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Wednesday, April 29, 2009
Sadrivaan A and B (The Hilton Istanbul Hotel )
Background: Health sector decentralization in Indonesia had been enforced since the beginning of 2001. Health sector decentralization represents the concequences of the political and fiscal decentralization policy which was enacted by the Law No. 22 in 1999. This research is concerned with the effectiveness of decentralization policy in health sector.
Objectives: To identify whether the decentralization policy is able to improve the public health status after 8 years of its implementation; and to analysis the policy making of decentralization in health, in terms of policy formulation and implementation.
Method: Restropective policy analysis. Data for this policy analysis were collected through documents, discussions, seminars, and observations.
Results: Public health status data showed no significant improvements during 2001 – 2007 period. The health care decentralization policy formulation was developed in a rush manner after political and financial decentralization. Technically, Ministry of Health was not ready and not much involved in the policy formulation. As result, the policy implementation is not fully supported by Ministry of Health. Some Ministry of Health leaders were infavor of a re-centralized health sector. The policy was changed by a new decentralization Laws in 2004. In the new Laws, health remained a decentralized sector. However, argument for re-centralization continued and marginalised the effort for organizational capacity building to implement health decentralization policy.
Conclusion: Between 2000 – 2007, decentralization policy implementation has no impact in public health status improvement. The debate of decentralization and re-centralization among key policy actors is one of the problems in health decentralization policy implementation in Indonesia.
Recommendation: It is expected that the different views of decentralization should be resolved. Decentralization policy needs more organizational capacity improvement of the local and central government organizations for its implementation.
Objectives: To identify whether the decentralization policy is able to improve the public health status after 8 years of its implementation; and to analysis the policy making of decentralization in health, in terms of policy formulation and implementation.
Method: Restropective policy analysis. Data for this policy analysis were collected through documents, discussions, seminars, and observations.
Results: Public health status data showed no significant improvements during 2001 – 2007 period. The health care decentralization policy formulation was developed in a rush manner after political and financial decentralization. Technically, Ministry of Health was not ready and not much involved in the policy formulation. As result, the policy implementation is not fully supported by Ministry of Health. Some Ministry of Health leaders were infavor of a re-centralized health sector. The policy was changed by a new decentralization Laws in 2004. In the new Laws, health remained a decentralized sector. However, argument for re-centralization continued and marginalised the effort for organizational capacity building to implement health decentralization policy.
Conclusion: Between 2000 – 2007, decentralization policy implementation has no impact in public health status improvement. The debate of decentralization and re-centralization among key policy actors is one of the problems in health decentralization policy implementation in Indonesia.
Recommendation: It is expected that the different views of decentralization should be resolved. Decentralization policy needs more organizational capacity improvement of the local and central government organizations for its implementation.
Learning Objectives: Analyze health sector decentralization policy impacts on public health status and stakeholders’ views in Indonesia.
Sub-Theme: Public Health and Research: Evidence Based Policy on Health