Indonesia Decentralization

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Decentralization on Health Personnels at District Level in Indonesia : Strengths, Weakness, and Challenges Indonesia began a process of rapid government decentralization in 1999 from a formerly strong centralized government structure. The World Bank defines decentralization as “the transfer of authority and responsibility for public functions from the central government to intermediate and local governments or quasi independent government organizations and/or the private sector” (Green, 2005).
As outlined by Bossert, the underlying notion of decentralization "...implies the expansion of choice at the local level." Using a principal/agent approach, Bossert describes this expansion as "decision space", "the range of effective choice that is
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Within a year, more than 70% of central civil servants and services facilities were transferred to the local government and also commenced implementation of a new intergovernmental fiscal framework. Intergovernmental relations in Indonesia was expected lead to many changes at the district level, particularly to improved public sector performance and this would remain heavily dependent on transfers of fund from central to local government. Like other government services, the health sector has also been affected by these change. One of the areas in the health sector most affected is human resource or in this term is health personnel.
The author of the paper have a goal to understand what is happening at the district level in the health sector, started with enumeration of all health care providers (doctors, nurses, and midwives) and the health facilities in which they work and deliver services. This study was conducted in 2007 and data collected were from 2006. The study worked concentrates on Java Island, where 60% of the Indonesian population
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Although there were inaccuracies and delayed in the report, it was possible for the central government to get a picture of the situation at the district, provincial and national level. After decentralization, there is weaknesess in the program, the districts no longer feels to maintain the records and give a report to central government so the central government have less information about whole components in health sector and its critical assets, human resources. That is strong indicators that the central government have to adapt and modified the policies to overcome this changes and facing the health challenges in the future. However, the districts and provinces government should worked together to maintain the records so the central government could improved the health system in Indonesia. At the same time, governments at all levels should genuinely implement the six health system building blocks to planning, implementing, monitoring, and evaluation of
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