Received date: January 15, 2018; Accepted date: January 22, 2018; Published date: January 29, 2018
Citation: Salesman F, Jap J (2018) Analysis of professional health provider need in east Nusa Tenggara until 2019. Health Syst Policy Res Vol. 5 No.1:68
Copyright: © 2018 Salesman F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: The number of health professionals in increasing the extent and quality of health services in East Nusa Tenggara have not met the standard ratio between health professionals and population accordingly with the standard of Health Ministry.
Purpose: Analyze plan of health personnel needed in East Nusa Tenggara until 2019 according to standard used by Health Ministry.
Methods: Using descriptive quantitative method with secondary data analysis constructed time-series by Statistic Center Body publication and Health profile of East Nusa Tenggara Province. Variables; (1) Information about health personnel now; (2) Plan for health personnel needed in East Nusa Tenggara until 2019. Analysis technique: (1) counting extrapolation until 2019, formula Pn=Po(1+r)n; year 2016 growth rate (r) 1.71% per year. (2) Analyze plan for health personnel need using guidelines from Health Ministry.
Result: There is need of professional health personnel in 13 kinds of health personnel accordingly with constitution No. 39 year 2014 about health personnel.
Conclusion: The need of health personnel are in quantity, quality, and professionalism in giving health services for people in East Nusa Tenggara. Health educational institutions should have comparative and competitive competence in serving people.
Health clinics; Quantity of health personnel; Quality of health providers
The shortage of health personnel number in increasing the extent and quality of health services in East Nusa Tenggara has not yet become the priority concern of the health stakeholders in East Nusa Tenggara (ENT). According to ENT Statistic Center Body (SCB) report, number of ENT population in 2016 is 5,120,061 with growth rate 1.71% per year. The ideal should be the number of health personnel goes hand in hand with the number of population each year. The same report shows the number of health facility in ENT up to 2016; Hospital 45 units, Maternity Hospital 2 units, Community Health Clinic 385 units, Village Maternity House 710 units, and Alert village 1599 units. Number of health personnel consists of: 108 Specialists, 610 Doctors, 19 Specialist dentists, 138 Dentists, 4733 Midwives, 6794 Nurses, 347 Dental nurses, 162 Pharmacists, 1049 Pharmacies, 608 Community health personnel, 677 Environment health personnel, 635 Nutritionists, 1136 Physiotherapist, 16 Radiograviers, 7 Radiotherapists, 7 Electromedic technicians, 22 Nutrition technicians, 243 Medical laboratory technicians, 1 Refractive optician, 52 Prosthetic orthotics, 40 Medical record, 6 Blood transfusion personnel, and none Cardio vascular .
All of them having different status: as National Civil Officers, Government contract officers, monthly and daily waged officers. Number and quality of health personnel that do not grow accordingly with number of population of East Nusa Tenggara resulted in the large amount of sick people who do not get appropriate medical services. Epidemiology patron in 2015 showed the number of most sickness suffered are: Upper Respiratory Tract Infection 55.05%, Muscular system 10.83%, Myalgia 6.95%, Skin allergic 5.33%, Rheumatoid arthritis 4.98%, Skin Infection 4.67%, Diarrhea 3.58%, other Upper Respiratory Tract Infection 3.46%, fever for unknown cause 2.98%, and other infection sickness 2.18% .
In the case of delivery aid given, out of 132,856 deliveries, 87,783 deliveries (68%) are helped out by health personnel, and 45,073 deliveries (32%) helped out by traditional midwife. Baby Mortality Rate in 2013 was 13.50/1000 Living Birth (LB), in 2014: 14/1000 LB, and in 2015 was 11/1000 LB. Whereas Mother Mortality Rate in 2013: 185.60/100,000 LB, in 2014: 169/100,000 LB, and in 2015: 178/100,000 LB . The cause tendency of mortality now and the possibilities of future occurrence show that there will be increasing in mortality rate in the future caused by non-infection sickness and unhealthy life style (innutritious food, less physical activity, stress, alcoholic, smoking, etc.). The result of low community health standard is shown by Life Expectancy (LE) and Human Development Index (HDI). In 2016, with the average LE is 68.05 (compare to national standard: 70.18), and HDI: 61.13 (National: 70.18) East Nusa Tenggara province was on 32nd rank of 34 provinces in Indonesia .
The aim of this research is to analyze the plan for health personnel need according to Health Human Resource Plan Composing Guidelines in East Nusa Tenggara Province until 2019.
This research is using descriptive quantitative method with Secondary Data Analysis (SDA) . SDA is a method in research using secondary data as its main data source, those are data constructed time series and published officially by Statistic Center Body and Health Profile of East Nusa Tenggara Province. Those data are then reanalyzed in order to make clear the problems and aims of the research. Research variables are information about health personnel now and the need of health personnel until 2019. Analysis technique: (1) counting number of population in 2017 until 2019 using population data from 2016. Extrapolation analysis of population in 2017 to 2019 by using the population projection formula year-n: Pn=Po (1+r)n with population growth rate (r) 1.71% per year . To analyze the need of health personnel, using technical guideline published by Ministry of Health about Health Human Resource Plan Composing Guidelines in the scope of Province, District, and Hospital .
Health personnel and the need of it in 2019 in the East Nusa Tenggara Province
The order about health personnel is constituted in Constitution Number 39 in 2014 about Health Personnel that explains health personnel is all persons subjugate in Health Department and having appropriate knowledge and skills through education in health institution which for particular types need privileges in doing health efforts . In chapter 11 verse (1) the Constitution breaks down the health personnel into: (1) medical personnel; (2) Clinic Psychology personnel; (3) Nursery personnel; (4) Midwifery personnel; (5) Pharmacy personnel; (6) Community Health personnel; (7) Environment Health personnel; (8) Nutrition personnel; (9) Physical Therapy personnel; (10) Medical Technician personnel; (11) Biomedical Technique personnel; (12) Traditional Health personnel; (13) Other Health personnel. There is health personnel included in medical personnel: doctors, dentist, specialist, and specialist dentist. Health personnel included in Clinical Psychology personnel are the clinical psychologists. Health personnel included in nursery personnel are all kinds of nurses (nurse, dental nurse, etc.). Health personnel included in midwifery is midwives. Health personnel included in pharmacy personnel are pharmacies and pharmacists. Health personnel included in community health personnel are health epidemiologist, health promotion, health behaviorist, work health, health administration and policies, health bio statistical and population, and reproduction and family health. All health personnel are assisted by health personnel assistant. According to the Regulation of Minister of Health Number 80 in 2016, health personnel assisted by health personnel assistant which consist of: (1) Nurse assistant; (2) Pharmacy assistant; (3) Dental assistant; (4) Medical laboratory technician assistant; and (5) Blood transfusion technician assistant .
Refer to Minister of Health Regulation number 33 in 2015 about health personnel ratio with population and using basic data of East Nusa Tenggara population in 2016 with Population Growth Rate (PGR) 1.71%, therefore the projection of East Nusa Tenggara population until 2019 is 5,387,240 persons. According to the population projection above, the need of specialist: 563 (short of 455), doctor: 2,304 (short of 1,694), dentist: 665 (short of 527), midwife: 6,144 (short of 1,411), nurse: 9,216 (short of 2,422), dental nurse: 922 (short of 575), pharmacist: 614 (short of 452), community health: 820 (short of: 211), nutritionist: 716 (short of 81), sanitarian: 922 (short of: 245), physical therapy: 256 (short of 249), electro medical: 819 (short of 812). The need of quantity of medical personnel experienced by people of East Nusa Tenggara in this year and the years to come should become the concern of the health stakeholders without neglecting the quality and competence of the health personnel so that quality health service could become reality in the future .
Health personnel professionalism
The parameter of a health professionalism measured by the competence he/she has. As for a health personnel, his/her main competence shown through the ability of applying. Generally, the character of a professional health personnel are: (1) Ideal in act and appearance according to the regulations of the profession; (2) Keeping the good name of the profession according to the norms and values of the profession organization; (3) Always try to enhance the knowledge and skill in order to increase his/her competence in dealing with the change of epidemiologic map caused by either weather or people life style; (4) Follow the ethical code according to the profession standard in serving the patients and their families; (5) Work according to the procedure operational standard of service established by knowledge and technology of health service; and (6) Showing the hospitality, sympathy, and fast response upon the complain of patients and their families [10,11]. In doing health service, a health personnel or health personnel assistant should give total service without any interest in tribes, religions, casts, and backgrounds. That is why, health personnel during his/her duty always wearing white uniform as a symbol of “serving with a clean heart” as white as the uniform worn .
Medical service given by a health provider should show with it the characteristic of satisfy and professional service. Satisfy service is a new need health service taken from patients and their family’s point of view while receiving medical service in this millennial era. A patient and his/her family, when meet the doctor and other health personnel asking for health assistant, psychologically are in deficiency of heart disposition, between get cured, defect, or dead. This deficiency of heart needs to be filled with a hospital, sympathy, empathy, fast-response, and non-time cost health service. This is the package of service that sometimes ignored by the health personnel in the past. Satisfy service as an attribution service in contemporary health service has an equal and complementary status with main service (medical service) . The main principle of a professional service is responsiveness. An act with empathy has shown by health provider during his/her service to the patients meaning that the provider enters into the psychological empty space of the patients or the families. Treat the patients and their families as customers not merely as consumers who will disappear after getting the things or service needed. Customers of health are the main focus of health service.
East Nusa Tenggara Province from now until 2019 still short of health personnel to reach the ideal ratio standard stated by Ministry of Health. The need of health personnel not only in quantity number but also in quality, commitment, and professionalism in giving health service to the people of East Nusa Tenggara. The role of health education institution is in fulfilling the expectation of giving the good quality graduate so that they can become care provider, community leader, educator, researcher, and manager with six parameters of professionalism: science, knowledge, know-how, skill, affection, and competency. This set of competencies is a guarantee of competitive and comparative independency while they offer their abilities in serving people of East Nusa Tenggara.
Appreciation and gratitude given to Health Minister of Indonesia, High School of Public Health Citra Husada Mandiri Kupang East Nusa Tenggara, Head of Statistic Center Body of East Nusa Tenggara Province, Head of Health Department in East Nusa Tenggara who without holding back provided the data and information used by the writer in completing this research. May God bless all your kindness. Thank you.