National Reporting Instrument 2021
Background
[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 3rd round of national reporting in March 2019. The WHO Director General reported progress on implementation to the 72nd World Health Assembly in May 2019 (A 72/23). The 3rd Round of National Reporting additionally informed the Member-State led Review of the Code’s relevance and effectiveness, as presented to the 73rd WHA in 2020 (A 73/9).
The Review highlights that Code implementation, through targeted support and safeguards, is necessary to ensure that Health Emergency and Universal Health Coverage-related progress in Member States serves to reinforce rather than compromise similar achievement in others. In light of the considerations in the Report and decision WHA 73(30), the WHO Secretariat has additionally prepared the Health Workforce Support and Safeguards List, 2020.
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 findings from the 4th Round of National Reporting are to be presented at the 75th World Health Assembly in May 2022. Given the ongoing COVID-19 pandemic, the NRI (2021) has been adapted to additionally capture information related to health personnel recruitment and migration in the context of the pandemic.
The deadline for submitting reports is 31 January 2022.
Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: https://www.who.int/teams/health-workforce/migration/code-nri. 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
Disclaimer: 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 75th WHA in 2022. 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/).
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 3rd round of national reporting in March 2019. The WHO Director General reported progress on implementation to the 72nd World Health Assembly in May 2019 (A 72/23). The 3rd Round of National Reporting additionally informed the Member-State led Review of the Code’s relevance and effectiveness, as presented to the 73rd WHA in 2020 (A 73/9).
The Review highlights that Code implementation, through targeted support and safeguards, is necessary to ensure that Health Emergency and Universal Health Coverage-related progress in Member States serves to reinforce rather than compromise similar achievement in others. In light of the considerations in the Report and decision WHA 73(30), the WHO Secretariat has additionally prepared the Health Workforce Support and Safeguards List, 2020.
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 findings from the 4th Round of National Reporting are to be presented at the 75th World Health Assembly in May 2022. Given the ongoing COVID-19 pandemic, the NRI (2021) has been adapted to additionally capture information related to health personnel recruitment and migration in the context of the pandemic.
The deadline for submitting reports is 31 January 2022.
Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: https://www.who.int/teams/health-workforce/migration/code-nri. 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
Disclaimer: 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 75th WHA in 2022. 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/).
[hidLabels]
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Please describe
Disclaimer
[disclaim]
For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
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
Designated National Authority Contact Details
[q01b]
Contact information:
Country
Indonesia
Full name of institution:
Anna Kurniati
Name of designated national authority:
Anna Kurniati
Title of designated national authority:
PhD
Telephone number: (E.g. +41227911530 .)
+62-8158913250
Email: (Please enter one email address only.)
anna.kurniati@kemkes.go.id,hrhinfo@who.int
Implementation of the Code
[q1]
1. Has your country taken steps to implement the Code?
Yes
[q1x1x]
1.1 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.
Yes
[q1x1]
Action 1
The MoH of Indonesia has been convening regular events to disseminate policies and activities on the management of international migration of health related to the implementation of the code to stakeholders. At the national level, the stakeholders include the Ministry of Manpower (MoM), National Board for Indonesian Migrant workers Protection (BP2MI), Ministry of Foreign Affair (MoFA), Ministry of Education (MoE), Ministry of Trade (MoT), health professional associations, health workforce education institution associations, and private recruiter agencies. At sub national levels, MoH also invite key stakeholders including provincial health offices, district health offices, district manpower offices, and nursing schools.
Action 2
The code has been used as one of references during negotiation or discussion of bilateral and regional cooperation especially in relation to the migration management of Indonesian health workers overseas, the licensure system of foreign health professionals, the mutual recognition arrangement and the movement of natural persons
Action 3
[q1x2x]
1.2 Measures have been taken or are being considered to introduce changes to laws or policies consistent with the recommendations of the Code.
Yes
[q1x2]
Measure 1
The code principles have been incorporated into the MoH regulation on the management of international health workers which include outflow and inflow of health workers. The implementation of the regulation has been monitored and reviewed regularly. The most recent review suggests some adjustment as follows:
The MoH regulation no: 37/2015 on the utilization of Indonesian health workers overseas will be revised to include the a more comprehensive management stages not only pre departure and during the placement but also post migration. Reintegration program in the post migration stage is proposed to promote the brain strategy process and enable health workers to return to practice.
The MoH regulation no: 67/2013 on the utilization of foreign health workers to expand the area of activities involving the employment of foreign health workers and the simplification of licensing system in terms of work permit, as well as inclusion of foreign health workforce into the health workforce plan.
Measure 2
In reference to the adoption of the code, the MOH conducted policy studies on the international migration especially for the nursing workforce and developed new policies related to the regulation of the competency evaluation of foreign health workers (FHW) and Indonesian health workers who received professional training from overseas. The competency evaluation system is developed to provide a clear and fair evaluation procedure for foreign health workers and foreign trained health workers
Measure 3
[q1x3x]
1.3 Records are maintained on all recruiters authorized by competent authorities to operate within their jurisdiction.
Yes
[q1x3]
Please describe:
Indonesia has established a database system that maintain records of the Indonesian migrant workers and private recruiters from the pre departure, during the migrant stay in destination countries and after the return (post migration). This database system enables integration of information applications at MoM (Sisnaker), BP2MI (Sisko P2MI) and MoFA (Portal Peduli WNI). Currently there is a collaborative effort to initiate the integration into the health workforce information system at the MoH.
[q1x4x]
1.4 Good practices, as called for by the Code, are encouraged and promoted among recruitment agencies.
Yes
[q1x4]
Please describe:
1.4.1 Promotion of the Code among private recruitment agencies.
The MoH recognize the important roles of private recruiters and always invite them during the socialization of the code to ensure their recruitment practice following the ethical conduct. The MoH also involve private recruiters during the development stage of policies related to the international migration of health workers.
1.4.2 Domestic legislation or policy requiring ethical practice of private recruitment agencies, as consistent with the principles and articles of the Code.
As stipulated in the national act no 18/2017 on the Protection of Indonesian Migrant Workers and Government Regulation no 59/2021 on the Implementation of Protection of Indonesian Migrant Workers, private recruiters should follow these regulations in carrying out the recruitment process. Private recruiters are also required to consult and coordinate with regulators both national and local levels during this process
1.4.3 Public or private certification of ethical practice for private recruitment agencies.
Private recruiters should be registered and licensed by Ministry of Manpower. Only private recruiters with a valid certificate from the MoM (SIP3MI) are allowed to conduct the recruitment process. MoM has an authority to conduct monitoring and supervision to the operation of private recruiters. Should private recruiters violate the regulation, a penalty will be applied and the MoM may blacklist the recruiters and made a public announcement in the MoM website. Aside from the compulsory certificate of the MoM, private recruiters should receive approval from BP2MI in a form of SIP2MI. This certificate works as a license for the private recruiters to conduct recruitment and placement of Indonesian workers to work overseas. To get the approval, private recruiters should satisfy BP2MI with some required documents including cooperation agreements, job orders, draft of employment agreements and draft of placement agreements
1.4.4 Others
[q1x5x]
1.5 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.
Yes
[q1x5]
Measure 1
MoH works in collaboration with key stakeholders in facilitating the migration of Indonesian health workers to work overseas, including MoFA, BP2MI, MoT, MoM, professional organizations, and associations of educational institutions. MoH particularly concerns with the supply side and the national demand to ensure the migration will not negatively affect the health workforce sustainability of the national health system.
Coordination and collaboration are conducted through various activities including supply-demand analysis of health workforce, identification of job market opportunities, exploration of overseas job opportunities through bilateral cooperation, negotiation of cooperation documents, and migration procedures from stages of recruitment and placement to the monitoring and evaluation.
Measure 2
To facilitate migration of foreign health workers to Indonesia, the MoH has established a coordination team consisting of MoFA, MoM, Ministry of Law and Human Rights, Ministry of Internal Affair, Coordinating Ministry for Political, Legal and Security Affair, health professional councils, and other government institutions
Measure 3
[q1x6x]
1.6 Other steps:
No
Partnerships, Technical Collaboration and Financial Support 1/2
[q2x1]
2.1. 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?
2.1.1 Specific support for implementation of the Code
Indonesia has not provided a specific technical or financial assistance for other WHO member states in relation to the implementation of the code. However, Indonesia was actively involved in the WHO expert advisory group (EAG) on the Relevance and Effectiveness of the WHO Global Code of Practice on the International Recruitment of Health Personnel in 2019. Engagement in this process was aimed to support the effective implementation of the Code in safeguarding the sustainability of health workforce and health systems in all member states and particularly to countries facing the greatest challenge.
2.1.2 Support for health system strengthening
Indonesia has not provided any direct technical assistance to other countries to support health system strengthening. MoH provides technical guidance to stakeholders within the country especially provincial and local health offices in the development of HRH plan in their administrative region. The HRH plan is developed as the reference document to the utilization of HRH including the national and local recruitment and deployment in their respective regions.
2.1.3 Support for health personnel development
Other supports provided by the MoH to the provincial health offices include technical assistances in strengthening the HRH information system. One of the key activities is training on the data warehouse (data visualization).
2.1.4 No support provided
2.1.5 Other areas of support:
[q2x2]
2.2. 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?
2.2.1 Specific support for implementation of the Code
2.2.2 Support for health system strengthening
In line with the implementation of the code, Indonesia has received technical and financial assistances from WHO and USAID to develop the National Health Workforce Account (NHWA). The aim was to strengthen an integrated HRH information system. Key activities were conducted in three stages including planning, designing and testing, implementation at full scale. During the implementation stage, some technical supports include training for essential staffs, adoption into the government policies, implementation and management of the registry country-wide.
2.2.3 Support for health personnel development
2.2.4 No support received
2.2.5 Other areas of support:
Partnerships, Technical Collaboration and Financial Support 2/2
[q3]
3. Has your country or its sub-national governments entered into bilateral, multilateral, or regional agreements and/or arrangements with respect to the international recruitment and migration of health personnel?
Yes
[q3xTitle]
Title of Agreement
| Title | Web-link to agreement | Upload the full text of the agreement | |
|---|---|---|---|
| Agreement 1 | The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi” | ||
| Agreement 2 | MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany | ||
| Agreement 3 | MoU for Cooperation in the field of Health RI-Kingdom of Saudi Arabia | http://biroksln.kemkes.go.id/page/doccategory/1/perjanjian-bilateral-antar-negara | |
| Agreement 4 | MoU on Health Cooperation RI-UAE | http://biroksln.kemkes.go.id/page/doccategory/1/perjanjian-bilateral-antar-negara | |
| Agreement 5 | Indonesia-Australia Comprehensive Partnership |
[q3xUploadx1]
The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi” between Agency for the Protection of Indonesian Migrant Workers of the Republic of Indonesia and Japan International Corporation of Welfare Services
No comment
[q3xUploadx2]
MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany
No comment
[q3xUploadx3]
MoU for Cooperation in the Field of Health between MoH RI and MoH of KSA
No comment
[q3xUploadx4]
No comment
[q3xUploadx5]
No comment
[q3xTOA]
If you cannot share the full text of the agreement please fill :
| Type of Agreement | Coverage | |
|---|---|---|
| The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi” (SQ001) | Bilateral (A1) | National (A1) |
| MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany (SQ002) | Bilateral (A1) | National (A1) |
| MoU for Cooperation in the field of Health RI-Kingdom of Saudi Arabia (SQ003) | Bilateral (A1) | National (A1) |
| MoU on Health Cooperation RI-UAE (SQ004) | Bilateral (A1) | National (A1) |
| Indonesia-Australia Comprehensive Partnership (SQ005) | Bilateral (A1) | National (A1) |
[q3xMCA]
Main content of agreement
(check 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): | |
|---|---|---|---|---|---|---|---|---|
| The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi” | 1 | |||||||
| MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany | 1 | |||||||
| MoU for Cooperation in the field of Health RI-Kingdom of Saudi Arabia | 1 | 1 | ||||||
| MoU on Health Cooperation RI-UAE | 1 | 1 | ||||||
| Indonesia-Australia Comprehensive Partnership | 1 |
[q3xMCAOth]
Main content of agreement (Please specify:)
The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi”
MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany
MoU for Cooperation in the field of Health RI-Kingdom of Saudi Arabia
Collaboration in the field of application of health requirement for Hajj and Umrah, Human Resources Development
MoU on Health Cooperation RI-UAE
Health Services, Pharmaceutical and Medical Devices, Prevention and Control of Diseases, HRH Development
Indonesia-Australia Comprehensive Partnership
[q3xCHP]
Categories of Health Personnel (check all that apply)
| Doctors | Nurses | Midwives | Dentists | Pharmacists | Other (include details as necessary) : | |
|---|---|---|---|---|---|---|
| The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi” | 1 | |||||
| MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany | 1 | |||||
| MoU for Cooperation in the field of Health RI-Kingdom of Saudi Arabia | 1 | |||||
| MoU on Health Cooperation RI-UAE | 1 | 1 | ||||
| Indonesia-Australia Comprehensive Partnership | 1 |
[q3xCHPOth]
Categories of Health Personnel (Please specify:)
The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi”
MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany
MoU for Cooperation in the field of Health RI-Kingdom of Saudi Arabia
MoU on Health Cooperation RI-UAE
Human Resources for Health
Indonesia-Australia Comprehensive Partnership
Human Resources for Health
[q3xVP]
Validity period
| From: | To: | |
|---|---|---|
| The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi” (SQ001) | 2020 (2020) | 2024 (A27) |
| MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany (SQ002) | 2020 (2020) | 2050 (A1) |
| MoU for Cooperation in the field of Health RI-Kingdom of Saudi Arabia (SQ003) | 2017 (2017) | 2022 (A29) |
| MoU on Health Cooperation RI-UAE (SQ004) | 2020 (2020) | 2023 (A28) |
| Indonesia-Australia Comprehensive Partnership (SQ005) | 2018 (2018) | 2050 (A1) |
[q3xCN]
Countries that are involved
The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi”
Japan
MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany
Germany
MoU for Cooperation in the field of Health RI-Kingdom of Saudi Arabia
Kingdom of Saudi Arabia
MoU on Health Cooperation RI-UAE
Uni Emirates Arab
Indonesia-Australia Comprehensive Partnership
Australia
[q3xSYC]
Signatory of the agreement from your country
| Ministry of Foreign Affairs | Ministry of Health | Ministry of Education | Ministry of Trade | Ministry of Labour | Ministry of Immigration /Home Affairs | Other: | |
|---|---|---|---|---|---|---|---|
| The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi” | 1 | ||||||
| MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany | 1 | ||||||
| MoU for Cooperation in the field of Health RI-Kingdom of Saudi Arabia | 1 | ||||||
| MoU on Health Cooperation RI-UAE | 1 | ||||||
| Indonesia-Australia Comprehensive Partnership | 1 |
[q3xSYCOth]
Signatory of the agreement from your country (Please specify:)
The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi”
The Indonesian Migrant Worker Protection Board (BP2MI)
MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany
MoU for Cooperation in the field of Health RI-Kingdom of Saudi Arabia
MoU on Health Cooperation RI-UAE
Indonesia-Australia Comprehensive Partnership
[q3xSPC]
Signatory of the agreement from the partner country (ies)
| Ministry of Foreign Affairs | Ministry of Health | Ministry of Education | Ministry of Trade | Ministry of Labour | Ministry of Immigration /Home Affairs | Other: | |
|---|---|---|---|---|---|---|---|
| The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi” | 1 | ||||||
| MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany | 1 | ||||||
| MoU for Cooperation in the field of Health RI-Kingdom of Saudi Arabia | 1 | ||||||
| MoU on Health Cooperation RI-UAE | 1 | ||||||
| Indonesia-Australia Comprehensive Partnership | 1 |
[q3xSPCOth]
Signatory of the agreement from the partner country (ies) (Please specify:)
The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi”
Japan International Corporation of Welfare Services (JICWELS)
MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany
Bundesagentur fur Arbeit, Germany
MoU for Cooperation in the field of Health RI-Kingdom of Saudi Arabia
MoU on Health Cooperation RI-UAE
Indonesia-Australia Comprehensive Partnership
[q3xCOP]
Does the agreement explicitly reference the Code?
The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi”
No
MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany
No
MoU for Cooperation in the field of Health RI-Kingdom of Saudi Arabia
No
MoU on Health Cooperation RI-UAE
No
Indonesia-Australia Comprehensive Partnership
No
[q3xPAP]
Does the agreement reflect the code’s principles and practices?
The Deployment and Acceptance of Indonesia Candidate for “Kangoshi”, Indonesian Candidate for “Kaigofukushisi”, Indonesian “Kangoshi” and Indonesia “Kaigofukushisi”
Yes
MoU on Labour and Employment between Ministry of Manpower of the Rep of Indonesia and the Bundesagentur fur Arbeit, Germany
Yes
MoU for Cooperation in the field of Health RI-Kingdom of Saudi Arabia
Yes
MoU on Health Cooperation RI-UAE
Yes
Indonesia-Australia Comprehensive Partnership
Yes
Health Workforce Development and Health System Sustainability
[q4]
4. Does your country strive to meet its health personnel needs with its domestically trained health personnel, including 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
[q4x1x]
4.1 Measures taken to educate the health workforce
Yes
[q4x1]
4.1.1 Manage production
4.1.2 Improve quality of education
4.1.3 Strengthen regulation
4.4 Others
[q4x2x]
4.2 Measures taken to ensure the sustainability* of the health workforce
Yes
[q4x2]
4.2.1 Workforce planning/forecasting
4.2.2 Increasing domestic production and education opportunities
4.2.3 Increasing employment opportunities
4.2.4 Manage recruitment of international health personnel
Conducting various continuing professional development program in order to maintain and improve the professional abilities of health workers based on the competency standards. The CPD was held to various methods such as e-learning, webinars, workshops, seminars
Other
[q4x3x]
4.3 Measures taken to address the geographical mal-distribution and retention of health workers*
Yes
[q4x3]
4.3.1 Education (Education institutions in underserved areas; students from under-served areas; relevant topics in education/professional development programmes; others)
• Opening new medical faculties in remote regions to scale up production of doctors in underserved areas • Establish a temporary distance learning program of the Diploma 3 program of nursing and midwifery (associate level) to provide a higher education level for nursing assistants and midwifery assistants who serve in remote areas. By the end of the program 660 nurses and midwives were graduated. • Establish an affirmation program of the higher education at MoH health polytechnics to provide students from remote and underserved areas with financial supports with a service contract after completing the education.
4.3.2 Regulation (Mandatory service agreements; scholarships and education subsidies with return of service agreements; enhanced scope of practice; task shifting; skill-mix; others)
Mandatory service agreement : In 2017 MoH also enforced a mandatory services for medical specialist graduates who were not scholarship awardees. In return, the MoH provided a higher financial incentive and other allowances depending on the hospital location. The program only last one year and after a dispute process at the Supreme court in 2018, the program was called off and changed into a voluntary deployment program. In this revised program, the MoH open hiring for fresh graduate medical specialists. Applicants can voluntarily submit job application and select the hospitals with available positions. Scholarship and education subsidies with return of service: - Provide scholarships for doctors and dentists to attend specialist education program with a mandatory service agreement. Upon completion of the study, medical specialists and dental specialists shall return and serve the district hospitals or hospitals in need based on the location and the length of service stated in the agreement. Since 2008 to 2021, MoH has provided scholarship for 8,555 doctors/dentists. - Provide financial supports for employees to pursue higher education degree of bachelor, master and doctoral programs with an obligation to return to work and to serve for a certain period as stipulated in the agreement. Enhanced scope of practice: As regulated in the MoH decree no. 43/ 2019 concerning public health centers, PHC in the remote and very remote area were allowed to enhance the scope of practice for certain competencies and to delegate certain competency authorities for doctors, nurses and midwives.
4.3.3 Incentives (Financial and non-financial)
The most common forms of incentives provided by the national and sub national governments are financial incentive based on the remoteness of work location, category of health workers, and work performance, and non financial incentives. The latter was provided in form of training programs, short courses, study scholarship and best health workers awards. In order to support the covid 19 handling, Indonesia provides additional financial incentives for frontline health workers and monetary compensation for frontline health workers who died from covid-19.
4.3.4 Support (Decent and safe living and working conditions; career advancement opportunities; social recognition measures; others)
Decent and safe working and living conditions: Indonesia has stipulated the importance of decent working conditions at the National Act no. 13/ 2003 concerning manpower and the government regulation no. 33/ 2013 concerning expansion of employment opportunities. The national act no. 36/2014 concerning health workers also stipulate that employers of health workers shall ensure the welfare of employees and to take into account safety and security at the workplace. Those policies imply that healthy and safe working conditions are determined by the number of working hours, working place conditions, minimum wage, social security, health insurance, employment status, and dual practice regulations. Career advancement opportunities: Indonesia has established a guideline on the nursing career ladder system. For health workers employed as civil servants, Indonesia has also established a career system for the functional positions. Health workers are provided with a regular capacity building program and supports for the self-development, access to higher education, training and other forms of continuing professional development. For those working in the remote area would be awarded extra credit points up to 25% of the cumulative credit point. This credit point award is useful for their promotion to the higher level of functional positions
[q4x4x]
4.4 Other relevant measures
No
[q5]
5. Are there specific policies and/or laws that guides international recruitment, migration and integration of foreign-trained health personnel in your country?
Yes
[q5x1]
5.1 Please provide further information in the box below:
Law/policy 1
Ministry of Health Regulation number 67 year 2013 about the utilization of foreign health worker
Law/policy 2
Medical Council regulation no 17/2013 about temporary and conditional registration for foreign GP and dentist
Law/policy 3
MOH regulation no 6/2020 about foreign health management consultant
[q6x]
6. Recognizing the role of other government entities, 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
[q6x1]
6.1 Please provide further information in the box below:
The role of MoH in the process of monitoring the international recruitment of health workers includes:
a. Pre-migration
• The MoH is actively involved in the coordination mechanism with MoM and BP2MI in the framework of exchange information related to the job market analysis (supply-demand), identification of employment opportunities, exploration of cooperation, discussion of cooperation documents, recruitment, placement, monitoring and evaluation
• MoH monitors and ensures the qualifications of Indonesian migrant health workers meet the requirement and facilitate the issuance of letter of goodstanding and health worker registration certificates.
b. Migration
• In coordination with BP2MI and MOFA, MoH monitor the employment and placement of health workers in the destination countries. The monitoring process involves regular meetings and official visits through the Indonesian representatives at the destination countries.
• MoH also implement another form of monitoring through facilitating the document verification such as diploma certification, letter of goodstanding, and renewal of health professional certifiacte.
c. Post migration
• In collaboration with MoM, BP2MI, and hospital associations to convene workshops to provide employment opportunities for returnees who wish to return and work at home country.
[q7x]
7. 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
[q7x1x]
7.1.a Please provide further information in the box below.
https://jdih.bp2mi.go.id
https://sisdmk.kemkes.go.id
http://bppsdmk.kemkes.go.id/web/peraturan
https://jdih.kemnaker.go.id/
[q7x2x]
7.1.b Please upload any format of documentation that provides such information (e.g. pdf, excel, word)
Upload document:
Responsibilities, Rights and Recruitment Practices
[q8x]
8. 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:
8.1 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
8.2 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
8.3 Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression
8.4 Other mechanisms, please provide details below if possible:
[q8xoth]
8.4 Please describe at least one mechanism
Mechanism 1
Regulation concerning foreign health workers: • Foreign health workers should be employed by a sponsor and work at the determined health facilities. • Foreign health workers are not allowed to conduct a private practice. • Foreign health workers are required to transfer knowldege and technology to the domestic health workers
Mechanism 2
A further technical regulation enacted by the MoM decree No. 8 of 2021 concerning procedures to employ foreign workers stated that employers of foreign workers should enroll their foreign employees into the insurance program including the corporate insurance, the social security insurance and the national health insurance, and facilitating access to the Indonesian language training.
Mechanism 3
[q9x]
9. 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.
Indonesia has carried out several policy revisions related to the employment of foreign health workers:
1. Law No. 11/2020 concerning job creation and the government regulation No. 34/ 2021 on the employment of foreign workers emphasized on the simplification of work permit procedures.
2. Specifically for foreign health workers, prior to the employment in Indonesia, they should meet the following requirements:
a. Having a certificate of competence issued by Indonesian authorities;
b. Having a registration certificate issued by the Indonesian health professional/medical councils
c. Having a license of practice issued by the local government
d. Having a minimum 5 years of work experience; and
e. Having an excellent Bahasa Indonesia proficiency
[q10x]
10. Regarding domestically trained/ emigrant health personnel (diaspora) 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
Measure 1
Pre migration: - To ensure valid employment overseas, aside from the government as the recruiter, only licensed private recruiters are allowed to conduct recruitment. Recruitment process should involve careful document checks to ensure the completeness and validity of placement documents and the appropriate working contract. - Publish information on the overseas employment opportunities at the BP2MI and MoH websites and social media. - Convene events to disseminate information on the overseas employment opportunities, requirement and the recruitment procedure, the risk and benefits, and the rights and obligation. Representatives of Indonesian migrant health workers are also invited to share their experience. - Provide additional training relevant to the requirement of the country of destination
Measure 2
Migration stage: - Data exchange on Indonesian health workers employed overseas by job position and country of destination - Develop an online mechanism for renewing the certificate of registration and conducting a coordination with the Indonesian Nurse Association to develop e- learning program as part of the continuing professional development. This system is helpful to maintain their professional record in the health professional database system that enable them to return to practice in Indonesia at any time. - Provide legal support for health workers having difficulties or dispute with employers at the country of destination.
Measure 3
Data on International Health Personnel Recruitment & Migration
[iq11]
Improving the availability and international comparability of data is essential to understanding and addressing the global dynamic of health worker migration.
[q11]
11. Does your country have any mechanism(s) or entity(ies) to maintain statistical records of foreign-born and foreign-trained health personnel?
Yes
[q11x1]
Please describe
For foreign-trained health workers, the database is maintained by the Indonesian Medical Council and the Indonesian Health Professional Council. This process is enabled as all foreign trained health workers should undergo a competency evaluation prior to practice in health facilities. All foreign trained health workers who pass the competency evaluation are granted with certificate of competence and the certificate of registration.
For foreign health workers who receive professional training overseas, the certificate of registration is on temporary basis that is valid for one year and can be renewed once.
For foreign -born health workers who receive professional training in Indonesia, with an exception for medical staffs (doctors, dentists, medical specialists, and dental specialists), the competency evaluation will be the same as other Indonesian citizens. However, the certification of registration will be on temporary basis and can only be renewed once.
[iQ12]
12. Data on the active stock of health personnel, disaggregated by country of training and birth
Previous data shared with WHO is available here. Please liaise with your NHWA focal point and update as relevant.
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 workforce1), 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.
Previous data shared with WHO is available here. Please liaise with your NHWA focal point and update as relevant.
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 workforce1), 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.
[q12x0]
12.1 Consolidated stock of active health personnel
This information can be provided by one of the following three options. Please choose your preferred mode of data entry:
This information can be provided by one of the following three options. Please choose your preferred mode of data entry:
Option A: Completion of the table below
[q12x1x1]
Option A: Please complete the table below
Please fill red highlighted cells.
| Total | Domestically Trained | Foreign Trained | Unknown Place of Training | National Born | Foreign Born | Source* | Year | Does the data represent active stock? | Remarks | |
|---|---|---|---|---|---|---|---|---|---|---|
| Medical Doctors | 182,075 | 181,158 | 917 | 182,021 | 54 | Indonesia Medical Council | 2021 | 1 | Database for medical doctors is maintained by Indonesian medical council | |
| Nurses | 616,330 | 616,310 | 20 | 616,330 | Indonesia Healthworkforce Council | 2021 | 1 | Database for nurse is maintained by Indonesian healthworkforce council | ||
| Midwives | 465,543 | 465,532 | 11 | 465,543 | Indonesia Healthworkforce Council | 2021 | 1 | Database for midvives is maintained by Indonesian healthworkforce council | ||
| Dentists | 37,477 | 37,463 | 14 | 37,463 | 14 | Indonesia Medical Council | 2021 | 1 | Database for dentist is maintained by Indonesian medical council | |
| Pharmacists | 69,134 | 69,133 | 1 | 69,134 | Indonesia Healthworkforce Council | 2021 | 1 | Database for pharmacist is maintained by Indonesian healthworkforce council |
[q12x1x3]
Upload any format of documentation that provides such information (e.g. pdf, excel, word).
[q13x2]
12.2 Top 10 countries of training for foreign-trained health personnel
Please provide data on the top 10 countries of training for foreign-trained health personnel in your country. This information can be provided by one of the following two options:
Please provide data on the top 10 countries of training for foreign-trained health personnel in your country. This information can be provided by one of the following two options:
Option A: Completion of the table below
[q13x2x1]
Option A : Completion of the template below or in in Excel (Download the Excel template and Upload the complete form)
Please indicate data from the latest year available
Please indicate data from the latest year available
| Doctors | Nurses | Midwives | Dentists | Pharmacists | |
|---|---|---|---|---|---|
| Total foreign trained personnel | 163 | 20 | 11 | 14 | 1 |
| Country 1: Top country of training | China | Thailand | Australia | US | Belgium |
| Country 1: No. of foreign trained health personnel | 107 | 6 | 6 | 3 | 1 |
| Country 2: Top country of training | Japan | The Philippines | UK | UK | |
| Country 2: No. of foreign trained health personnel | 20 | 4 | 2 | 2 | |
| Country 3: Top country of training | Philippines | Australia | South Korea | Netherlands | |
| Country 3: No. of foreign trained health personnel | 10 | 3 | 2 | 2 | |
| Country 4: Top country of training | Chinese-Taipei | UK | New Zealand | Hongkong | |
| Country 4: No. of foreign trained health personnel | 6 | 3 | 1 | 1 | |
| Country 5: Top country of training | India | Malaysia | Japan | ||
| Country 5: No. of foreign trained health personnel | 5 | 2 | 1 | ||
| Country 6: Top country of training | Malaysia | Scotland | Philippines | ||
| Country 6: No. of foreign trained health personnel | 4 | 1 | 1 | ||
| Country 7: Top country of training | Singapore | Japan | Australia | ||
| Country 7: No. of foreign trained health personnel | 3 | 1 | 1 | ||
| Country 8: Top country of training | US | Egypt | |||
| Country 8: No. of foreign trained health personnel | 3 | 1 | |||
| Country 9: Top country of training | Russia | Turkey | |||
| Country 9: No. of foreign trained health personnel | 3 | 1 | |||
| Country 10: Top country of training | Thailand | China | |||
| Country 10: No. of foreign trained health personnel | 2 | 1 | |||
| Source (e.g. professional register, census data, national survey, other) | Indonesia Medical Council | Indonesia Healthworkforce Council | Indonesia Healthworkforce Council | Indonesia Medical Council | Indonesia Healthworkforce Council |
| Year of data | 2021 | 2021 | 2021 | 2021 | 2021 |
| Additional Comments | Cumulative since 2012 | Cumulative since 2012 | Cumulative since 2012 | Cumulative since 2012 | Cumulative since 2012 |
[q13x2x3]
Upload any format of documentation that provides such information (e.g. pdf, excel, word).
Please upload file
COVID-19 and Health personnel mobility
[q13]
13. Were measures undertaken at national or sub-national level in response to the COVID-19 pandemic with respect to the temporary or permanent mobility of international health personnel?
13.1 No change in national or sub-national regulation, policy or processes related to the entry or exit of foreign-trained or foreign-born health personnel
13.2 National and/or sub-national regulation, policy or processes enacted to ease entry and integration of foreign-trained or foreign-born health personnel
13.3 National and/or sub-national regulation, policy or processes enacted to limit the exit of health personnel from country
Due to the Covid-19 pandemic, in March 2020 the Ministry of Manpower had a policy to temporarily stop sending migrant workers to certain countries in order to protect Indonesian Migrant Workers candidates and to prevent the transmission of covid 19. By the end of July, the ban was lifted, and the Ministry of Manpower released a new guidance on the safe management procedures for Indonesian migrant workers by following strict health protocols and management procedures since pre-departure, during the placement in the destination country, as well as before and after returning to the home country. The policy and guidelines were updated regularly based on the most recent situation of the Covid-19 Pandemic.
13.4 Others
During the covid-19, Indonesia issued a policy to temporary stop the new recruitment of foreign workers to Indonesia. However, exception is granted to foreign workers employed for national strategic projects or at national vital objects and those participating in health and humanitarian works. During the peak cases of covid-19 and the enforcement of the public activity restriction (PPKM) from July 2021 to the present, Indonesia has stoped all recruitment of foreign workers. Permission could be granted for very few foreign workers in health sector working for health and humanitarian activities related to Covid-19 after a careful review process involving key stakeholders of the coordination team for the utilization of foreign health workers.
[q14]
14. Did you have a mechanism to monitor the inflow and outflow of health personnel to/from your country during the COVID-19 pandemic?
Inflow
Outflow
No
[q14x1]
14.1 How many foreign-trained or foreign-born health personnel were newly (inflow) active (temporarily and/or permanently) in your country in 2019 and 2020?
| Doctors | Nurses | Midwives | Dentists | Pharmacists | Comments | |
|---|---|---|---|---|---|---|
|
Data Source (e.g. Regulatory authority, immigration records, work permits, etc.) Please ensure data source consistency for each category of personnel for the two years |
||||||
| 2020 | 45 | 0 | 0 | 0 | 0 | |
| 2019 | 69 | 0 | 0 | 10 | 0 |
[q14x2]
14.2 How many domestically-trained health personnel left (outflow) your country in 2019 and 2020 (for temporary or permanent migration)?
| Doctors | Nurses | Midwives | Dentists | Pharmacists | Comments | |
|---|---|---|---|---|---|---|
|
Data Source (e.g. letters of good standing, emigration records, G-G agreements etc.) Please ensure data source consistency for each category of personnel for the two years |
||||||
| 2020 | 0 | 490 | 0 | 0 | 0 | |
| 2019 | 0 | 1452 | 0 | 0 | 0 |
[q15]
15. Please list any challenges related to ethical international recruitment of health personnel during the COVID-19 pandemic
Please describe (e.g. active recruitment of ICU personnel)
Please describe (e.g. active recruitment of ICU personnel)
1st Challenge
Aspects of Regulation • Restrictions from certain countries for Indonesian migrant workers to enter due to the covid-19 pandemic • Some countries enforce an immigration policy that allow the arrival of migrant workers who have vaccinated using certain covid-19 vaccines preferred by the country of destination • Unclear policies on how to manage migrant workers who are tested positive upon arrival at the country of destination and require hospitalization.
2nd Challenge
Technical Aspects • The increase of travel cost due to limited national and international airlines, the cost for covid-19 PCR test, and quarantine facilities prior to departure • Delayed departure of some migrant candidates due to tested positive. Some candidates should wait to reschedule the departure almost a year in accordance with the policy of the receiving country. • Preparatory training program was shifted from offline to online. For some candidates they are responsible for having the proper gadgets that enable online meeting and learning and the internet communication at their own home
3rd Challenge
Constraints, Solutions, and Complementary Comments
[q16]
16. Please list in priority order, the three main constraints to the ethical management of international migration in your country and propose possible solutions
| Main constraints | Possible solution /Recommendation | |
|---|---|---|
| Most countries implemented special restriction policies for foreigners to enter their countries during the pandemic. | Bridging the needs of user countries with policies in Indonesia | |
| There has been frequent changing information related to immigration requirements and health protocols to enter the country of placement during the pandemic which resulted in uncertainty to the departure schedule | Continuously update information on migration and health protocols and discuss measures to take in order to ensure safe migration process for both sending and receiving countries | |
| Negotiation over the international recruitment were limited to virtual meetings that create some technical constraints due to less comprehensive understanding on the real situation of both sides. | improve the quality of discussion and the mutual understanding while strengthening the network system in support of the development of international migration |
[q17]
17. Is there any specific support your country requires to strengthen implementation of the Code?
17.1 Support to strengthen data and information
17.2 Support for policy dialogue and development
17.3 Support for the development of bilateral/multi-lateral agreements
17.4 Other areas of support:
[q18]
18. 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.
The Code is a useful instrument to encourage each country to follow the ethical principles of the international recruitment practices. It is imperative for any country to maintain a sustainable health workforce of the health system within their own nation, to promote fair and equal treatment for migrant health workers, and to establish international cooperation on the basis of mutual benefit. Indonesia is committed to implement the Code by continuously improving the effective health workforce plan at all administrative levels, improve education and training of health workers and apply retention strategies to ensure health facilities in underserved areas provided with sufficient health workers. From Indonesia’s experience, the Code should be internalized not only by the MoH policies but also other key stakeholders related to the regulation and implementation of the international migration. Dissemination information of the code should be conducted not limited to the seminar or workshop but also during the policy formulation, bilateral or regional negotiation/discussion, and also supervision of the migration procedures involving public and private agencies
[q18x1]
Please upload any supporting files
Thank You
[iThank]
You have reached the end of the National Reporting Instrument - 2021. You may go back to any question to update your answers or confirm your entry by clicking ‘Submit’.