“Service Development Under ASEAN Economic Community” Health and Education Fasli Jalal...

“Service Development Under ASEAN Economic Community”

Health and Education

Fasli JalalChairperson of BKKBN

INDONESIA among ASEAN COUNTRIES

Basic Demographic Indication

Demographic transition is taking place at among the fastest rates compared with other regions of the world, whether in terms of fertility reductions, population ageing, and rural-to-urban migration. Rapid epidemiological transition is also occurring, with the disease burden shifting from infectious to chronic diseases.

Kanchanachitra C, Lindelow M, Johnston T, Hanvoravongchai P, Lorenzo FM, Huong NL, Wilopo SA, Rosa JF. Human resources for health in southeast Asia: shortages, distributional challenges, and international trade in health services. Lancet; 2011

Availability of Health Workers in South East Asia


Production of Health Workers in South East Asia

Trade in Health Services


Migration of ASEAN Health Workers


Kebutuhan, Perkiraan Lulusandan Kekurangan/Kelebihan Tenaga Kesehatan Tahun 2014

No Jenis Tenaga

Tahun 2014

Kebutuhan 2014

Ketersedia-an 2013

Lulusan

Atrisi (2,5%/ tahun)

Kekurangan/

Kelebihan

1Dokter Spesialis

29.452 20.602 366 515 8.999

2 Dokter Umum 117.808 85.405 6.939 2.135 27.5993 Dokter Gigi 26.998 28.772 1.675 719 (2.730)

4 Perawat 387.785 427.24328.83

510.681 (57.612)

5 Bidan 184.075 217.01618.54

55.425 (46.061)

6 Perawat Gigi 39.269 37.897 1.085 947 1.2357 Apoteker 29.452 31.076 3.946 777 (4.793)

8Asisten Apoteker

58.904 53.293 4.864 1.332 2.080

9 SKM 29.452 35.424 6.174 886 (11.260)10 Sanitarian 36.815 26.631 1.685 666 9.16511 Gizi 58.904 44.364 1.812 1.109 13.837

12Keterapian Fisik

14.726 10.816 730 270 3.450

13Keteknisan Medis

22.089 25.036 4.107 626 (6.428)

Challenges : Human Resources of Health in Indonesia

10

Incompatibility of Role & Functions of MoH & MoE

Incongruity of regulations for health education

Geo

grap

hic

chal

leng

esD

emographic challenges

Healthcare in AEC 2015

Lim J. Healthcare & AEC 2015: framework for considering benefits and costs. Available at www.insightshealthassociates.com. Downloaded March 2014

http://www.insightshealthassociates.com/

Trade in Health Care Services• Two types of health care services:

1. Medical professional services2. Health services by hospitals or other facilities (e.g.

laboratory, ambulance)

• Four modes of service trade:

Hanvoravongchai P. ASEAN Community 2015: what is it all about. Department of Preventive & Social Medicine, Faculty of Medicine Chulalongkorn University.

Mutual Recognition Arrangement

• Allows health professional (doctors, dentists, nurses) certified in one ASEAN country to be recognized in other countries within certain conditions, such as:

• Registration and certification by the regulatory authority of the country of origin

• Active practice experience

• Compliant with Continuing Professional Development

• Free of professional ethical violation or any legal proceeding

• Compliant with other assessment or requirement by host country

Hanvoravongchai P. ASEAN Community 2015: what is it all about. Department of Preventive & Social Medicine, Faculty of Medicine Chulalongkorn University.

• Goals of Mutual Recognition Agreements:

• Encourage Foreign Direct Investment (FDI)

• Meet short-term skill shortages

• Facilitate upgrading of local population

• Meet international commitments under GATS/FTA

• Challenge: policies and regulatory frameworks affecting mobility of skilled labor flow

Lim J. Healthcare & AEC 2015: framework for considering benefits and costs. Available at www.insightshealthassociates.com. Downloaded March 2014

http://www.insightshealthassociates.com/

Strategic Steps : Continous Quality Improvement

Quality of System

Quality of Schools

Quality of Graduates

Quality of Practice

The Best Health Outcomes

Health Education System

Accreditation System

Certification System

Continuous Professional Development

QUALITY CASCADE

3 Paradigms of Reform

•Standards of Education •Standards of Competencies•Academic paper of Education System

for each profession

• Accreditation System• Competency Examination

System• Indonesian Qualification

Framework

Partnership between government, professionals community & independent agencies

Partnership among professions :

education to services

Re-engineering Quality Culture

agent for maintaining sustainability

REGULATORY REFORM IN HEALTH HIGHER EDUCATION

PRE PROJECT POST PROJECTPROJECT IMPLEMENTATION

Act No.20/2003 : National Education

System

Government Decree No.19/2005 :

National Education Standard

Act No.36/2009 : Health

Act No.29/2004 : Medical Practices

Act No.44/2009 : Hospital

Act No.20/2005 : Teacher & Lecturer

< Year 2010 Year 2010 - 2014 > Year 2014

Act No.12/2012 :Higher Education

Ministrial Decree :Accreditation system

Ministrial Decree :National HE Standards

Ministrial Decree :Quality Assurance System

Joint Decree (MoEC-MoH):Competency Examination

Joint Decree (MoEC-MoH):Teaching Hospital for Public Universities

UU No.20/2013 :Medical Education

Health Worforce Act

Nursing Act

Govern. Decree :Teaching Hospital

Ministrial Decree :Competence Certificate

Joint Decree (MoEC-MoH):Transfer of academic coaching for the

instititutions under MoH to MoEC

Govern. Decree :Primary Healthcare &

Internship Arrangement

Govern. Decree :Clinical Lecturer

Ministerial Decree :Medical Student

Selection

Ministerial Decree :Medical Faculty

GovernanceDGHE Decree :Student Quota

Harmonization of higher education & health regulation

Educ

ation

Sec

tor

Hea

lth S

ecto

r

Road Map from Quality Education into Services : Lessons Learned from Medicine

Academic diploma

& Professional

diploma

Professional Certificate

& Competency

Certificate

Letter of Registration

(STR)

Letter of License

(SIP)

Medical Faculty Professional Organization

Independent Agency of Accreditation & Competency Examination

Indonesian Medical Council

Government

Stakeholder Roles & Authorities & Legal Aspects

• Higher Education Decree• Medical Education Decree

Medical Practice Decree

Regulations on Foreign Ownership in the Healthcare

Sector of each ASEAN Country

• Indonesia

Foreign equity share limit in hospital services, clinics of specialist doctors, clinic laboratories and medical check-up clinics is 67%.

SIGNIFICANT IMPORTANCE

• The 12th ASEAN Summit in January 2007- Cebu Declaration on the Acceleration of the Establishment of an ASEAN Community by 2015.

• This process is set up to achieve the noble target in enduring solidarity and unity among the nations and peoples of ASEAN.

• “Education is the pre-eminent source of economic development in the 21st century, creating more and higher quality jobs and bolstering economic growth”. (20th APEC Economic Leaders’ Declaration: Annex D Promoting Cross-Border Education Cooperation)

I. ROAD MAP for the DEVELOPMENT of ASEAN QUALIFICATION REFERENCE FRAMEWORK

Adoption of the Cha-Am Hua Hin Declaration-2009• DEVELOP national skills framework national skills framework as an incremental

approach towards an ASEAN skills recognition framework;

• PROMOTE greater mobility of students;• SUPPORT greater mobility of skilled workers;• DEVELOP an ASEAN competency-based occupational ASEAN competency-based occupational

standard standard aimed at supporting the development of ASEAN human resources that are regionally and globally competitive;

• ENCOURAGE the development of a common standard of competencies for vocational and secondary education as a base for promoting mutual recognition.

ASEAN QUALIFICATIONS REFERENCE FRAMEWORK

OBJECTIVES: OBJECTIVES:

development of infrastructure in the form of Regional common reference frameworks that enable:

1. deepen integration and harmonization by strengthening mutual trust and cooperation among ASEAN nations

2. create a common identity;3. support and inform reform in individual countries,

providing guidance and promoting good international policy and practice in HRD;

4. Facilitate transparency and commonality of multiple complex systems; mobility of workers and students;

5. support economic imperatives such as removal of barriers to trade by promoting labour market mobility with fair recognition of competencies and reduction of barriers to the mutual recognition of the skills and qualifications.

Bateman&Cole-2013; David Lythe-2013

20142014

the ANNZFTA Qualifications Reference Framework Forum held in late April 2011

2011

The creation of the free flow of skilled labour through ‘harmonisation and standardisationFormation of MRAs

20072005

The ASEAN Framework Arrangement on Services (AFAS) of 1995

Referencing Processes is concluded

2015

2018

Establishment of AQRF BoardSectoral implementation

1995

The 12th ASEAN Summit in January 2007- Cebu Declaration on the Acceleration of the Establishment of an ASEAN Community by 2015

2012-2013

Oct 12- concept paper of AQRFMarch 2013 draft outlines of AQRF

66

55

44

77

88

33

22

11

99

VOCATIONAL & PROFESSIONAL

VOCATIONAL & PROFESSIONAL

CERTIFICATION

CERTIFICATION

EDUCATION G

RADES OR LE

VELS

EDUCATION G

RADES OR LE

VELS OCCUPATIONAL PATHWAYS

OCCUPATIONAL PATHWAYS

IN INDUSTRY OR WORK

IN INDUSTRY OR WORK

PLACEPLACE

INDIVID

UAL EXPERIENCE O

R

INDIV

IDUAL E

XPERIENCE OR

SELF

LEARNIN

G

SELF

LEARNIN

G

Yr-11

Yr-12D-1

D-2

D-3

Vocational

Professional

S-1D-4

S-2

S-3

Operator

Technician

Expert+

Time of in

dividual e

xperie

nce or s

elf learn

ing

II. Strategic Alliances among ASEAN Universities

• Specific Educational Program(s) based on Strategic Alliances is required to be operated under national and international laws.

• Strategic Alliances should be engaged based on these five principles:

1. Prioritizing the national development2. Equal and mutual respect3. Highest value addition to a Quality improvement4. Sustainable5. Diversity

Types of Specific Educational Program(s)

based on Strategic Alliances

Degree awarding programs:1. Joint Degree (Program Gelar Bersama) 2. Double degrees (Program Gelar Ganda)

2 types of Double Degree programsA.Acceleration or fast track B.Regular

Operating Modes

• Credit Transfer (Program Pemindahan Kredit) & Credit Earnings (Program Perolehan Kredit);

• Twinning (Program Kembaran)• Joint Supervision (Program Pembimbingan Bersama dalam

Penelitian);• Student and/or Staff Exchanges (Program Pertukaran

Mahasiswa dan/atau Dosen)

MINISTRY OF EDUCATION AND MINISTRY OF EDUCATION AND CULTURE’S COMMITMENT FOR AFAS CULTURE’S COMMITMENT FOR AFAS 88

Universities throughout the world, including those in South-East Asia, will no longer be the sole producer and disseminator of knowledge amid the emergence of multiple competitors such as corporate universities, research institutes, industrial laboratories, think tanks and various kinds of consultancies.

Greater cross-border provision through transnational education expansion and the concentration of research expertise and funding will ensure that this area will continue to be of interest and concern to higher education providers and policy makers.

South-East Asian higher education institutions face multiple challenges. How well they redefine and reinvent themselves to suit the changing societal needs in the era of globalization is critical for their development and future.

There is a need for greater cooperation and collective effort in tackling the challenges of making higher education more relevant and competitive within the global knowledge economy.

Universities also have a role to play in promoting inclusive multiculturalism and universal values. This has become even more significant given the greater polarization of communities and religions around the region and the world.

Student and academic mobility and exchange can serve to share a greater sense of cross-cultural understanding and tolerance among ASEAN member countries and communities.

HPEQ DIKTI

Together We Can

Thank You

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