Abstract
BackgroundIn 2000, an external review mission of the National Tuberculosis Control Programme of Indonesia identified suboptimal results of TB control activities. This led to a prioritization on human resource capacity building representing a major shift in the approach following the recommendations of the external review team.Case descriptionThe National Tuberculosis Control Programme (NTP) used a systematic process to develop and implement two strategic action plans focussing on competence development based on specific job descriptions. The approach was a change from only focussing on training, to a broader, long term approach to human resource development for comprehensive TB control.A structured plan for capacity building, including standardized competency based training modules and curricula, was developed in the first phase. This was supported by an organisational system comprised of a training focal point, master trainers, and regional training centres in which nationwide training of supervisors was implemented. Training was expanded to the health service delivery level in the second phase, as well as broadened in the scope of activities beyond training to also include other aspects of human resource development.Discussion and evaluationThe result was improved technical and managerial capacity of health workers for TB control at all levels. The impact on case detection and treatment outcome was spectacular, with major improvements in quality of all aspects of service delivery.ConclusionThe strategic decision by the NTP in 2000 to put the highest priority on capacity building has resulted in impressive progress towards TB control targets, a progress that despite many challenges has been sustained.
Highlights
In 2000, an external review mission of the National Tuberculosis Control Programme of Indonesia identified suboptimal results of TB control activities
The strategic decision by the National Tuberculosis Control Programme (NTP) in 2000 to put the highest priority on capacity building has resulted in impressive progress towards TB control targets, a progress that despite many challenges has been sustained
DOTS, the TB control strategy recommended by the World Health Organization (WHO) [2], was introduced in Indonesia in 1992 with combined tuberculosis-leprosy pilot projects in four Sulawesi provinces
Summary
As the implementation of the DOTS strategy progresses, the complexity of HRD increases, with major challenges related to the long-term management of training and staffing remaining. The mechanism of in-depth assessments through comprehensive monitoring missions, including key internal and external partners, has been continued following the mission in 2000; and these assessments do include the HRD activities. This mechanism provides a systematic, regular situation analysis that includes identification of problems. Ensuring that all staff involved are highly competent, as well as ensuring that there are enough staff available, requires continued priority attention to training and staffing activities from the NTP, other sectors of the Ministry of Health, other ministries, as well as from donors and other partners, over the coming years. The experiences gained by the NTP in Indonesia, in collaboration with key partners, are major contributing factors in the development of global strategies for HRD in TB control
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