A methodology for assessing the professional development needs of nurses and midwives in Indonesia: paper 1 of 3

Deborah Hennessy,Yoanna Kawonal,Aflah Hilan,Carolyn Hicks

doi:10.1186/1478-4491-4-8

Abstract

BackgroundDespite recent developments, health care provision in Indonesia remains suboptimal. Difficult terrain, economic crises, endemic diseases and high population numbers, coupled with limited availability of qualified health care professionals, all contribute to poor health status. In a country with a population of 220 million, there are currently an estimated 50 nurses and 26 midwives per 100 000 people. In line with government initiatives, this series of studies was undertaken to establish the training and development needs of nurses and midwives working within a variety of contexts in Indonesia, with the ultimate aim of enhancing care provision within these domains.MethodsAn established, psychometrically valid and reliable training needs instrument was modified for use within the Indonesian context. While this technique has had widespread international use in the developed world, its application for developing countries has not yet been established. The standard form consists of a biographical cover sheet and a core set of 30 items (all health-related tasks), which have to be rated along two seven-point scales. The first of these scales asks respondents to assess how important the task is to their job and the second scale is a self-assessment of respondents' current performance level of the task. By comparing the importance rating with the performance rating, an index of training need can be obtained (high importance and low performance indicating a significant training need). The modifications incorporated for use in this series of studies were a further 10 items, which were constructed following expert group and focus group discussions and a review of the relevant literature. Pilot trials with 109 respondents confirmed its feasibility and acceptability. The instrument was then administered to 524 nurses and 332 midwives across Indonesia.ResultsThe data were subjected to a retrospective factor analysis, using a Varimax rotation and Cronbach's α to check the instrument's validity and reliability following modification. The results yielded six factors, which accounted for >53% of the variance, each of which had a Cronbach's α score of between 0.8644 and 0.7068.ConclusionThe results suggest that the modified instrument remained valid and reliable for use in the Indonesian nursing and midwifery context.

Highlights

Despite recent developments, health care provision in Indonesia remains suboptimal
All 30 items refer to tasks that are central to the health care professional's role and come within five superordinate categories: research/ audit, communication and teamwork, administrative/ technical, management/supervisory and clinical
The customization of the original instrument for use in Indonesia did not compromise its psychometric properties, and its ease of use by the respondents indicated its feasibility as a large-scale survey instrument for use with nurses and midwives in a wide range of health care contexts in Indonesia

Summary

Introduction

Health care provision in Indonesia remains suboptimal. Difficult terrain, economic crises, endemic diseases and high population numbers, coupled with limited availability of qualified health care professionals, all contribute to poor health status. In line with government initiatives, this series of studies was undertaken to establish the training and development needs of nurses and midwives working within a variety of contexts in Indonesia, with the ultimate aim of enhancing care provision within these domains. The management of health problems across a cultural and geographically diverse country is a major issue, which has been compounded by the political restructuring in 2001, decentralizing all government departments to autonomous provinces and districts. Embedded in this federalization programme was the requirement, incumbent upon each provincial government, to raise a third of its income independently of central government. A 33% drop in central resourcing represents a significant challenge to health care providers and this, together with the deteriorating heath status of the population, has significantly affected the quality and extent of health care provision

Methods

Results

Conclusion