Alternatif Strategi Pelaksanaan Peran Regulasi Pascadesentralisasi Di Daerah = Alternative Strategies To Implement Regulatory Function Post Decentralization At The Provincial And District Level

Abstract

Background: Several reports and observations have urged the need to strengthen regulatory function in decentralization era. This is not unexpected as regulation is not only a new role for the provincial and district health office, but also regulation is not perceived as an important role. Limited literature in this field motivates the author to compose this review paper, with the objective to define regulatory function and its activities, and to discuss strategies to strengthen this function. Subject and methods: This policy paper reviews regulatory concepts in the context of decen¬tralization in health. Empirical papers and on-going projects related to development of this regulatory function is presented to illustrate the concept. Results: Regulatory function differs from provision of services in terms of its objective, unit of analysis, consequence and requirement. The objective of regulation is to ensure quality of service provided by health care facilities. The unit of analysis is, therefore, not only government facilities but also those that are privately owned.The scope of regulation covers modern, comple¬mentary and alternative medicine. Consequently, this function should be implemented in a credible and objective way, either through licensing, certification and accreditation. Two strate¬gies were presented to develop this regulatory function, i.e. strengthening the capacity of pro¬vincial-district health offices or building alliance with an independent body. Conclusions: This paper has presented the definition and breadth of regulatory function in terms of its scope and activities. Taking into consideration the design, information, capacity, authority and context, an appropriate strategy should be explored and determined by the pro¬vincial or district health offices. Future development of the strategy should then be based on a multiyears planning. Keywords: decentralization, regulatory function, healthcare service delivery, development strateg