Individual Responsibilities in Partial Compliance: Skilled Health Worker Emigration from Under-Served Regions

One of the ways to address the effects of skilled worker emigration is to restrict the movement of skilled workers. However, even if skilled workers have responsibilities to assist their compatriots, what if other parties, such as affluent countries or source country governments, do not fulfil their fair share of responsibilities? This discussion raises an interesting problem about how to think of individual responsibilities under partial compliance where other agents (including affluent countries, developing states, or other individuals) do not fulfil their fair share of responsibilities. What is fair to expect from them? Taking health worker emigration as a case in point, I discuss whether the individual health workers’ fair share of responsibilities to address basic health care needs decreases or increases when the other parties do not fulfil their share. First, I review the responsibilities that different stakeholders may hold. Second, I argue that there are strong reasons against increasing or decreasing health workers’ fair share of responsibilities in a situation of partial compliance. I also argue that it is unfair for non-complier states to enforce health workers to fulfil their fair share or take up the slack.

Gender dynamics on access to maternal care among nine ethnics in Indonesia

This is a review of maternal mortality risk due to preference of non skilled health worker delivery assistance among 9 ethnics applying gender analysis. Data obtained from 9 ethnograpic studies reports conducted by Pusat Humaniora. Estimation of maternal mortality rate (MMR) in Indonesia is between 305 (Supas) – 359 (Susenas) per 100.000 live birth. There is no single cause of maternal death. The greatest contributors 75% are due to direct cause namely bleeding, infection, hypertension, delivery complication and unsafe abortion. Government intervention prioritizes to prevent direct cause of maternal death through health service delivery improvement. Among them are midwives in village, PONEK, PONED. However MMR is still high. Social factors as Indirect causes such as poverty, distance, information, inadequate service and culture have not yet considered as important. In fact contribution of social factors cannot be neglected. This review explores gender dynamics of preferences on non skilled health worker delivery assistance from 9 ethnic in Sumatra, Jawa and NTT. The results showed each ethinc had different gender dynamics. Among which are gender relation in each culture. Some ethnic shows gender equity, while others believe woman have full responsibility of her pregnancy and delivery without assistance from others. Powerlessness of woman is indicated by preference of traditional birth attendant for delivery due to culture and comfort. Even the pregnant women herself did not aware that delivery is a life risk. However the studies showed there is no sharp inequity with strong preference to boy over girl. Accessibility, education, comfort perceived culture, and economy are important for delivery assisted by health providers.

Regional Competitiveness and National Economic Growth

Indonesia is a country with a notable economic inequality both across its provinces and districts. This inequality can be attributed to the disparities in access to development. In this paper, the effects of regional competitiveness and economic reforms on economic growth is studied. Regional competitiveness factors include infrastructure pillar, health and education pillar, and labor market efficiency pillar. The data come from the Indonesia Database for Policy and Economic Research (INDO-DAPOER) of the World Bank for the year 2010. The results of the study show that the percentage of households with electricity, the percentage of births attended by skilled health worker, the net enrollment ratio for primary education, the number of people employed, and the total grants statistically and significantly influence regional economic growth positively. Indonesia is to reduce inequality in regional competitiveness and improve the total grants distribution in order to promote regional economic growth equality in the country.