CHAPTER 1
Introduction
Over the past decade, a number of important reforms and transitions have taken place in Indonesia and in its health sector. With the implementation of decentralization in 2001, the responsibility for delivery of services, including health services, was delegated to the district level. Public resources for health have increased almost fourfold since 2002, but Indonesian disease outcomes still lag those of many neighboring countries (World Bank 2008). At the same time, chronic diseases and injuries are becoming more prevalent while communicable diseases remain an important part of the burden of disease, changing needs for health care services and provider skills. Finally, the implementation of Law No. 40/2004, Universal Health Insurance Coverage, will influence demand for health services and health workers. As staffing responsibilities have evolved with decentralization, and as the number of training institutions has steadily risen, important human resource policy changes have been introduced in the health sector. The recruitment and incentive structures for health providers have undergone several changes over time, especially regarding remote area compensation. At the same time, the private health sector is expanding rapidly, and a combination of events has reduced the information that the government has about the private health sector. The regulatory framework governing human resources in the health field is weak at best, and public oversight 15