Desentralisasi, Dinasti Politik Dan Kemiskinan Di Indonesia

This paper examines the link between decentralisation, political dynasty and poverty in Indonesia. Data come from Indonesia Social Economic Survey 2013 and official statistics. Multilevel modelling is used to test whether people live in districts with political dynasty are poorer compared to other districts without political dynasty. The results show people live in districts with political dynasty are significantly poorer and it robust with other individual and district characteristics. The results highlight the detrimental effect of political dynasty on poverty in Indonesia and therefore policy makers should aware of the danger of political dynasty which can impede decentralisation in reducing poverty

Communal Conflict in Indonesia: Contagious or Latent Issues?

Penelitian ini mengkaji faktor sosial, ekonomi dan politik sengketa komunal yang terjadi di Indonesia dan menguji bagaimana sengketa komunal secara spasial terhubung antar kabupaten atau kota di seluruh Indonesia. Data bersumber dari Sensus Potensi Desa (Podes) tahun 2008 dan laporan statistik pemerintahyang berisi informasi mengenai sengketa komunal di seluruh kabupaten/kota di Indonesia (N kabupaten/kota= 465). Penelitian ini menemukan bahwa sengketa komunal di Indonesia terjadi akibat adanya faktor faktor laten di dalam kabupaten/kota. Dibandingkan dengan keragaman agama dan etnis, sengketa komunal memiliki hubungan kuat dengan kemiskinan, ketimpangan ekonomi, elite capture dan lemahnya kapasitas kabupaten/kota dalam mengelola sumber-sumber fiskal daerah

Desentralisasi, Tata Kelola Pemerintahan, Dan Kemiskinan Di Negara-negara Berkembang

Theoretical arguments of the link between decentralisation, governance and poverty reduction are merit, but the implementation of decentralisation often fails to reduce poverty. This paper examines why decentralisation works and does not work to reduce poverty in developing countries. It shows that decentralisation will benefit for poverty alleviation if exist local political competition, community participation, and capacity of local government

Desentralisasi Dan Kesehatan Keuangan Daerah Di Indonesia

Local government fiscal health is important for effective fiscal decentralisation. This study examines local government fiscal decentralisation in Indonesia. Data comes from Indonesian Financial Information System 2013. The findings show that after more than four decades decentralisation, most of local governments are still strongly depend on central government in financing local development. The wide gap of fiscal capacity exists between local government at Java and outside Java. The findings suggest that improving local government capacity in mobilising and managing fiscal resources is vital to improve local government fiscal health in decentralised Indonesia

Does Democracy Make You Happy? Multilevel Analysis of Self-rated Happiness in Indonesia

The linkage between democracy and citizen happiness in developing countries is rarely examined. This study examines the link between democracy and citizen happiness in Indonesia, a new emerging democratic country in South East Asia. Data comes from the Indonesian Family Life Survey 2007 (Nindividual = 29.055; Nhousehold = 12.528; Ndistrict = 262) and the Indonesian Family Survey East 2012 (Nindividual = 5.910; Nhousehold = 2.546; Ndistrict = 55). Results from a three-level ordinary logit model show that democracy as measured by age of direct local democracy is not associated with citizen happiness. Instead of age of direct local democracy, district community social capital and spending public services give benefit for citizen happiness.The results are robust against individual and district characteristics relatedto happiness. The results highlight the importance of promoting community social capital and improving district capacity in delivering public service to improve citizen happiness in Indonesia

Performance-based incentives and community health workers’ outputs, a systematic review

Objective To review the evidence on the impact on measurable outcomes of performance-based incentives for community health workers (CHWs) in low-and middle-income countries. Methods We conducted a systematic review of intervention studies published before November 2020 that evaluated the impact of financial and non-financial performance-based incentives for CHWs. Outcomes included patient health indicators; quality, utilization or delivery of health-care services; and CHW motivation or satisfaction. We assessed risk of bias for all included studies using the Cochrane tool. We based our narrative synthesis on a framework for measuring the performance of CHW programmes, comprising inputs, processes, performance outputs and health outcomes. Findings Two reviewers screened 2811 records; we included 12 studies, 11 of which were randomized controlled trials and one a non-randomized trial. We found that non-financial, publicly displayed recognition of CHWs’ efforts was effective in improved service delivery outcomes. While large financial incentives were more effective than small ones in bringing about improved performance, they often resulted in the reallocation of effort away from other, non-incentivized tasks. We found no studies that tested a combined package of financial and non-financial incentives. The rationale for the design of performance-based incentives or explanation of how incentives interacted with contextual factors were rarely reported. Conclusion Financial performance-based incentives alone can improve CHW service delivery outcomes, but at the risk of unincentivized tasks being neglected. As calls to professionalize CHW programmes gain momentum, research that explores the interactions among different forms of incentives, context and sustainability is needed

Performance-based incentives and community health workers' outputs, a systematic review.

ObjectiveTo review the evidence on the impact on measurable outcomes of performance-based incentives for community health workers (CHWs) in low- and middle-income countries.MethodsWe conducted a systematic review of intervention studies published before November 2020 that evaluated the impact of financial and non-financial performance-based incentives for CHWs. Outcomes included patient health indicators; quality, utilization or delivery of health-care services; and CHW motivation or satisfaction. We assessed risk of bias for all included studies using the Cochrane tool. We based our narrative synthesis on a framework for measuring the performance of CHW programmes, comprising inputs, processes, performance outputs and health outcomes.FindingsTwo reviewers screened 2811 records; we included 12 studies, 11 of which were randomized controlled trials and one a non-randomized trial. We found that non-financial, publicly displayed recognition of CHWs' efforts was effective in improved service delivery outcomes. While large financial incentives were more effective than small ones in bringing about improved performance, they often resulted in the reallocation of effort away from other, non-incentivized tasks. We found no studies that tested a combined package of financial and non-financial incentives. The rationale for the design of performance-based incentives or explanation of how incentives interacted with contextual factors were rarely reported.ConclusionFinancial performance-based incentives alone can improve CHW service delivery outcomes, but at the risk of unincentivized tasks being neglected. As calls to professionalize CHW programmes gain momentum, research that explores the interactions among different forms of incentives, context and sustainability is needed

Understanding community health worker employment preferences in Malang district, Indonesia, using a discrete choice experiment

Background Community health workers (CHWs) play a critical role in supporting health systems, and in improving accessibility to primary healthcare. In many settings CHW programmes do not have formalised employment models and face issues of high attrition and poor performance. This study aims to determine the employment preferences of CHWs in Malang district, Indonesia, to inform policy interventions. Methods A discrete choice experiment was conducted with 471 CHWs across 28 villages. Attributes relevant to CHW employment were identified through a multistage process including literature review, focus group discussions and expert consultation. Respondents' choices were analysed with a mixed multinomial logit model and latent class analyses. Results Five attributes were identified: (1) supervision; (2) training; (3) monthly financial benefit; (4) recognition; and (5) employment structure. The most important influence on choice of job was a low monthly financial benefit (US∼2) (β=0.53, 95% CI=0.43 to 0.63), followed by recognition in the form of a performance feedback report (β=0.13, 95% CI=0.07 to 0.20). A large monthly financial benefit (US∼20) was most unappealing to respondents (β=-0.13, 95% CI=-0.23 to -0.03). Latent class analysis identified two groups of CHWs who differed in their willingness to accept either job presented and preferences over specific attributes. Preferences diverged based on respondent characteristics including experience, hours' worked per week and income. Conclusion CHWs in Malang district, Indonesia, favour a small monthly financial benefit which likely reflects the unique cultural values underpinning the programme and a desire for remuneration that is commensurate with the limited number of hours worked. CHWs also desire enhanced methods of performance feedback and greater structure around training and their rights and responsibilities. Fulfilling these conditions may become increasingly important should CHWs work longer hours

A study of the quality of cardiovascular and diabetes medicines in Malang District, Indonesia, using exposure-based sampling

Background The WHO has warned that substandard and falsified medicines threaten health, especially in low and middle-income countries (LMICs). However, the magnitude of that threat for many medicines in different regions is not well described, and high-quality studies remain rare. Recent reviews of studies of cardiovascular and diabetes medicine quality recorded that 15.4% of cardiovascular and 6.8% of diabetes samples failed at least one quality test. Review authors warn that study quality was mixed. Because they did not record medicine volume, no study reflected the risk posed to patients. Methods and findings We investigated the quality of five medicines for cardiovascular disease and diabetes in Malang district, East Java, Indonesia. Our sample frame, based on dispensing volumes by outlet and price category, included sampling from public and private providers and pharmacies and reflected the potential risk posed to patients. The content of active ingredient was determined by high-performance liquid chromatography and compared with the labelled content. Dissolution testing was also performed. We collected a total of 204 samples: amlodipine (88); captopril (22); furosemide (21); glibenclamide (21) and simvastatin (52), comprising 83 different brands/products. All were manufactured in Indonesia, and all samples met specifications for both assay and dissolution. None was suspected of being falsified. Conclusions While we cannot conclude that the prevalence of poor-quality medicines in Malang district is zero, our sampling method, which reflects likely exposure to specific brands and outlets, suggests that the risk to patients is very low; certainly nothing like the rates found in recent reviews of surveys in LMICs. Our study demonstrates the feasibility of sampling medicines based on likely exposure to specific products and underlines the dangers of extrapolating results across countries