Anna Kurniati

Retaining and motivating health workers in very remote areas of Indonesia, do they respond to incentives?

Adequate Human Resources for Health (HRH) are crucial to the delivery of health care services in very remote areas of Indonesia. However, very remote areas suffer shortages in terms the number, type and quality of staff. This situation must be addressed through innovative policy, planning and implementation, such as incentives for retaining and motivating health workers. This paper aims to assess the application of an incentive scheme based on working location. The role of decentralized local government on incentives given to health workers also will be discussed. A desk study was performed from a relevant published materials, MoH database and online literature. The document highlights the importance of financial and non financial incentives. However, financial incentives alone are insufficient to retain and motivate the health workforce. Incentive systems must be integrated within the health system, in line with the goal and objective of Indonesia’s health development. The role of local leadership under decentralization is also crucial to motivate and maintain staff in the workplace. Different incentives between contracted and permanent staff in very remote areas must be established to ensure sustainability of the program.

Factors influencing Indonesian women's use of maternal health care services

ABSTRACT Employing the 2012 Indonesia Demographic and Health Survey data, we aimed to examine factors influencing married women to use maternity services. Data of married women who had given birth in the last five years before the survey were included in the analysis (n = 14,672). Factors of education, employment, womens age at first marriage, age at first birth, spousal education difference, contraceptive use, place of residence, and womans attitude toward wife beating were associated with the use of antenatal care, institutional delivery, and postnatal care services. The likelihood of women using those recommended maternal health care services increased along with the increased educational attainment among women and their spouses, and the older age at first birth. Higher schooling years may contribute to improving adequate maternal health care. Community awareness on maternal health issues should be promoted and include the prevention of early marriage, teenage pregnancies, and domestic violence.

Nursing qualification and workforce for the Association of Southeast Asian Nations Economic Community

International nurse migration among Association of Southeast Asian Nations (ASEAN) countries has the potential to increase the effectiveness of health services and access for the ASEAN Economic Community. Providing equivalent nursing qualifications and licensure standards and increasing the availability of the nursing workforce has become a challenge for ASEAN members. The purpose of this study is: 1) to comparatively analyze information on nursing licensing examinations (NLE) across ASEAN countries; and 2) to present information on the human resources required for a successful nursing workforce. This study reviews all documents published on the subject within the ASEAN Economic Community. NLE systems exist in all ASEAN Member States (AMSs)s except Brunei, Vietnam, and Lao PDR. Nursing education systems also vary across ASEAN countries. Language as a means of general communication and nursing examinations also differs. The availability of a qualified health workforce at the regional level is above the threshold in some areas. However, at the national level, Indonesia, Myanmar, Cambodia, and Lao PDR fall below the threshold. Professional licensure requirements differ among ASEAN nurses as a part of the process to become a qualified nurse in host and source countries. Mutual Recognition Agreements on nursing services should address the differences in NLE requirements as well as the availability of nurses.

Return migration of nurses: A concept analysis

Background: Return migration is a complex, challenging phenomenon and to date it remains a concept that is not well understood. A concept analysis would help to clarify what is meant by return migration. This paper aims to report on an analysis of the concept of return migration of nurses. Design: Concept analysis using the Walker and Avant approach. Data Sources: Google Scholar, Pubmed, EBSCO, JSTOR and Web of Science databases were searched without a timeframe. Twenty-one articles meeting the inclusion criteria were included. Method: This study employs eight steps of Walker and Avant’s method to conduct the concept analysis. Results: Return migration of nurses can be defined by five attributes: the motivation and decisions of migrant nurse, return as human right, resource mobilisation, reintegration and return itineraries. Antecedents of return migration include the economic, social, geographical, political, family and life cycle that comprise the cause and eRect framework. With regards to return migration, the consequences are beneficial or detrimental depend on the point of view migrant nurses, source country, receiving country, nursing profession and country health system. Empirical referents have been identified and support potential area to undertake a research on return migration. Conclusion: This concept analysis has clarified current understandings and enhance the clarity of return migration concept. It recognises the centrality of return as a component in migration stage that needs a comprehensive approach.

Premarital Sex Initiation and the Time Interval to First Marriage Among Indonesians

This study examines the determinants of premarital sex and its effect on the ages at which Indonesians first marry. Survival analysis has been applied to the 2012 Indonesia Demographic and Health Survey (IDHS), in which 11% of Indonesians reported they had had premarital sex. Our study shows the prevalence of premarital sex is higher when based on reports from married females and males aged 15–24 instead of reports from unmarried Indonesians. Males, less-educated people, and rural residents are also more likely to have premarital sex, while females, more-educated people and rural residents marry sooner after first having sex. Generally, however, Indonesians who have had premarital sex marry later than their counterparts. The long time span between Indonesians initiating premarital sex and marrying needs to be considered in policy that provides unmarried adolescents with rights to comprehensive sexual reproductive health (SRH) services.

Determinants of utilization of antenatal care services among adolescent girls and young women in Indonesia.

ABSTRACT Due to the high number of maternal deaths, provision of antenatal care services (ANC) in Indonesia is one of the key aims of the post-Millennium Development Goals agenda. This study aimed to assess the key factors determining use of ANC by adolescent girls and young women in Indonesia. Data from the Indonesia Demographic and Health Survey 2012 were used, with a focus on married adolescent girls (aged 15–19 years, n = 543) and young women (20–24 years, n = 2,916) who were mothers. Bivariate and multiple logistic regression analyses were performed to determine the factors associated with ANC use. The findings indicated that adolescents were less likely to make ANC visits than young women. Richer women were more likely to make four ANC visits in both groups compared to the poorer women. Living in urban areas, higher educational attainment, and lower birth order were also all associated with higher levels of receiving ANC among young women. The results showed that socio-economic factors were related to the use of ANC among adolescent girls and young women. Ongoing health-care interventions should thus put a priority on adolescent mothers coming from poor socio-economic backgrounds.