Sesi 17B_Health Human Power_Blok I_Dwi Handono

8/12/2019 Sesi 17B_Health Human Power_Blok I_Dwi Handono

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Implementation Strategies

and Cases:Alliance-coalition-merging

By:

Dwi Handono Sulistyo


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Health System (WHO)

All activities whose primary purpose is topromote, restore or maintain health. FormalHealth services, including the professionaldelivery of personal medical attention, are

clearly within these boundaries. So are actionsby traditional healers, and all use ofmedication, whether prescribed by provider ornot. Such traditional public health activities ashealth promotion & disease prevention, andother health enhancing intervention like road& environmental safety improvement, specific

health-related education, are also part of the


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Peran Pemerintah Dalam Sistem

Kesehatan

Menurut WHO:

1. Peran dalam stewardship

2. Peran dalam Financing 3. Peran dalam service provision

4. Peran dalam pengelolaan resource.


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Total Financial

Resources

Other

recurrent

Maintain

-ance

Labour

costs

Investment in

Buildings &equipment

Training

Of people

Recurrent

Capital

Production ofHealth

interventions

Consum

-ables

Physical

capital

Human

resources

(Retirement,

Obsolescence)

(Depreciation,

Obsolescence)

(Expiry, loss)

Expenditure

categories

Budget

elements

Health System

Inputs

HRH Are One of Three Principle Health System Inputs

World Health Report 2000, p.75


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HUMAN CAPITAL

Kombinasi P, K, inovasi & kemampuananggota perusahaan untuk melaksanakantugas-tugasnya (Edvinson & Malone)

Kemampuan untuk mentransfer potensimanusia menjadi produk atau jasa(Seetharaman dkk)

Akumulasi dari kemampuan individu untukmenyediakan solusi bagi pelanggan (Hubert &Saint-Onge)


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Karakteristik Human Capital

HC dalam bentuknya: tacit, know-how &kompetensi SDM tidak dapat dimiliki olehperusahaan, karena semua itu menghilangbegitu mereka tidak berada di kantor.

(Edvinson & Malone) JADI: Pemilik SDM bukan perusahaan tapi

manusia ybs.

Dimensi HC: pendidikan & pelatihan;pengalaman; kompetensi; & komitmen(Sangkala); motivasi; dedikasi; integritas(Sucipto)


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Manajemen Human Capital

SDM diperlakukan sebagai investorsehingga mereka akan menanam modalnyadalam perusahaan (Sucipto)

Sebagai investor, SDM ditempatkan sejajarkedudukannya sehingga ketika menetapkantarget, aspirasi mereka wajib diperhatikan.

Hambatan: belum ada formula yang pastiuntuk menghitung nilai modal tsb.


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Manajemen Human Capital 2

Dari sisi perusahaan: Bagaimana HC dapat

melahirkan atau menciptakan nilai bagi

perusahaan

Dimensi2 HC harus diperlakukan berbeda

untuk setiap orang

Penting: mengubah tacit knowledge menjadi

explicit knowledge (Knowledge Management)


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Perkembangan Konsep

Dari konsep Human Capital menjadiIntellectual Capital

Dalam Intellectual Capital, HC hanya menjadisalah satu aspek. Aspek lain adalah Structural

Capital (Sangkala) & Customer Capital (Saint-Onge)

Intellectual Capital: kemampuan

mentransformasi P & asset intangible ke dalampenciptaan sumber kekayaan denganmelipatgandakan HC & modal struktural:(Edvinson)


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CBHRM: Competency-Based

Human Resource Management

Premise: If competencies are the best

predictors of performance, they should be used

throughout the employment life cycle: for

hiring, appraisal, development, succession

planning, high-potential tracking, training, &

career planning (Zwell, 2000 p.4).

Premis tersebut harus diyakini penuh &diterapkan secara konsekuen & total.


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Evolution of Thinking: What Predicts Performance

1973

Size & shape of the head;

Brain weight;Skin color;Ethnicity;Social class;Birth order;Handwriting;

Religion;IQ;Cultural heritage;

Astrology;Heredity;Gender;

So on

David McClelland:

-Behavioral traits-Characteristics

Competencies

Zwell (2000), P. 22


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Job: Competence or Competency?

Job Competence: An employees capacity to meet (or exceed) a jobs

requirements by producing the job outputs at anexpected level of quality within the constraints of the

organizations internal & external environments.Job Competency:

An underlying characteristic of an employee (i.e.motive, trait, skill, aspect of ones self-image, social

role, or a body of knowledge) which results ineffective and/or superior performance in a job

Dubois (2004), p. 9


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Competency = Skill?

Competency tidak sama dengan Skill

Skill hanya salah satu bagian/aspek dari

Competency

(Dalam praktek, Competency sering dianggap

= Skill)


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A body of

knowledge;

Skill;

Aspects of ones

self image;

Motive;

Trait

Bisa diperoleh dari

Pendidikan & Pelatihan;

Pengalaman

Mungkin bisa diperoleh dari

Pendidikan & Pelatihan;

Pengalaman

Faktor bawaan; tidak bisa

diperoleh secara sengaja

Competency: Bisa diperoleh atau tidak ?


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Konsekuensi CBHRM

Karena Competency ada yang bersifat bawaan,maka:

Lebih baik sejak awal memilih SDM yang

sesuai atau memenuhi trait yang diinginkan;dan memenuhi aspek-aspek yang sulitdirekayasa (motive; self image)

Aspek-aspek yang bisa direkayasa, harusdikelola secara sistematis &berkesinambungan.


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Competency Identification

Competency Model

Competency Assessment

Training & Development

Planning

Training & Development

Intervention

Selection

Development

Evaluation

SYSTEMS MODEL

FOR

CBHRM


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HRH: SOME CHARACTERISTICS

The workforce is large, diverse, and comprisesseparate occupations often represented by powerful

professional associations

Some have sector-specific skills Access to health professional training (education) and

employment is controlled by standards

Entry requirements determined by the professions

Aspect of their work are regulated.

Buchan (2004), p. 4


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HRH: SOME CHARACTERISTICS (2)

Personnel cannot simply be stored & used at a laterdate;

It cannot be easily substituted;

it very greatly in their motivation, skills, & values; The production of personnel in the health services has

a long time lag;

It is difficult to predict future work actions &

behavior; Work patterns of personnel get set in traditional ways

& are difficult to change.

Collins (1994), p. 197


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HRH PROBLEMS

SHORTAGE

WASTAGE

LOW MOTIVATION OUTDATED SKILL

LOW PRODUCTIVITY

MIGRATION/MALDISTRIBUTION

Report of the Working Group on Demand (2004), P. 10


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HRH-Related Constraints

Individual Characteristic:

Gender: Proportion of women in the workforceby skill level

Social class & ethnicity of staff:Representation of health workers fromminority groups

Demand for medical training: Number ofapplicants per training position

Disease: HIV/AIDS prevalence rates amonghealth workers


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HRH-Related Constraints 2

Health Service Level:

Team building & interaction: Number of team

meetings & supervisions

Surpluses, shortages, & skill mix: Proportion

of health staff working in correctly staffed

services

Physical working environment: Proportion of

health staff working in correctly equipped

services


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Health Sector Level:

Salary level & monetary incentives: Salary

grids in absolute terms

Performance management & productivity:Existence of frameworks managing the

collection and use of performance evidence

(including career plans)

Composition of workforce & skill mix:

Shortages or surpluses of staff in particular

occupations or professions/ Appropriately

skilled workers for addressing priority diseases


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HRH-Related Constraints 3a

Health Sector Level (2):

Geographical Imbalance: Distribution of

appropriately skilled workers across regions

Retention Policy: Existence of retention policy

Health Sector Reform: Improvements in

performance & responsiveness to adjust staff

roles

HRH policy & planning: Planning of future

availability & requirements


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Training Capacities:

Training: Number of trainees per skilled level

Retraining: Number of re-trainees per skilledlevel


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Socio-political & economic context of a country:

Multisectoral approaches: Quality of exchange

among different interest groups & ministries

Migration: Number of health staff migrating

Governance & overall policy framework:

Political stability, priority attached to social

sectors, decentralization, civil service rules, etc

Wyss (2004), p. 3


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The Health Workforce Crisis

Deficits doctors, nurses, & midwives

The exodus from rural area to urban center or

other province

Inappropriate skill mix and gaps in service

coverage in poorer area

Large numbers of unemployed health

professionals

WHO The World Health Report 2006, p. 144

THE AUSTRALIAN


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CommunityHealth service

Public Health &Other health services

Repatriationhospitals

Publichospitals

Privatehospitals

Nursinghomes

Otherproviders

Doctors &optometrists

State/Territorygovernments

Commonwealthgovernment

Health insurancefunds

HEALTH CAREPROVIDERS

GOVERNMENTS& HEALTH FUNDS

INSTITUTIONS & OTHER

ORGANIZATIONS

THE AUSTRALIANHEALTH CARE

SYSTEM

Source: Palmer & Short (1989, p.18)


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Non Health

Health:-Financing

-Stewardship/

Health planning-Provision

-Resource

generation

-MarketFailures

-Stakeholders

-Regulations

-Time lag

-Potential

Market power

Utilization of

Health care

Education/training

Labor participation

Migration

Financial/Physical/

knowledge

Shortage

EquilibriumOver supply

Policies

Health care

System

Health

LabourDemand

HealthLaboursupply

Resources

Socio-demographic

Economic

Cultu

ral

Geog

raphical

HRH

CONCEPTUAL

FRAMEWORK

WHO (2004; p.5)


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Strategy Implementation:

PRIORITIES FOR ACTION

Educating & Training Health Workers

Supporting & Protecting the Health Worker

Community

Enhancing the Effectiveness of the Health

Workforce

Tackling Imbalances & Inequities

WHO, 2006


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Case: Educating & Training Health

Workers

Estimasi jumlah kebutuhan tenaga kesehatan

(berbagai profesi) di Indonesia tahun 2010 (646.692

orang)

Institusi pendidikan kesehatan yang ada TIDAKAKAN MAMPU memenuhi kebutuhan tersebut

Peluang ditangkap swasta, dirikan banyak PTS baru

Dampak UU Pendidikan: Pendidikan tinggi di bawahDepdiknas; kecuali kedinasan

Dikotomi: Poltekkes/Akademi vs STIKES


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Workers (2)

Dikotomi: Poltekkes/Akademi vs STIKES

Poltekkes/Akademi Kes. Di bawah Depkes;

berorientasi mutu (jumlah mahasiswa dibatasi)

STIKES di bawah Depdiknas berorientasi

mencerdaskan kehidupan bangsa; tak ada

batasan jumlah mahasiswa

Rumor: Depkes tidak akan menerima lulusan

STIKES!!


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Workers (3)

Dikotomi: Poltekkes/Akademi vs STIKES:

BAGAIMANA SOLUSINYA?

Alliance-coalition-merging??

Environment


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Health CareReform

Declared objectives:-Efficiency-- Equity

-- QualityStrategies:-Decentralization-Outcontracting

-Strategies for equity-Strategies for quality

Intermediary

Factors

-HR included in the

reforms agenda

-Congruence in values

-Timeframe allowing

participation

-Role of unions

-Implementation

process-Behavior of health

authorities

Human

ResourcesReactions

Individual responses:

-Incentives

-Motivation

-Psychological contract

Collective Responses:-Public sector

employees

-Professional

associations

-Non professional

Health workers

Environment-economic-driven

reform-other public sector

Changes-changing labor laws

HR ReactionsPerformance changes/

Industrial actions/Obstruction to

implementation/

Effects on HRDownsizing/

Performance-tied payment/

Flexibilization/

Changing roles

Documents

Sesi 17B_Health Human Power_Blok I_Dwi Handono