Implementation Status & Results Indonesia Health Professional Education Quality Project (P113341)

Transcription

1 Public Disclosure Authorized Public Disclosure Authorized The World Bank Implementation Status & Results Indonesia Health Professional Education Quality Project (P113341) Operation Name: Health Professional Education Quality Project (P113341) Project Stage: Implementation Seq.No: 4 Status: ARCHIVED Archive : 04-Jun-2011 Country: Indonesia Approval FY: 2010 Product Line: IBRD/IDA Region: EAST ASIA AND PACIFIC Lending Instrument: Specific Investment Loan Implementing Agency(ies): Ministry of National Education Key s Board Approval 24-Sep-2009 Original Closing Planned Mid Term Review Last Archived ISR 04-Jun-2011 Effectiveness 09-Dec-2009 Revised Closing Actual Mid Term Review Project Development Objectives Project Development Objective (from Project Appraisal Document) The specific Project Development Objectives are to strengthen quality assurance policies governing the education of health professionals in Indonesia. This will be achieved by: 1) rationalizing and assuring competency-focused accreditation of public and private health professional training institutions; 2) developing national competency standards and testing procedures for certification and licensing of health professionals; and 3) building institutional capacity to employ results-based grants for encouraging the use of accreditation and certification standards in the development of medical school quality. Has the Project Development Objective been changed since Board Approval of the Project? Yes No losure Authorized Public Disclosure Authorized Component(s) Component Name Component Cost Component 1 Strengthening Policies and Procedures for School Accreditation 7.18 Component 2 Certification of graduates using a national competency-based examination Component 3 Results-based FAP for Medical Schools Project Management 5.24 Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Implementation Status Overview The 4th Implementation Review Mission was conducted from October 24th to November 1st, 2011 and the wrap up meeting was conducted on November 21st. The mission found significant progress have been made in the three Project components especially in the completion of key activities to achieve this year's performance indicators for Component 1 and Page 1 of 6

2 2. This year's indicators for both components are the establishment of two independent bodies for health professions education; one is for accreditation of health study programs (the Independent Accreditation Board for Health Professional Education Institution or LAM-PTKES) and the other one is for the competency testing (Board for Development of Competency Testing or LPUK). The delays in the establishment of both agencies are mainly due to longer time needed for the legal reviews and stakeholder consultations, and also the time to develop robust business plans to ensure the validity and sustainability of these new institutions. These activities are still ongoing and the establishment of the agencies is now projected to be achieved next year. Although the Project is not going to achieve those two indicators, two task forces have been established to exercise the functions of the two agencies. For instance, currently the task force for accreditation is conducting the LAM-PTKES functions such as preparing the accreditation of schools whose accreditations have expired, and the task force for competency testing LPUK is currently implementing activities to build the capacity of the National Health Professional Council (MTKI) in competency testing. In exercising these functions both task-forces are working in close collaboration with the major stakeholders. The disbursement of the Project fund is lower than expected, with projected only 18 percent of total Project value compare to the initial projection of 33 percent. The main reasons for the low disbursement are the Ministry of Education and Culture (MOEC)'s efficiency policy to cut the budget for transport, and also delays in this year's budget availability and delays in processing several procurement packages at the CPCU that have to be carried over to the next fiscal year. The first year implementation of the Financial Assistance Package (FAP) marked by delays in the budget availability which subsequently delayed the implementation of planned activities. This brings more difficulties to the partnership between leading medical schools under Scheme A and the weaker ones under Scheme C in implementing their joint plans, especially in re-scheduling activities. There were delays in completing procurement packages among grantees and several packages will have to be carried out in Despite of the delays the disbursement in the grant component is projected to be 76% of the total allocation for the grant component. Locations No Location data has been entered Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Mean Test Score of Graduates from FAP Percentage Value Recipient Schools who take the National 03-Jan Feb-2012 Competency Testing Average from 41 FAP Not yet available recipient Medical Schools, non-weighted. The baseline will be updated with the weighted average once it is available Graduates of health professional schools Percentage Value passing the national competency testing at first 31-Dec Jan-2011 attempt Medical 71.67%, Dental Medical 84%, Dental 83%, 81.69% Nursing 65%, Midwifery 65% Graduates of Medical Schools passing the national competency test at the first attempt Percentage Sub Type Supplemental Value Page 2 of 6

3 Graduates of Dental Schools passing national competency test at the first attempt Health Professional Schools (medical, dental, nursing, and midwifery) that have gone through the accreditation process and publicize the results Establishment of the National Agency for Competence Examination of Health Professionals (NACE HealthPro) Establishment of the independent National Accreditation Agency (NAA) Percentage Sub Type Supplemental Percentage Value Value Accreditation instrument is just being pilot-tested/tried out 31-Dec-2009 Consortium of College of Indonesian Doctors (KDI) and Association of Medical Education Institutions (AIPKI) is the current engagement The name of the body is now agreed to be called Lembaga Pengembangan Uji Kompetensi or Board of Competency Testing Development (LPUK). The Business plan is being fimalized Medical 100%, Dental 100%, Nursing 48%, Midwifery 18% The Charter of NACE HealthPro i/lpuk is established in Dec-2009 The Joint Commission of National Accreditation Board for Higher Education (BAN- PT) and Indonesian Medical Council (KKI) 21-Nov-2011 Commitment building among multi-stakeholders and the legal review and academic papers are being finalized. A task force has been established to exercise the function of the NAA especially to start accrediting schools whose accreditation is expired Charter of the NAA is established in 2012 Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Number or percentage of medical schools Number Value receiving finance support to strengthen the 30-Nov-2010 program 42 medical schools passed the proposal review and 41 of them have signed the contract to receive the grant Page 3 of 6

4 A charter supporting the establishment of the NACEHealth Pro (National Agency for Competency Examination of health Professionals) including its tasks and responsibilitis, and working arrangements The National Accreditation Agency NAA has access to adequate numbers of suitably trained assessors The National Accreditation Agency (NAA) has independent and adequate budget to conduct accreditation Education and competency standards are agreed by all stakeholders and published Responsibility for policies on prefessional accreditation, certification, and school licensure are clear and accepted by key stakeholders for each of four health professions 31-Dec-2009 Current arrangement for competency testing: Consortium of College of Indonesian Doctors (KDI) and the Association of Medical Schools (AIPKI) 19-Oct-2010 Under development The charter has been established by the end of 2011 Percentage Value Numbers of trained assessors for each profession: Medical : 60 Dental : 30 Nursing : 105 Midwifery : Dec-2009 A Joint Commission between the National Accreditation Agency for Higher Education and Indonesian Medical Council is the current arrangement An independent NAA has adequate budget to cinduct accreditation 31-Dec-2009 Medical and Dental: Standards for Medical and Standards of Competencies Standards of Competencies Dental are being reviewed; for and Standards of Education and Standards of Education Nurses and Midwives have for four professions are released by Indonesian finalized drafts and waiting for agreed by all stakeholders Medical Council (KKI) in 2006 Nursing: Drafts of both standards are available Midwifery : Standards of Competencies released by MOH in 2007 and Draft standard of education available validation and published 31-Dec-2009 Medical and Dental : Indonesian Medical Council (KKI) established in 2006 Under development GoI has established a formal entity with responsibility for oversight of accreditation Page 4 of 6

5 Data on Financial Performance (as of 07-Feb-2012) Financial Agreement(s) Key s Nursing and Midwifery : a formal entity with responsibility for oversight of accreditation standards, competency-based examination for each profession, nursing and midwifery is not yet established standards, competency-based examination of each nursing and midwifery profession Project Loan No. Status Approval Signing Effectiveness Closing P IBRD Effective 24-Sep Oct Dec-2009 Disbursements (in Millions) Project Loan No. Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P IBRD Effective USD Disbursement Graph Key Decisions Regarding Implementation Page 5 of 6

6 During the mission the mission team suggests to the CPCU to prioritize the recruitment of procurement management specialists and financial management specialists to support the Project implementation as already projected from the beginning that the workload will peak in the fiscal year 2012 and there will be additional workload from the carried over procurement packages and activities from FY The newly recruited procurement specialist has already been active in January The finalization of the accreditation framework still requires further consultation with the Indonesian Medical Association (KKI), particularly regarding the functions and authorities of the LAM-PTKES. It was agreed during the mission that the Directorate General of Higher Education will call a meeting in the near future involving the relevant parties to clarify the functions and authorities of the LAM-PTKES with the Indonesian Medical Council (KKI). A forum to discuss lessons learned and to intensify communication between the more advance medical schools (Scheme A) with the weaker ones (Scheme B) will be established to improve the partnership mechanism under the FAP grant component. The forum and also increasing the involvement of AIPKI (The Association of Medical Education Institutions) to improve the external review process is hoped to improve the implementation of the partnership. The forum will also bring up issues that require attention and interventions from higher authorities, i.e., the DG of Higher Education. The Fifth Implementation Review is scheduled to be conducted in May 2012 that includes initial review of some of the Project Component as a part of the Mid Term Review scheduled for the next year. The initial review in May 2012 will also focus on the disbursement and the measures that the CPCU has taken to overcome the lower that expected disbursement in The Mid Term Review will be conducted in October Restructuring History There has been no restructuring to date. Related Projects P Additional Financing for Health Professional Education Quality Project Page 6 of 6