ISSN 2086-5953 responsibility. Besides, the coastal people must be
encouraged to actively participate in preserving the Mangrove. The people must be well nurtured on the
importance of Mangrove to linger their life. Without the support from people, the preservation
action will not be feasible to be done. The NGOs must also be invited to join this collaboration. There
are a lot of NGOs who put attention in coastal area. They will be good to do monitoring and control
towards the preservation, furthermore these NGOs are also good at becoming governments partner in
socializing the preservation framework to the people.
It is needed to underline that what proposed by this paper is a holistic preservation scheme.
Some initial preservation have been done previously by Ministry of Forestry, but this paper
focuses more on the collaboration among related institutions and stakeholders to trigger a lot bigger
impact. This collaboration must be actualized as an integrated policy, which will be followed by all the
related stakeholders and institutions without any overlapping or dispute and this integrated policy
can be assessed together by all the parties involved.
3.3 Strategic Actions in the
Implementation Stage on Mangrove Preservation
Mangrove preservation
requires an
assessment from all the parties involved such as government, private sector, and coastal people. The
role of government is mainly to ensure the implementation of Mangrove preservation by
releasing more policies that have a legal power to instruct the interested parties to do the preservation
and to restrict the utilization of coastal area from commercial activities that would possibly ruining
the ecosystem. The policy must be implemented top-down
from national
to regional
lever governance. The government also has to provide a
reward to those parties who are successful in conducting the preservation as recognition towards
their valuable contribution. The private sectors play an important role in supporting the funding aspect
and also monitoring the government program so that they also could be actively participated in
reporting
any misconduct
during the
implementation. Private sectors for example industries especially tourism industries can also
invest their funds in developing the coastal area, so that this area will be more convenient and support
their business better. The funding allocation also shows their CSR Corporate Social Responsibility
program.
The academician and researchers are also encouraged to design the preservation action,
through researches or studies on coastal area, it is expected that the preservation will run well and
directed. The researchers or academician can create a partnership with NGOs, government, or even
private sector to foster their activities. Last but not least, the coastal people can also be considered as
the major actors in the preservation issue. They are obligated to keep what have been preserved by
other parties, so that the continuation of this program can be kept stable.
The real action that can be taken in order to create an integrated system is by gathering all the
stakeholders in a focus group discussion FGD to get
the same
understanding and
also to
accommodate all the opinion and interest from the whole parties involved. Through the FGD, the
generation of idea, opinion, and same conclusion on Mangrove preservation can be triggered.
4 CONCLUSION AND DISCUSSION
Mangrove is an asset to the coastal area that must be preserved. It plays an important role in
the mitigation action against global warming because of its ability in absorbing CO2 and
maintaining the micro climate. The preservation of Mangrove must be seen as an alternative to preserve
the earth besides rehabbing the tropical forest and coral ecosystem. The preservation needs an
integrated policy that connects all the stakeholders such as government, private sector, and local
community to get the same understanding and direction in preserving Mangrove.
The current preservation method such as GERHAN Forest Rehabilitation Program which
was initiated by Ministry of Forestry must be re- evaluated by other related parties, because the
impact can be considered minor. Therefore, to scale up the impact, the inter-stakeholder collaboration in
terms of policy and creation of a new integrated preservation program is needed. This program
further must be engaged to the local community and other interested parties such as private sectors so
that the Mangrove reforestation rate can soon be targeted and the projection of futures impact on
how much CO2 can be reduced through this program can be calculated.
REFERENCES
[1] Satria A. 2009 Pesisir dan Laut untuk Rakyat. Bogor: IPB Press.
ISSN 2086-5953 [2] Rochana E. 2010 Ekosistem Mangrove dan
Pengelolaannya di Indoensia. PhD Thesis: Institut Pertanian Bogor.
. [3] Babo, Nenny R and Jeffery W. Froehlich
1998 Community-Based
Mangrove Rehabilitation: A Lesson Learned from East
Sinjai, South Sulawesi, Indonesia. The World BankWBI‘s CBNRM Initiative.
[4] Santoso N.
2000 Pola
Pengawa san Ekosistem Mangrove
. In: Lokakarya Nasional Pengembangan
Sistem Pengawasan
Ekosistem Laut 2000. Jakarta.
[5] Yayasan Terumbu
Karang Indonesia.
www.terangi.or.ididindex [Accessed:
7 November 2010].
[6] Food and Agriculture Organization United Nation
2007 The World‘s of Mangrove: a thematic study prepared on the framework of
global forest resources assessment 2005. Rome: Viale delle Terme di Caracalla.
[7] Mangrove Information
Center 2003
Pengelolaan Hutan Mangrove . In: Seminar
Pengelolaan Hutan
Mangrove 2003.
Denpasar. [8] Anonym 2009 Fungsi dan Peranan Hutan
Bakau Mangrove dalam Ekosistem, Jaga Kelestarian Ekosistem Hutan Bakau Bangka
Belitung . http:www.ubb.ac.id [Accessed: 8
November 2010].
19 ISSN 2086-5953
MANAGING HUMAN RESOURCES FOR HEALTH INDONESIA ’S
COUNTRY BORDER
Anna Kurniati
1
, Ferry Efendi
2
, Septian Arief ganda Putra
2 1
Center of Planning and Management of Human Resources for Health Ministry of Health, The Republic of Indonesia
2
Healthcare Administration, Asia University, Taichung, Taiwan Email: annakurniagmail
1
, fefendiindonesiannursing.com
2
, asnov_fisioterapiyahoo.com
2
ABSTRACT
Indonesia is an archipelago country comprises of 17.508 islands. The country shares
land borders with Papua New Guinea, Timor Leste, and Malaysia. Seeking the health need, people cross
the country border to meet the health care services.
One of Indonesia‘s priority development is improving the health status in the country border.
This paper will present the current health situation and health workers who work in health centers in
the remote country border areas in the eastern part of Indonesia i.e East Kalimantan province, East
Nusa Tenggara province and Papua province. Further emphasize is on the management aspect
which is retention strategy to fulfill the adequate number of health workforce availability. A desk
study was performed from relevant published materials. Literature was reviewed from databases
of the Ministry of Health The Republic of Indonesia. A clear understanding of health country
border situation and retention strategy is critical to face tomorrow challenges to improve health worker
distribution and performance in that area.
Keywords: retention, human resources for health
1 INTRODUCTION
Human resources for health HRH is an important asset for health systems and health care in
any country. In fact, health systems can‘t function without the health workforce including doctors,
nurses, midwives,
allied health
personnel, administrative and support staff NHRHO, 2009.
They are all critical to the management and delivery of health care to population. Indonesia is an
archipelago country extending 5,120 kilometers from east to west and 1,760 kilometers from north
to south. It encompasses an estimated 17,508 islands and only 6,000 of which are inhabited
Indonesia State Secretary, 2009. Administratively this country is divided into 33 provinces which
cover 440
districtscities. There
are 44
districtscities in 12 provinces that share continent and or sea boundaries with other countries i.e.
Malaysia, Singapore, Vietnam, Timor Leste, Philippines, Papua New Guinea PNG, Australia,
India and Palau. The continent border is shared by 4 provinces in West Kalimantan, East Kalimantan,
East Nusa Tenggara and Papua.
According to the Indonesian President Regulation No. 7 year 2005 on the National
Medium Term Development Plan, the country border areas is one of the development priorities
Bappenas, 2005. The development of the country border areas is considered very crucial as these are
strategic areas in the most front position to protect the unity, sovereignty and security of the country,
and also as the economic gate to achieve the prosperous community. Health sector is one of the
main agenda in developing the prosperity of the community in the country borders.
Ministry of Health MoH 2007
a
stated there are 101 health centres located in the country
border areas, 39 of them in outer islands. About 95 is categorized as less developed areas. There
are 54 health centres with in-patient facilities and supplied with minimum required number of health
staffs. However, based on the available data from 79 health centres, about 25 health centres suffering
shortages of health personnel and require additional 1 -2 doctors for each. Some of those health centres
also still require additional number of nurses, midwives and other health personnel in accordance
with the Index Staffing List of the MoH.
To counter those problems, the development of health sector in the country border areas has been
focused to the availability of medical doctors, midwives, nurses, nutritionists and sanitarians; the
upgrading of health centres with in-patient facilities; development of infrastructure and
operational cost; and the mobile health service. Using the contract scheme, since year 2006 the
MoH have consistently recruited doctors, dentists and midwives to be placed in remote and very
ISSN 2086-5953 remote areas including in the country border areas.
The doctors and dentists are contracted for duration of 6 months or 1 year depending on the criteria of
the location and can be prolonged upon request. With shorter period of contract, it is expected that
more doctors will be more interested to join as this is not a compulsory program. Thus shortages in
some remote and very remote health centres can be fulfilled. The districtscities have responsibility for
the distribution, providing facilities and other support as well as monitoring the availability and
performance of health personnel in their regions.
Overall, through this contract scheme, the percentage of health centres without doctors has
been decreased from 30 in year 2006 to 11 in year 2007 MoH, 2007
b
. However, as admitted by the District Health Offices, the most difficult
problem is to recruit and retain health workers in the remote outer islands or mountainous areas in the
country border. Some financial incentives and other benefits offered by some local government do not
always interest health workers. This paper focusing on human resources for health and aims to address
the following questions:
What is the current condition of the health situation in the country border area?
What was the implemented strategy and the future alternative strategies to retain the health
workforce in the country border area?
2 METHODOLOGY AND
CONCEPTUAL FRAMEWORK
2.1 Methodology
