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Draft Proposal for Global Fund Round 7 Strengthening of the Planning and Management

Draft Proposal for Global Fund Round 7 Strengthening of the Planning and Management of Human Resources for Health Development in Support of HIV/AIDS, Malaria and TB Control (Programs in Kalimantan, Sulawesi and Other Parts of Indonesia). Gemala R. Hatta & Siti Pariani.

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Draft Proposal for Global Fund Round 7 Strengthening of the Planning and Management

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  1. Draft Proposal for Global Fund Round 7 Strengthening of the Planning and Management of Human Resources for Health Development in Support of HIV/AIDS, Malaria and TB Control (Programs in Kalimantan, Sulawesi and Other Parts of Indonesia) Gemala R. Hatta & Siti Pariani

  2. Over 17.000 Islands, 33 Provinces Major Islands: Java, Sumatra, Kalimantan, Sulawesi, Papua Total Population: 224.000.000(Java Population : 120.000.000

  3. Human Resources for Health • Government Health Personnel • Private • Volunteers (TB, HIV-AIDS) • NGOs • Worldwide organizations

  4. New Platform for Health System Reform: 4 pillars of national initiatives (1) • Social mobilization & community empowerment: promotion of active participation of individuals & communities in their own health care and the preparation of village preparedness program • Improvement of health system performance through the strengthening of health care services through implementing QA and improving access and quality of human resource for health (HRH)

  5. New Platform for Health System Reform: 4 pillars of national initiatives (2) • Improvement of monitoring and HIS • Improvement of health sector financing

  6. EMERGING infectious DISEASES Re-emerging infectious diseases: • Malaria • Tuberculosis • Dengue hemorrhagic fever • Polio New emerging infectious diseases: • HIV/AIDS • Avian influenza • SARS

  7. HRH Challenges • Decentralization • HRH planning has not functioned optimally • Mal-distribution • Less quality & quantity • Inadequate HRH information • Limited resources to support HRH development Inefficiency Ineffectiveness Low quality

  8. Health care provider data – estimation HRH needs in 2007 – 2010 (table below)

  9. Challenges of HRH • Limited HRH mobility between districts after decentralization system of the government which affects the availability of the up-to-date HRH data • Lack in numbers of skilled HRH to conduct surveillance, early diagnosis and prompt treatment • Problems on recruitment/deployment • Difficult to retain health personnel in remote areas

  10. CUMULATIVE AIDS CASESUp to the End of September 2006 Cumulative

  11. AIDS CASES: by Sex Up to the End of September 2006 Unknown Female Male

  12. RISK FACTORS OF AIDS CASES By Mode Of Transmission Up To September 2006 Unknown Transf Risk factor

  13. 93.968 – 130.000 ALL PROVINCES 159 5392 253 2040 4099 410 1263 3296 573 2338 230 294 302 292 3615 1396 639 61 25678 3620 1377 2621 12850 13884 924 5088 136 554

  14. TBC Control Program Number of Case Detection 1987-2005 AFB : Acid Fast Bacillus

  15. >. 75 /1000 25-75/1000 0-25/1000 Non Endemic MALARIA ENDEMICITY DISTRIBUTION 2005

  16. HRH Intervention Stategies • Commitment building through advocacy to stakeholders at all administrative levels for political and financial supports. • Involvement of community health cadres/informal leaders • Capacity building for health personnel at all levels • Technical assistance • Synergies of HIV/AIDS, malaria, and TB interventions with other health interventions, e.g. nutrition.

  17. Strategic Interventions Needed Strategic Interventions Needed • Improvement of HRH equitable distribution: evaluating, redesigning, pilot testing and formulating/developing alternative policies for health workforce distribution, especially in underserved (remote, unattractive) areas  inventive schemes (financial, shortened service period) • Refresher training of health personnel to response the need for the development of village preparedness program  12,000 villages in 2006  69,000 by the year 2009 • Develop national training models in all aspects (HIV/AIDS, TB, malaria)

  18. Strategic Interventions Needed • Advocacy to local government and other local stakeholders (legislative, politicians, informal leaders, etc). • Improvement of surveillance, monitoring and HIS at all administrative levels • Technical assistance and budget support to local government • Facilitate the establishment of educational institutions in eastern part of Indonesia • Self-regulatory of health professional body  e.g. medical/dental council

  19. Strategic Interventions Needed • Capacity building in the management and technical aspects of HIV/AIDS, TB, and malaria control program for central (Ministry of Health) and local staff (provincial and district health offices, primary health centers and/or community health cadres): e.g. through the provision of fellowships for relevant degree or non-degree programs. • Inter-sector and international collaboration for technical and financial support (GFATM, etc.)

  20. Thank You Thank You Foto : Wamena-Jaya Wijaya (2007)

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