“Community health centers should play more active roles in delivering healthcare services for people,” Endang told journalists after opening a three-day regional consultation on “Strengthening Human Resources Management to improve Health in Southeast Asia”, which was held in Bali.
“Patients don’t have to go to major hospitals for treatment if the community health centers have adequate facilities and health workers at the ready,” she said.
“We are planning to equip community health centers with in-patient facilities and improve their quality of services,” she said.
The regional consultation aims to review the progress of the implementation of the regional strategic plan finalized in Bali in 2006 and the Dhaka Declaration, agreed in Bangladesh in 2006, which target the strengthening of the health workforce in the Southeast Asia region.
Representatives of 11 World Health Organization, Regional Office for Southeast Asia (WHO-SEARO) member countries attended the consultation. They were Bangladesh, Bhutan, India, Indonesia, Korea, the Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor Leste.
In his remarks, WHO Southeast Asia regional director Samlee Plianbangchang said countries should reorientate their national health policies towards public health interventions and community-based health services.
“We have invested a bigger portion of our resources in developing health facilities to serve sick people,” he told participants.
Samlee said, however, that giving more attention to curative care rather than preventive care would only bring heavier financial burdens on the healthcare system.
“Healthcare costs will skyrocket. We may reduce such burdens by promoting preventive care through public health interventions. To make it happen, we need more public health workers, including at the community level,” he said.
Those workers, he said, should have adequate skills to develop healthcare programs both in the population and at community levels, ranging from health promotion to disease prevention and control.
During the consultation, health professionals from countries in the region learned from each other the challenges they faced in delivering proper healthcare services.
Tari Tritarayati, an official with the Health Ministry, said adjusting the balance between the number and quality of health workers was vital in providing quality healthcare.
Citing an example, she said that Indonesia now had a sufficient number of nurses and midwives. It was still overwhelmed with a lack of physicians, however, as the proportion of doctors stood at one to every 3,000 people.
“Improving people’s access to healthcare workers, especially doctors, remains our target. We hope the proportion of doctors can improve in stages to 1:900-1,000 people by 2025,” she said.
About 25 percent of a total 9,133 community health centers (Puskemas), located especially in remote areas, were currently not led by doctors. “Frankly speaking, the lack of doctors is not the only factor as most of them would rather work in big hospitals in urban areas instead of in remote ones,” said Tari.
The government is planning to recruit 10,225 midwives, 2,586 doctors and 722 dentists this year. Giving these individuals an incentive is one of measures the ministry has taken to ensure more doctors are attracted to serving those in remote areas.
In the package, each PTT doctor will have an incentive of Rp 5 million per month. A monthly incentive of Rp 2.5 million is available for PTT nurses and midwives. Specialist candidates will receive an additional Rp 7.5 million if they agree to go to remote areas.
“With such incentives, I hope more health workers, especially doctors and specialist physicians, are more evenly distributed,” said Tari.