sesi 17b_health human power_blok i_dwi handono
TRANSCRIPT
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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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HRH-Related Constraints 3
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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HRH-Related Constraints 4
Training Capacities:
Training: Number of trainees per skilled level
Retraining: Number of re-trainees per skilledlevel
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HRH-Related Constraints 5
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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Case: Educating & Training Health
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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Case: Educating & Training Health
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