e-ISSN 2598-3849       print ISSN 2527-8878

Vol 3, No 2 (2018)

Health Workforce Assessment in Jakarta for Effective HIV Policy Implementation: Challenges and Opportunities toward Epidemic Control

Rachel Hoy Deussom, Elisabeth Rottach, Ciptasari Prabawanti, Edhie Rahmat, Tetty Rachmawati, Nanda Sirajulmunir

Abstract


Abstract

Strategic efforts are needed in Indonesia to implement the recently released human immunodeficiency virus (HIV) Test and Treat policy which promotes increased treatment uptake, known to have important economic benefits. Of Indonesia’s estimated 631,635 people living with HIV (PLHIV) in 2018, only 12% are on treatment. The USAID- and PEPFAR-funded Human Resources for Health in 2030 (HRH2030) Program undertook policy analysis and assessed the available health workforce and service delivery at select sites in Jakarta to identify and anticipate Test and Treat implementation gaps. A mixed methods concurrent triangulation design was used, including policy analysis, key informant interviews, and site-level tools to capture workforce availability, skills, quality, and performance. Results indicate priorities to: define and implement HIV standards of practice for the Test and Treat policy; improve relevance and coordination of pre-service and in-service training programs; and support managers to optimize task and workforce allocation, including allocating lower-skilled workers to routine testing. Additional site-level data are needed from rural and remote sites in Indonesia, where fewer health workers are distributed. Efficiencies can help sustain HIV programs and contribute to epidemic control.

Abstrak

Upaya strategis dibutuhkan Indonesia untuk implementasi kebijakan Pemeriksaan dan Pengobatan (Test and Treat) HIV, seperti yang diterbitkan oleh USAID dan PEPFAR. Kebijakan ini mendorong peningkatan cakupan pengobatan yangd diyakini penting secara ekonomi. Diperkirakan pada tahun 2018 terdapat 631,635 ODHA di Indonesia dan hanya 12% yang menjalani pengobatan. Program HRH2030 yang didanai oleh USAID dan PEPFAR melakukan analisis kebijakan dan penilaian ketersediaan tenaga kesehatan dan pelayanan HIV di beberapa unit layanan di Jakarta, untuk mengidentifikasi dan mengantisipasi kesenjangan implementasi kebijakan. Kajian menggunakan metode campuran dengan melakukan analisis kebijakan, wawancara informan kunci, dan serangkaian alat asesmen tingkat unit layanan untuk menangkap informasi terkait ketersediaan, keterampilan, kualitas, dan kinerja tenaga kesehatan. Hasil kajian ini memprioritaskan adanya penetapan dan penerapan standar praktik layanan HIV yang sesuai dengan kebijakan Pemeriksaan dan Pengobatan. Peningkatan koordinasi program pendidikan pra-layanan dan pelatihan dalam jabatan dan dukungan kepada manajer unit layanan untuk mengoptimalkan alokasi tugas dan tenaga kesehatan menjadi hal yang penting. Pendekatan ini diharapkan dapat meningkatkan efisiensi layanan dan keberlanjutan program HIV. Data dan informasi tingkat unit layanan dibutuhkan, khususnya dari wilayah pedesaan dan terpencil. 


Keywords


human resources for health; health workforce; HIV/AIDS; policy implementation; workforce management

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Full Text: PDF

DOI: 10.7454/eki.v3i2.2790

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