Conclusion Meeting Day 1.

14 May 2014

Note by: Prof. Laksono Trisnantoro

Meeting Day 1 of the Physician Migration in conjunction with the Health System in South East Asia as well as the implications on curriculum concludes :

1. Southeast Asian countries has two poles of different communities, namely : (1) in remote areas or difficult; and (2) in an area that has direct access to the international health system. The second area has a health care system that is largely determined by the laws of the market, and have service levels such as five-star hotels or jasmine.
2. Demographics and disease patterns in Southeast Asian communities closer to equality, there are convergence.
3. Based on the data in the speaker presentations and needs, physicians who perform the migration is the dynamic moving specialists , especially in areas that have international access and there are a lot of people can afford. Remote areas usually for international migration of doctors in primary care level, which is supported by international funding agencies or foreign governments who want to serve. Activity in this area is not based on the principle of market mechanism.
4. Situation is mainly an impact on resident education ( PPDS1 , specialists ) and fellow ( PPDS2 , sub - specialists). International atmosphere must go into resident education, although in medical education (undergraduate) should also be given international development. But in Indonesia, the need for doctors in remote areas must also be met.

In overall: Educational physician , resident , and fellow users in Indonesia is facing two different extremes : ( 1 ) the needs of international medical services including medical tourism ; and ( 2 ) the need for medical services in remote areas . How strategies to improve the quality and capabilities of graduates ? This is a challenge that has a faculty of medicine (FK-FK) accreditation (which is authorized to conduct residency education).

Topic C: The Medical Doctors Migration Policy
Facts and policies of foreign doctors in Thailand

13 Mei 2014

The first session was explained by Dr. Prasobsri Ungthavorm ,who share the experience and shape policy for foreign doctors in this white elephant country . Dr . Prasobsri start by telling doctors fundamental foreign policy establishment promoted in Thailand comes from the ASEAN declaration on August 8, 1967. Thailand has similarities with characteristics similar fate and between countries . This policy thus becomes the direction of solving the problem for ASEAN and Thailand in particular.

Problems in Thailand in general has similarities with problems in other developing countries. Shortage of health resources are very vulnerable place. In terms of health facilities, Thailand only has 926 government hospitals and 322 private hospitals , general practitioners and the ratio of only 1 : 4319 . Thailand aims at increasing doctors up to 1 : 2500. While the number of specialist physicians themselves only 34500.

Measures taken regarding the issue of Thailand is shaping policy universal health coverage ( UHC ) started in 2002 which has a principle of justice, equity, and has a better quality. Newborns can immediately be covered by the government. This program aims at the improvement of health services, especially in rural and remote areas. The second policy is taken form the center of medical education with the goal of increasing the quantity of health personnel through scholarship programs, public and private cooperation, the addition of specialists, to bring in experts from abroad. The third policy is the policy of accelerating the establishment of the ASEAN community study in 2015. Policy aims to solve the problem of shortage of doctors in Thailand to bring in doctors from abroa .

Dr . Prasobsri added challenges to be faced in the next era of the free market is the increasingly complex problems of disease and high mortality rates. So this policy as one of the solutions to anticipate this. Networking between the countries will work together to be an important key for the program to be on target and allows the doctor to move to the country.

Facts and policies of foreign doctors in Indonesia

Prof. Dr. Med Trihanggono Achmad, Association of Indonesian Medical Education School

Prof. Dr. Med Trihanggono Achmad, Association of Indonesian Medical Education School opportunity in the second session on this topic to explain the policy and the situation in Indonesia related to foreign policy in Indonesian doctor and situations regarding physician needs in Indonesia.

Prof. Dr. Med Trihanggono Achmad, Association of Indonesian Medical Education School start talks on Indonesian policy for foreign doctors are specified on the doctors who have a similar level of education equivalent undergraduate and graduate school education. In addition, doctors are divided over the classification of doctors and dentists where doctors from outside Indonesia and ASEAN countries.

Multi recognition arrangement ( MRA ) in Indonesia is not much different from what is in Thailand and Malaysia. If in Malaysia and Thailand have the MRA group distinguishes dentists and general practitioners, in Indonesia two into one group. In addition , Prof. . Dr . Med Trihanggono Achmad, Association of Indonesian Medical Education School noted the role and duties of the board in Indonesia through Legislation Number 29 of 2004.

Indonesia also has implemented a policy mode 4 , which emphasizes the need for setting back the domestic rules. This policy needs to be reviewed because of the problems idi Indonesia is not the amount of force the doctor. Doctors had a considerable proportion, but has not spread to the needs in the area .

Facts and policies of foreign doctors in Malaysia

S The last session on the topic of physician migration policy presented by Dato ' Seri Dr . Noor Hisham bin Abdullah as a representative of the board of health of Malaysia's policy . Hisham explained overview of the situation regarding the movement of doctors in Malaysia.

According to Hisham, the number of doctors in Malaysia is not a problem anymore, because countries such as Vietnam, the Philippines, Myanmar, Indonesia, and Egypt contribute to the availability of doctors in this country . Breakthrough owned by the Malaysian government in power sufficient for the doctor to send them to the citizens of certain countries before returning to Malaysia to serve.

Hisham in his views on physician migration policy in 2015 knew this explains the real needs to be met is perepatan of medical education itself. Countries that accelerate development of medical school, will be able to meet the minimal needs of the country are still going to doctors.

Reporter: Faisal Mansur

Topic D:
The Impact of Doctor Migration on Medical Doctors Education
and Residency (medical specialists) Training

13 May 2014

This session was given by representatives from Indonesia and Thailand. Health education in the future should be improved in order to support the ability of health professionals to face the challenges of an increasingly complex future. This was stated by dr . Ova Emilia , M.Med . Ed.Sp.OG ( K ) , PhD in the last session of the first day of the event Postgraduate Forum on May 13, 2014. Specified future not only of the exact path. According to dr . Ova , many ways you can do to improve the competence of health personnel, among others, not only related to education alone but also related to the real world. The first way is Practice based Learning and Improvement. These competencies to improve the ability to fix an error, use of technology in decision making, knowing the areas that must be improved to be more enhanced insight, skill, attitud, and maintenance processes.

The second point is a Systems Based Practice , the goal of competence is the ability to understand, access, and resource and support system for service. Understanding the advantages and disadvantages of a system and trying to find a way out in order to improve services. Using the evidence and common purpose in the prevention, diagnosis and action . Establish good cooperation with colleague health professionals to better serve patients facing complex systems.

Additionally dr . Ova Emilia , M.Med . Ed.Sp.OG ( K ), PhD states that there is a form of training in the future must be obtained by a doctor: to develop the ability to understand the needs of the patient's physician, the clarity of duties / work area general practitioners and specialists, Continue professional development (CPD) is a requirement importantly, the achievement of broader expectations for the training phase of postgraduate ( master general abilities such as leadership, communication, orientation on quality and patient; adapt themselves to work in teams ; quality training) . Application of a new form of training will bring pressure from within and outside the educational environment. Limited resources, must bring in new teachers, need a great effort to change the old express their views is the pressure of the educational environment. External pressures include enjoy unlimited time because they have to share the work time, changes in services, the demand of safety service that is currently booming, increased productivity and great complexity of an increase in knowledge.

Wanicha Cheungkongkeuw (Thailand)

Lack of health workers in Asia , especially Southeast Asia threatens to hamper the effectiveness of health care quality health announced by the government in each country . This was disclosed by Wanicha Chuenkongkaew . the Postgraduate Forum , WHO estimates that the ratio of physicians to population if less than 2.3 health workers per 1000 population effectiveness of health care will not be achieved. In comparison with developed countries like the U.S. which touched 12.3 Southeast Asia only touched 1.6 .

The cause of the lack of health workers due to several reasons, among others: the low level of acceptance and the high cost of education, less follows a curriculum, financing is not smooth, career uncertain, troubled institutions, the investment is not in place, and organizers are questionable accreditation. In response to this kind of thing then formed a forum of health education reforms in many countries, especially in Asia so that the education system in this area can be improved. Then in 2011 formed the Asia-Pacific Network on Health Professional Education Reform ( ANHER ) .

Wachita on this occasion expressed ANHER goal is to create and strengthen cooperation regarding the region 's health education professionals. Besides increasing the knowledge of health professionals in order to quickly respond to problems in the health system that is always changing and growing. Successful reform of health education to be relevant to the health system and in accordance with social needs in each country.

In order for the above purpose is achieved ANHER implement several attempts, among other things, the first to use a general rule in the survey analysis of the situation. Then, share experiences on effective innovation and improvement of training is getting better in every country. Finally, we should prioritize collaboration among the five countries, namely Bangladesh, China, India, Thailand, and Vietnam .

Reporter : Harumanto

Indonesia Health System Discussion Series

  Introduction

Indonesia health system is embarking on a very important phase with the implementation of the National Health Insurance System, the forthcoming agenda to revise the decentralization law and its impact to health sector, the increasing incidence of communicable and non-communicable diseases as well as automobile accidents and the growing population. On the other hand, government changes will take place in the upcoming presidential and legislative election, which would affect the long-term health planning at every level of the government.

As an effort to obtain inputs for future health policy development the Center for Health Policy and Management UGM holds a series of seminar as follow:

April 11th 2014, Jogjakarta : Decentralization Policy Reform
April 17th 2014, Jakarta : Health Financing Reform
April 23rd 2014, Jogjakarta : Hospital Organization Reform
April 29th 2014, Jakarta : Health Workforce Education Reform
May 7th and 12th 2014, Jakarta : How health system scenario would be in the context of health equity?

  The discussion series aim to:

1. Discuss health sector reform situation to feed into the development of the Indonesian Health System in Transition report
2. Obtain inputs for future policy analysis and projection

May 12th 2014, in Jakarta: What is the future scenario for Indonesian health system to achieve health equity?

Topics:

1. Will Indonesia achieve more efficient and equitable health system?
2. Socioeconomic inequity: will it be resolved?
3. Geographical inequity: will it be resolved?
4. Is Indonesia equipped to fund for JKN? Can Indonesia control unhealthy behavior? Can Indonesia control corruption and fraud in the health sector?

Presenter:

Prof. dr. Laksono Trisnantoro, MSc, PhD (PKMK Universitas Gadjah Mada)

Invitations:

1. APO Manila
2. WHO Indonesia
3. World Bank Indonesia
4. UNICEF Indonesia
5. DFAT – Indonesia

Venue:

Ubud Room 3rd Floor Gran Melia Hotel, Jl. HR. Rasuna Said Kav. X-0
Kuningan, Jakarta

Time:

May 12th 2014, 9 AM – 12 PM WIB

Pusat Kebijakan dan Manajemen Kesehatan
Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta

Menyelenggarakan

Diskusi Kebijakan Kesehatan

Skenario Sistem Kesehatan Indonesia Masa Depan
untuk Pencapaian Kesetaraan Kesehatan

Rabu, 7 Mei 2014
Gedung Granadi Kuningan Jakarta
Pukul 10.00 – 12.30

  PENGANTAR

Saat ini sistem kesehatan Indonesia memasuki masa penting dengan berjalannya Sistem Jaminan Kesehatan Nasional (JKN), adanya rencana perubahan UU desentralisasi dan dampaknya untuk sektor kesehatan, meningkatnya beban penyakit menular, tidak menular, dan kecelakaan serta jumlah penduduk yang semakin banyak. Disamping itu dengan akan bergantinya pemerintahan sebagai hasil pemilihan umum, berbagai rencana jangka menengah di bidang kesehatan di berbagai level pemerintah akan diperbaharui.

Dalam berbagai studi terlihat bahwa di Indonesia ada kesenjangan luar biasa dalam penyebaran tenaga dokter dan fasilitas kesehatan. Hal ini dapat mengancam tercapainya tujuan Universal Health Coverage. Sementara itu Road Map pencapaian Universal Coverage mempunyai berbagai asumsi yang terlihat sulit didapatkan. Oleh karena itu disamping Road Map, ada beberapa skenario yang dapat terjadi di masa depan. Ada skenario optimis seperti yang ada di Road Map, dan ada skenario pesimis.

 TUJUAN DISKUSI

1. Membahas skenario sistem kesehatan di Indonesia untuk mencapai universal coverage.
2. Memprediksi kemampuan fiskal Indonesia dalam pembiayaan kesehatan.

  JADWAL KEGIATAN

Rabu, 7 Mei 2014

  PESERTA

Peserta yang diharapkan menghadiri seminar ini adalah perwakilan dari Kemenkes, Ditjen Dikti, AIPKI, IDI, ARSADA, ADINKES, PERSI, BPJS, Fakultas Kedokteran, Dinas Kesehatan, dan setiap pihak yang berkecimpung dalam pembuatan kebijakan kesehatan. Seminar ini bersifat bebas biaya dan limited seat sehingga sangat diharapkan untuk mendaftar terlebih dahulu kepada pengelola. Kami juga tidak menanggung transport dan akomadasi para peserta.

  PENDAFTARAN DAN INFORMASI

Pusat Kebijakan dan Manajemen Kesehatan Fakultas Kedokteran UGM
Sdri. Intan Farida Yasmin/ Hendriana Anggi
Gdg. IKM Sayap UtaraLt. 2, Jl. Farmako Sekip Utara Yogyakarta 55281
Telp.: +62274 – 549425
Mobile: (Intan Farida Yasmin: +628129017065),
(Hendriana Anggi: +6281227938882)
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.; This email address is being protected from spambots. You need JavaScript enabled to view it.
Web: www.kebijakankesehatanindonesia.net