National Reporting Instrument 2018

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Background

Hide [iBG] Adopted in 2010 at the 63rd World Health Assembly (WHA Res 63.16), the WHO Global Code of Practice on the International Recruitment of Health Personnel (“the Code”) seeks to strengthen the understanding and ethical management of international health personnel recruitment through improved data, information, and international cooperation.

Article 7 of the Code encourages WHO Member States to exchange information on the international recruitment and migration of health personnel. The WHO Director General is additionally mandated to report to the World Health Assembly every 3 years. WHO Member States completed the 2nd Round of National Reporting on Code implementation in March 2016. The WHO Director General reported progress on implementation to the 69th World Health Assembly in May 2016 (A 69/37 and A 69/37 Add.1). During the 2nd Round of National Reporting, seventy-four countries submitted complete national reports: an increase in over 30% from the first round, with improvement in the quality and the geographic diversity of reporting.

The National Reporting Instrument (NRI) is a country-based, self-assessment tool for information exchange and Code monitoring. The NRI enables WHO to collect and share current evidence and information on the international recruitment and migration of health personnel. The NRI (2018) has been considerably shortened, while retaining key elements. It now comprises 18 questions. The common use of the instrument will promote improved comparability of data and regularity of information flows. The findings from the 3rd Round of National Reporting are to be presented at the 72nd World Health Assembly, in May 2019.

The deadline for submitting reports is 15 August 2018.

Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: http://www.who.int/hrh/migration/code/code_nri/en/. Please complete the NRI and submit it, electronically or in hard copy, to the following address:

Health Workforce Department
Universal Health Coverage and Health Systems
World Health Organization
20 Avenue Appia, 1211 Geneva 27
Switzerland
hrhinfo@who.int

The data and information collected through the National Reporting Instrument will be made publicly available via the WHO web-site following the proceedings of the 72nd World Health Assembly. The quantitative data collected will be updated on and available through the National Health Workforce Accounts online platform (http://www.who.int/hrh/statistics/nhwa/en/).
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Disclaimer

Hide [disclaim]
 For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
I have read and understood the WHO policy on the use and sharing of data collected by WHO in Member States outside the context of public health emergencies
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Designated National Authority Contact Details

Hide [q01a] Name of Member State:
Indonesia
Hide [q01b] Contact information:
Full name of institution:
MINISTRY OF HEALTH
Name of designated national authority:
dr. Maxi Rein Rondonuwu, DHSM, MARS
Title of designated national authority:
HEAD OF CENTRE FOR LANIG AD MANAGEMENT OF HRH
Telephone number:
08124447874
Email:
dr.maxirondonuwu@gmail.com , tkkibidang3@gmail.com
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Implementation of the Code

Hide [q1] 1. Has your country taken steps to implement the Code?
Yes
Hide [q2] 2. To describe the steps taken to implement the Code, please tick all items that may apply from the list below
2.a Actions have been taken to communicate and share information across sectors on the international recruitment and migration of health personnel, as well as to publicize the Code, among relevant ministries, departments and agencies, nationally and/or sub-nationally.
MOH has implemented and adopted the code into thge policy in Indonesia. The code has also been translated to Idnonesian in order to be understood easiliy by the stakeholder. The translated code was also being printed in a book and distribute to the stakeholder related with the international migration of health worker. MOH has also conducted socialization of the code and also data gathering to all related stakeholder, like Monistry of Manpower, Ministry of Trade, Nationanal Board for Palcement and Protection of the Overseas Indonesian worker (NBPPIOW), Indonesian Medical Council (IMC), Directorate of Referal Health Services, and the private agency for Indonesian Overseas Placement. It was expected that all of stakeholder would be able to adopt the principle of the code. The socialization and data gathering has been started from 2012 periodeically at national level. The detail of the activities will be described in the following : 2012: 1. Translated the code into indonesian 2. Public hearing 3. socialization at the national level (MOH). 2013: 1. socialization to the related stakeholder (Central Government) 2. adopted the code into the national regulation 3. Inserted the code in the initiation of G to G agreement with Japan 2014: 1. socialization to the related stakeholder, including provincial level 2. promoting the benefit of the code in the cooperation arrangement with ASEAN members 3. participate actively in the regional forum and send the first report to SEARO 2015: 1. Completing national reporting instrumen (NRI) WHO 2. Compiling Country Report 3. Actively participated in the executive board meeting at the central office . 2016: 1. socialization to the related stakeholder (central government) 2. data gathering related to national reporting instrumen (NRI) WHO 2017: 1. data collection related ti the implementation of the code 2. drafting Country Report 2018: 1. completing national reporting instrumen (NRI) WHO 2. compiling Country Report
2.b Measures have been taken or are being considered to introduce changes to laws or policies consistent with the recommendations of the Code.
Indonesia has adopted the principle of the code into some regulation: MOH regulation no 37 /2015 about Utilization of migrant health workforce and MOH regulation no 67/2013 about foreign helath worker utilization
2.c Records are maintained on all recruiters authorized by competent authorities to operate within their jurisdiction.
a. Government Placement For government palcement, the recruitment was managed by NBPPIOW. The information was distributed by socialization and coordnation by MOH and NBPPIOW and BP3TKI b. Private placement For private placement, conducted based on demand from user
2.d Good practices, as called for by the Code, are encouraged and promoted among recruitment agencies.
the ethic code has been adopted in the national regulation of MOH, as attached in MOH Regulation 37/2015 and 67/2013. Some of the principle were stated below: 1. Recruitment Ethic Recruitment of health workforce was conducted by considering the balance between: a. The need and demand of helath workforce in Indinesia b. The opportunity in the international level Foreign Health Workforce (FHW) did not allowed to give services directly to the patient, except for certain type of health workforce which is rare or limited number 2. Health workforce development The purpose of health worker utilization a) utilizing Indonesian health personnel optimally and humanely to carry out health efforts in the context of transfer of knowledge and technology b) b) Increase the professionalism and competitiveness of Indonesian workers at the international level c) Expanding employment opportunity, increasing knowledge, skills and work experience of health workers While in FHW utilization will be conducted through some activites as follow: a) Health services b) Education and training of health c) Social services in the health field d) Health research 3. Fair treatment of migrant health workforce The placement of Indonesian migrant health workforce was conducted to some mechanism: a) Government b) Private agency c) Company (interest of the company) d) Personal For placement by government mecchanism, will be held by National Board for pLacement and Protection of Indonesian Overseas Worker (NBPPIOW) in coordination with the Minsitry of Health. For private mechanism, it was handled by private agency in coordination with district manpower office and district health office after getting the demand from user country. Private agency should ensure the protection of Indonesian meigrat health workforce before, during and post placement. They should aslo ensure that health workforce will get a chance to increase their competencies through education and training based on the destination country. 4. Bilateral Cooperation For the utilization of Indonesian migrant health workforce should be conducted with the country fulfilled requirements below: a. Having written agreement with Indonesian government b. Having regulation or national act protected foreign worker While for FHW utilization will be conducted as long as having bilateral relationship with Indonesia
2.e Measures have been taken to consult stakeholders in decision-making processes and/or involve them in activities related to the international recruitment of health personnel.
2.f Other steps:
Hide [q3] 3. Is there specific support you require to strengthen implementation of the Code?
3.a Support to strengthen data and information
3.b Support for policy dialogue and development
3.c Support for the development of bilateral agreements
3.d Other areas of support:
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Data on International Health Personnel Recruitment & Migration

Hide [iq4] Improving the availability and international comparability of data is essential to understanding and addressing the global dynamic of health worker migration.
Hide [q4] 4. Does your country have any mechanism(s) or entity(ies) to maintain statistical records of foreign-born and foreign-trained health personnel?
Yes
Hide [q4x1] Please describe:
For medical doctors and dentist, the records was managed by Indonesian Medical Council, while for other health workforce, the records was managed by MOH
Hide [iQ5] For the latest year available, consistent with the National Health Workforce Accounts (NHWA) Indicators 1-07 and 1-08, please provide information on the total stock of health personnel in your country (preferably the active workforce), disaggregated by the country of training (foreign-trained) and the country of birth (foreign-born). Please consult with your NHWA focal point, if available, to ensure that data reported below is consistent with NHWA reporting.
Hide [q5x1] 5. Data on the stock of health personnel, disaggregated by country of training and birth

5.1 Consolidated stock of health personnel
Total Domestically Trained Foreign Trained Unknown Place of Training National Born Foreign Born Source* Additional Comments#
Medical Doctors 96899 0 59 96840 96851 48 MOH, Indonesian Medical Council, none
Nurses 347521 0 0 347521 347521 0 MOH none
Midwives 205087 0 0 205087 205087 0 MOH none
Dentists 12547 0 9 12538 12547 0 MOH, Indonesian Medical Council none
Pharmacists 48789 0 0 48789 48789 0 MOH none
Hide [iq5x2] 5.2 Country of training for foreign-trained health personnel

Please provide detailed data on foreign-trained health personnel by their country of training, as consistent with NHWA Indicator 1-08. This information can be provided by one of the following two options:
Hide [q5x2x1] Option A: Completion of the template in Excel
Download and Upload
Please upload file
Hide [q5x2x2] Option B: Uploading any format of documentation providing such information (e.g. pdf, excel, word).
Please upload file
Hide [Q5fn] *e.g. professional register, census data, national survey, other
#e.g. active stock, cumulative stock, public employees only etc.
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Partnerships, Technical Collaboration and Financial Support 1/2

Hide [q6] 6. Has your country provided technical or financial assistance to one or more WHO Member States, particularly developing countries, or other stakeholders to support the implementation of the Code?
6.a Specific support for implementation of the Code
6.b Support for health system strengthening
Provide technical assistance to Republic Democratic Timor Leste in the health services, including referral system, hospital system, pharmacy and health equipment, HRH (Training for midwives), infectious disease and preparation for pandemic, Mother and new born health, Research and development of health
6.c Support for health personnel development
In order to support the development of health personnel in Timor Leste, Indonesia send some trainers to provide the training for health personnel in RDTL
6.d Other areas of support:
Hide [q7] 7. Has your country received technical or financial assistance from one or more WHO Member States, the WHO secretariat, or other stakeholders to support the implementation of the Code?
7.a Specific support for implementation of the Code
In EPA scheme, Japan provides Japanese Language training for indonesian health workforce before they work in Japan
7.b Support for health system strengthening
To support health system strengthening in Indonesia, there are some countries provide the assistance to Indonesia government, such as: 1. Global Fund : the project aimed to strengthen health system especially in 2 main field, Health information system and medical management and medical supplies 2. AUSAID (2011-2016): the AIPHSS program contributes to strengthened health financing, human resources for health and policy decision at national, provincial, and district level. 3. USAID : The USAID program focusses on controlling tropical and infectoius diseases including Tuberculosis, HIV/AIDS, Lymphatic Vilariasis and to improve emergency care for mothers and new borns in Indonesia
7.c Support for health personnel development
To increase the competency of nurse Japan provides technical assistance to Indonesia in project called Project enhancement of nursing competency through in service training
7.d Other areas of support:
In order to support the returnee, Indonesiathrough MOH has conducted a program for making policy about returnee of health workforce after they come back to Inodnesia.
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Partnerships, Technical Collaboration and Financial Support 2/2

Hide [q8] 8. Has your country or its sub-national governments entered into bilateral, multilateral, or regional agreements and/or arrangements to promote international cooperation and coordination in relation to the international recruitment and migration of health personnel?
Yes
Hide [q8x1] 8.1 Please provide the text and/or web-links to the agreements or arrangements
Please upload file

No comment
Hide [q8x1wl] Web-links:
Hide [q8x2] 8.2 If documentation is unavailable, please use Table A on next screen to describe the bilateral, regional or multilateral agreements or arrangements:

Table A Description of bilateral, multilateral, regional agreements or arrangements
1.
2.
3.
4.
5.
Hide [q8x2fx1] Title of Agreement
Indonesian Japan Economic Partnership Agreement
Hide [q8x2ax1] Type of Agreement
Bilateral
Hide [q8x2bx1] Countries Involved
Japan
Hide [q8x2cx1] Coverage
National
Hide [q8x2dx1] Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
Hide [q8x2ex1] Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
Hide [q8x2gx1] Validity period
2008-now
Hide [q8x2fx2] Title of Agreement
MOU between MOH Republic of Indonesia and MOH Republic Democratic of Timor Leste on health cooperation
Hide [q8x2ax2] Type of Agreement
Bilateral
Hide [q8x2bx2] Countries Involved
Timor Leste
Hide [q8x2cx2] Coverage
National
Hide [q8x2dx2] Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Referral system
Other mechanism (include details if possible)
Hide [q8x2ex2] Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
Hide [q8x2gx2] Validity period
2010-2013
Hide [q8x2fx3] Title of Agreement

Hide [q8x2ax3] Type of Agreement
Hide [q8x2bx3] Countries Involved

Hide [q8x2cx3] Coverage
Hide [q8x2dx3] Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
Hide [q8x2ex3] Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
Hide [q8x2gx3] Validity period

Hide [q8x2fx4] Title of Agreement

Hide [q8x2ax4] Type of Agreement
Hide [q8x2bx4] Countries Involved

Hide [q8x2cx4] Coverage
Hide [q8x2dx4] Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
Hide [q8x2ex4] Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
Hide [q8x2gx4] Validity period

Hide [q8x2fx5] Title of Agreement

Hide [q8x2ax5] Type of Agreement
Hide [q8x2bx5] Countries Involved

Hide [q8x2cx5] Coverage
Hide [q8x2dx5] Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
Hide [q8x2ex5] Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
Hide [q8x2gx5] Validity period

Hide [q8x3] 8.3 Are recommendations of the WHO Global Code reflected in the agreements (e.g. taking into account the needs of developing countries)?
Yes
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Health Workforce Development and Health System Sustainability

Hide [q9] 9. Does your country strive to meet its health personnel needs with its domestically trained health personnel, including through measures to educate, retain and sustain a health workforce that is appropriate for the specific conditions of your country, including areas of greatest need?
Yes
Hide [q9x1]
9.1 Measures taken to educate the health workforce
MOH has increased and developed of health personnel In order to fulfill the need of health workforce in health care services, health management, education and trainingm research and development and community empowerment in the health field. The increasing and developing of health workforce refers to national education system through: 1) Developing standard of education of health workforce to fulfill the expected standard of competency and competitiveness both nationally and internationally. The expected outcame were the qualified, competitive amnd professional health workforce, who always updating knowlededge and technology, implementing high value and ethics. 2) Increasing the number of certain kind of health personnel institution based on the demand, acrreditation of the institution of health personnel, certification of instructor, including improvement of teaching and learning facilities.
9.2 Measures taken to retain the health workforce
In order to retain health workforce, MOH has developed some efforts as follwo: a. Improving Health Workforce Planing and also workload of health institution HRH planning was developed by considering the need of prioirty health workforce, as well as in primary health care effort, secondary and also tertiary. The planning has been developed to describe the recent condition of HRH in term of type, quantity, quality, and distribution in the specific place. It was also identify and analysis the current and future need of HRH as the basic for HRH development for education/training b. Improving and developing health workforce education The effort to produce health workforce was done by education and training based on standard of education nad training of HRH refres to standard of services and competency of HRH and supported by ethical code of the HRH. The government is responsible for regulating the establishment of education institution and the opening of a new study program for needed health workforce in health development. The purpose os to produce the qualified and competitive health workforce by consodering the ba;ance between demand and market both in domestic and international, and the production capacity of the existing healh workforce. c. Utilization of Health workforce To manage the distribution of HRH for public service, MOH has issued some regulations to give incentives for health personnel assigned in undesirable area, like emote areas, underdeveloped areas, border areas, outermost and frontier islands, and disaster and vulnerable areas While the utilization of Indonesian migrant health workforce was regulated by the government to ensure the balance between production and demand of health workforce. Beside the governmentshould protect the right of Indonesian migrant health workfrce working abroad. Foreign health workforce utilization was established through some requirements rstated in the regulation and the purpose is to transfer of knowledege and technology and was d. Gudance and supervision of health workforce Guidance and supervision of practical profession of health workforce was conducted through competency test, certification, registration, and license for qualified health workforce
9.3 Measures taken to ensure the sustainability* of the health workforce
Some efforts to keep the sustainability of health workforce: a. Health workforce need planning To develope HRH planning should consider some aspects, like the provision of the existing data, standard, lack/surplus/unavailability, provision of formation and recruitment and fulfilliment of HRH needs. HRH planning was conducted by evidence based mechanism through increasing the HRH informastion system. Involvement all stakeholders beyond health sector is very important in order to make a good planning of health workforce needs. b. Improvement and development of health workforce education Improvement and development of education for health workforce refers to the national education system and is enhanced through: 1) Development of education standards for health workers to meet the expected competency standards and competitiveness both nationally and internationally and produce quality, highly competitive health professionals and professionals, namely health workers who follow the development of science and technology, apply moral and ethical values high profession 2) Adding the number of educational institutions for certain health workers according to their needs, accreditation of educational institutions for health workers, as well as teaching staff certification, including improvement of teaching and learning facilities and facilities. 3) Improving the training of health personnel through accreditation of health personnel training institutions, as well as certification of trainers through the development of training standards for health workers to meet the competency standards expected by health services for all Indonesian. c. Utilization of health workforce MOH has manage the HRH utilization in order to fulfill the need of health development from local to central level across sector, including private sector, and also to fulfill the markert demand in the globalization era. To fulfill the health workforce in the underserved, remote, border area and outer island and are with health probelm, MOH has initiate some programs like Nusantara sehat, special assignment, internship, residen and Mandatory Employment for Specialist Doctor. Indonesia has a program for placement nurse in Japan thoruh Government Mechanism under Economic Partnership Agreement (EPA). The program is for nurse who have temporary surplus in Indonesia The development of health personnel including career imporvement, was conducted by motivating health personel to support self imporvement, and giving access of education and training, like Specialist Medical Education / Specialist Dentist Education (PDS / PGDS) assistance program, and fellowship for Bachelor, Master and Doctoral Degree d. Guidance and supervision the quality of health workforce Guidance and supervision has done to increase the quality of health personel based on expected competency to support health services in health care facilities The guidance and supervision was conducted by incerasing commitment and coordination between stakeholders related with health workforce development. The guidance and supervisioan was also condicted by stretngthening legislation including certification thorugh competency tes, registration, license and the right of health personnel (welfare and broader opportunity to improving their career path
9.4 Measures taken to address the geographical mal-distribution of health workers
To overcome the mal distribution of HRH, MOH has initiate some programs like Nusantara sehat, special assignment, internship, residen and Mandatory Employment for Specialist Doctor
Hide [q10] 10. Are there specific policies and/or laws, across governmental ministries, for internationally recruited and/or foreign-trained health personnel in your country?
Yes
Hide [q10x1] 10.1 Please provide further information in the box below:
1. National act 36/2014 about health 2. MOH Regulation no 67/2013 about foreign health workforce utilization 3. MOH Regulation np 37/2015 about Utilization of migrant health workforce 4. Medical Council regulation no 17/2013 about temporary and conditional registration for foreign GP and dentist 5. Medical Council regulation no 33/2015 about certificate of good standing
Hide [q11] 11. Recognizing the role of other parts of government, does the Ministry of Health have processes (e.g. policies, mechanisms, unit) to monitor and coordinate across sectors on issues related to the international recruitment and migration of health personnel?
Yes
Hide [q11x1] 11.1 Please provide further information in the box below:
To manage the foreign management of health workforce, MOH has issued a ministrer regulation, MOH regulation no 67/2013 about the foreign utilization of health workforce. The mechanism will be described in the folloeing steps: 1. MOH (coordination team of FHW license) accept the application of foreign health workforce from user 2. The next setp, the team will verify the document of application (the team consist of some units of MOH and related stakeholders) 3. Held a meeting to discuss the application of TKWNA 4. The result of the meeting will be two possibility : the approval or rejection of the recomendation application 5. The recomendation, both approval or rejection will be issued no more than 45 working day from the receipt of complete application documents 6. The recomendation will be sent to Minsitry of Manpower for the RPTKA issuance 7. After getting RPTKA, the user should come to immigration office for approval of VISA and KITAS 8. The issueance ofTemporary, conditional, special registration certificate. To get the registration certificate, the forign health workforcseshould pass the competency evaluation helad by KKI/MTKI/KFN 9. The certificate of Registration is needed to get certificate of Parctical Licenes (SIP)
Hide [q12] 12. Has your country established a database or compilation of laws and regulations related to international health personnel recruitment and migration and, as appropriate, information related to their implementation?
Yes
Hide [q12x1] 12.1 Please provide further information in the box below:
www.hukor.depkes.go.id www.bnp2tki.go.id www.kemnaker.go.id www.imigrasi.go.id
Hide [q9x3fn] *Health workforce sustainability reflects a dynamic national health labour market where health workforce supply best meets current demands and health needs, and where future health needs are anticipated, adaptively met and viably resourced without threatening the performance of health systems in other countries (ref: Working for Health and Growth, Report of the High-Level Commission on Health Employment and Economic Growth, WHO, 2016, available from http://apps.who.int/iris/bitstream/10665/250047/1/9789241511308-eng.pdf?ua=1 ).
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Responsibilities, Rights and Recruitment Practices

Hide [q13] 13. Which legal safeguards and/or other mechanisms are in place to ensure that migrant health personnel enjoy the same legal rights and responsibilities as the domestically trained health workforce? Please tick all options that apply from the list below:
13.a Migrant health personnel are recruited internationally using mechanisms that allow them to assess the benefits and risk associated with employment positions and to make timely and informed decisions regarding them
the recruitmen of Foreign Health Wrokforce was held with the country having bilateral cooperation with Indonesia
13.b Migrant health personnel are hired, promoted and remunerated based on objective criteria such as levels of qualification, years of experience and degrees of professional responsibility on the same basis as the domestically trained health workforce
All foreign health workforces who will work in Indonesia should obey the regulation establishhed. The foreign health workforce (FHW) should be accomanied by a health workforce as a partner, temporary stay and to transfer knowledge and technology to Indonesia. Beside there is also Ministry of Manpower Regulation issued to manage FHW. The regulation stated that the user of foreign health workforce should regitser the FHW to the national health insurance and company insurance. The user should also facilitate the FHW to get Indonesian Language Training. In addition the FHW should give transfer knowledge to the health workforce accompanied during their duty. In detail the rights and obligations of FHW are further regulated in a work agreement between the user and FHW.
13.c Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression
Indonesia and ASEAN member country has signed a joint consensus about the protection for migrant worker in all ASEAN country. Protection refers to the pirnciple of Human rights, and given not only for migrant worker but also their families. The consensus was in line with UN convention on the Protection and Promotion of the Rights of All Migrant Workers and Members of Their Families
13.d Other mechanisms, please provide details below if possible:
Hide [q14] 14. Please submit any other comments or information you wish to provide regarding legal, administrative and other measures that have been taken or are planned in your country to ensure fair recruitment and employment practices of foreign-trained and/or immigrant health personnel.
Each country has different regulation related FHW utilization. Indonesia has made several effort to fairly utilize FHW, and give them the same tratment as domestic health workforce. The efforts were stated below: a. President Regulation no 20/2018 about foreign health workforce utilization. The regulation is made to simplify the FHW registration prosedure in Indonesia b. The procedure of registration should complete the requirement of health filed as follow: • Having temporary registration certificate issued by the indonesian authorities • Having working expereince in the same field with the applied position, at least 5 consecutive years in the hospital or clinic or the related • Having letter of good standing issued by the authority of the country origin and Professional Regulatory Authority of the country origin • Verified education certificate • Fluent in Indonesia language before come to Indonesia as stated in the National act • The country should have Bilateral agreement in health, regional agreement or multilateral agreement with mutual benefit of both parties • Working only in clas A and B hospital, or main clinic, proven with the operational license of the hospital. • FHW will work as the management consultant only, and is not allowed to give direct services to the patient. • At least Magister graduation (S2) of managerial based on the position applied. Based on the princip of FHW utilization, FHW could only deliver the services to the patient for the purpose of transfer knowledge, held in hospital class A and B, and for certain type of health workforce which is rare or limited number
Hide [q15] 15. Please submit any comments or information on policies and practices to support the integration of foreign-trained or immigrant health personnel, as well as difficulties encountered.
In Indonesia, Foreign Health Workforce (FHW) should come with sponsor or by user. They should be accompanied by a health workforce with the same filed to get transfer knowledge. FHW did not allowed to give services to the patient, except for certain type of health workforce which is rare or limited number. In this case FHW will be able to deliver the service after passing competency test/competency evaluation by professional organization for the issuance of Temporary/conditional/certain registration scertificate. The difficulties are: 1. There is a lot of FHW working illegally without recomendation from MOH that cause the missing informastion about the competency of the FHW 2. Lack of staff from MOH concerning in the FHW guidance and supervision1.
Hide [q16] 16. Regarding domestically trained/ emigrant health personnel working outside your country, please submit any comments or information on measures that have been taken or are planned in your country to ensure their fair recruitment and employment practices, as well as difficulties encountered
In ensuring fair recruitment and employment practices that have been implemented in Indonesia, MOH was issued Minister of Health Regulation No. 37 of 2015 about Utilization of migrant health workforce which regulates several issue related to organizing, placement of migrant workers abroad by the government, the private sector and independent / individual, the responsibility of the central government, local government, monitoring and evaluation and guidance and supervision of the implementation of indonesian miigrant health workforce utilization abroad
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Constraints, Solutions, and Complementary Comments

Hide [q17] 17. Please list in priority order, the three main constraints to the implementation of the Code in your country and propose possible solutions:
Main constraints Possible solution
Some of Foreign Helath workforce (FHW) against the law and regulation in Indonesia related the procedure of license Need to increase the guidance and supervision in coordination with related stakeholder related the compatibility between the license issued and the activity of FHW
Giving concern for private placement: 1. demand letter should be emdorsed by indonesian representatives in user country 2. getting the explanation of the compatibility and clarity of the jobdesk of indonesian migrant health workforce in user country before they leave 3. the protection and the right of indonesian migrant health workforce in user country 4. health insurance for indonesian migrant health workforce in user country The placement of Indonesian migrant health workforce will be better using government to government mechanism
Problem in the document requierements of indonesian migrant health workforce, especially in middle east. Some of education certificate of indonesian migrant health workfocre were considering invalid due to some reason. To verify the certificate of edcucation of the health workforce, Ministry of Higher Education and Reserach and technology has launched an application for online numbering education certificate. This application will make the user country easier to verify the education certificate of Indonesian health workforce.
Hide [q18] 18. Please submit any other complementary comments or material you may wish to provide regarding the international recruitment and migration of health personnel, as related to implementation of the Code.
Indonesia commited to implement the principle of the code and will adopt to the national regulation
Hide [q18x1] Please upload any supporting files