Training Certification Research Articles

Transforming learning for adult protective services caseworker certification training: program evaluation of simulation training

ABSTRACT This study assesses the first statewide program to provide simulation training conducted via videoconference to all new caseworkers. The simulation training in Illinois was conducted at a mock house. A mock family played by standardized clients is physically present, and trainees participate remotely. The program evaluation team implemented a survey that asks trainees to rate their confidence in different skills at multiple timepoints, to appraise the quality of feedback and debriefing of the training team, and to write text responses to the questions regarding their learning experience. Analysis of quantitative data over the course of the training showed statistically significant linear increases in trainees’ confidence for all the 14 skills. Their text responses indicated that they received feedback they appreciated and felt they gained ability on a range of different skills. The simulation training makes a valued and effective contribution to the certification training.

Empowering Veterinary Herd Health Management: Insights into Education, Implementation, and Regulation Across Europe

In recent years, integrated veterinary herd health management (VHHM), improving animal health, welfare, food safety, public health, farm management, and economics, has become ever-more important in the European Union due to structural and regulatory advancements. A mixed-methods study analyzed the current state and gaps in VHHM education and training across Europe. Data from 41 European veterinary institutions showed that 83% (n = 34/41) offered VHHM education, either as standalone courses and/or integrated into other subjects. An online survey for veterinarians, primarily working with cattle, poultry, pigs, and small ruminants (75%; n = 86/114), assessed perceived training knowledge gaps and needs. The majority of respondents were unaware of VHHM training programs (69.4%, n = 43/62) or projects (59.6%, n = 59/99) and reported the biggest gaps in VHHM training certification (14%, n = 7/49), followed by soft skills (12%, n = 6/52) and demonstrating VHHM benefits to their clients (9%, n = 5/53). To conclude, while undergraduate VHHM education was generally adequate, enhancing post-graduate certified multi-species training opportunities, incl. soft skills VHHM training were perceived as essential. Our findings also underscored the urgent need for robust economic evaluations of preventive strategies across various animal species to allow veterinarians to better demonstrate VHHM’s direct and indirect benefits to farmers.

Improving the rights of people with mental disorders in the Republic of Croatia

Abstract The mental health care system in the Republic of Croatia, despite the ongoing reform, is still based on hospital treatment. Hospitalizations due to mental disorders are in first place according to the length of stay. According to the annual report of the Ombudsman in the Republic of Croatia, 2% of hospitalizations due to mental disorders are involuntary hospitalization. Coercive measures and deprivation of business capacity are also often used. In order to reduce the number of coercive measures, involuntary hospitalizations and deprivation of professional capacity, it is necessary to increase mental health literacy and knowledge about human rights and the rights of persons with mental disorders, both among mental health experts and among patients and their families, as well as the general public. In order to increase knowledge and skills related to the rights of people with mental disorders, the Croatian Institute of Public Health, has been conducting WHO Quality Rights workshops in Croatian counties since 2019. The two-day workshops include all stakeholders: local politicians and decision-makers, associations of people with mental disorders and their families, employees in the mental health care system with the involvement of the media. So far, the training has been conducted in five major Croatian counties. The Quality Rights e-training platform has been translated into Croatian and the link to access the training is available online. In order to ensure the sustainability of the program and expand knowledge and skills, obtaining a certificate of completed Quality Right training became a requirement for passing the specialist exam in public health and in psychiatry. In five years of implementation of the program, the number of coercive measures in psychiatric hospitals decreased by 58%. Respect for human rights is a prerequisite for improving the mental health care system and the mental health. of both patients and the entire population. Key messages • Respect for human rights is necessary for the mental health of the population. • Knowledge and skills about the rights of patients with mental disorders reduce the rate of coercive measures.

Pediatric pain physician workforce: an assessment of supply and demand.

Many youth with pain lack access to pediatric pain expertise. There is a critical shortage of pediatric pain physicians, due partly to a paucity of training programs in Pediatric Pain Medicine. Pain fellowships are Anesthesiology-based and there is no pathway to fellowship training or Pain Medicine board certification for pediatricians. This workforce assessment sought to examine the current state of Pediatric Pain Medicine in the United States and future interest in pursuing Pain Medicine among pediatricians. A multidisciplinary working group of Pain Medicine clinicians designed three surveys to examine pediatric comprehensive pain programs in the US, practice patterns of pediatricians and their motivations and opinions regarding Pain Medicine board certification, and current residents' exposure to and interest in Pediatric Pain Medicine. Wait times for initial evaluations are two months or longer for two-thirds of responding centers, and barriers to increase staff size and resources were reported, including an inadequate number of trained or available physicians. Pediatricians expressed interest in earning board certification in Pain Medicine, given the opportunity. Additionally, there is interest among pediatric residents in pursuing Pediatric Pain Medicine, and qualitative data highlight information residents perceived needing in order to pursue a career in the field. Results demonstrate the need for increased training opportunities in pediatric pain medicine. A formal pathway to Pain Medicine for Pediatricians should be developed to increase the potential workforce and to address the lack of trained pediatric pain specialists, thereby improving access to care for youth with pain.

GreenHopper: The Danish spearhead towards autonomous waterborne mobility

Abstract GreenHopper is the first Danish zero-emission ferry developed as a test platform for autonomous waterborne navigation technologies. The paper presents technology development within the innovation project ShippingLab Autonomy, which led to the commissioning of GreenHopper at Limfjorden (DK) in December 2022. The technology research resulted in a holistic system architecture for surface vessel autonomy, based on distribution of functionality and responsibility on software modules, similar to the structure observed in the International Maritime Organization (IMO) Seafarers Training Certification and Watch-keeping (STCW) regulatory framework. The paper shows how this approach results in an architecture that supports safe behaviours of individual modules and of autonomous navigation at a system level. The paper presents the individual modules, specific features and benefits. Elements of the regulatory framework are highlighted to poise technology approval by maritime authorities. The paper reflects on lessons learned, discusses continued technology validation in dedicated operational scenarios.

Inclusive and Equity Training Needs of a Lactation Consultant Training Certificate Program

Inclusive and Equity Training Needs of a Lactation Consultant Training Certificate Program

INSAFEDARE Project: Innovative Applications of Assessment and Assurance of Data and Synthetic Data for Regulatory Decision Support.

Digital health solutions hold promise for enhancing healthcare delivery and patient outcomes, primarily driven by advancements such as machine learning, artificial intelligence, and data science, which enable the development of integrated care systems. Techniques for generating synthetic data from real datasets are highly advanced and continually evolving. This paper aims to present the INSAFEDARE project's ambition regarding medical devices' regulation and how real and synthetic data can be used to check if devices are safe and effective. The project will consist of three pillars: a) assurance of new state-of-the-art technologies and approaches (such as synthetic data), which will support the validation methods as part of regulatory decision-making; b) technical and scientific, focusing on data-based safety assurance, as well as discovery, integration and use of datasets, and use of machine learning approaches; and c) delivery to practice, through co-production involving relevant stakeholders, dissemination and sustainability of the project's outputs. Finally, INSAFEDARE will develop an open syllabus and training certification for health professionals focused on quality assurance.

Gaps in Education: A Cross-Sectional Survey Study of Knowledge of Advanced Lifesaving Interventions among Canadian Lifeguards.

Objective: The aim of this study was to assess lifeguards' knowledge retention of airway management, oxygen administration, and ventilation interventions following certification and employer-provided training. Methods: This cross-sectional study was conducted using an online survey administered between February and May 2024. A total of 1322 responses from Canadian lifeguards certified in airway management and oxygen administration were deemed eligible for analysis. The survey included 15 knowledge assessment questions, with data analyzed based on lifeguard experience and the date of last certification or in-service training. Results: The mean knowledge assessment score was 10.4 ± 2.2 (69.3 ± 14.6%), with the highest scores in the airway management category and the lowest in the oxygen administration category. Lifeguard experience significantly increased knowledge retention, whereas recertification showed no significant impact, and employer-provided training significantly decreased knowledge retention. Conclusions: The findings underscore the importance of lifeguarding experience in knowledge retention among lifeguards. Optional airway management and oxygen administration recertification, coupled with inconsistent in-service training, have created significant gaps in lifeguard education. This study identifies the need for regular, competency-based training delivered by qualified facilitators. Addressing these gaps is crucial for enhancing the effectiveness of lifeguards in emergency response and ensuring high-quality care for drowning victims.

Challenges and Strategies of Developing Certified Anesthetist Nurse Practitioners in the Post-Pandemic Era in Taiwan

<p>臺灣的麻醉護理在專業定位、執業範圍、證照考試和標準化訓練制度等方面面臨著諸多挑戰，尤其2020 年衛生福利部雖將麻醉護理師正式納入專科護理師之制度內，但後續所推行之標準化課程也衍生出更多待解決之難題，如：未導入核心能力架構及評量機制、欠缺思考成人學習理論、龐大的訓練課程時數、麻醉專師之師資量能不足及欠缺系統性師資培育等窘境。本文提出二項教育改革的因應策略，首先是建構以勝任能力導向的麻醉專科護理教育架構並發展麻醉訓練專師之系統性評量工具，即「可信賴專業活動」，未來則需建立共創教學和共享資源文化，以促進教師之間的協作和知識分享，期能提高教學品質，並為教師和學員帶來更豐富、多元化的學習體驗。本文呼籲麻醉專師訓練應即刻進行課程再造，打破傳統以知識和時間為本的教學框架，改以混成授課、自主學習作為課程規劃與執行之原則，積極接軌「勝任能力導向教育」的全球發展趨勢，朝向共創、共享之目標邁進。</p> <p> </p><p>Anesthetist nurse practitioners in Taiwan encountered several challenges, particularly in terms of professional identity, scope of practice, certification, and standardized training programs. In 2020, the Ministry of Health and Welfare in Taiwan recognized anesthetist nurse practitioner as one of the advanced practice nurses and included them under the regulation of the nurse practitioner system. However, the implementation of the nationwide standardized training program had faced some unre-solved issues and challenges including that the lack of alignment with competency frameworks or pro-grammatic assessments, the extensive increase of training courses, neglects of adult learning theories, shortage of nurse anesthetists instructors, and lack of faculty development system for nurse anesthetist instructors. This article proposes two initiatives as responses to educational reform: 1. constructing a competency-based framework and developing programmatic assessments for training Student Reg-istered Nurse Anesthetist Nurse Practitioner (SRNANP) ; 2. establishing a culture of collaborative teaching and resource sharing. The new culture enhances teaching quality and provides a richer, more diverse learning experience for both trainers and trainees. The article emphasizes the need for im-mediate curriculum transformation in SRNANP training. It emphasizes on the removal of traditional knowledge-centric and time-centric teaching frameworks and focused on adopting blended learning and self-directed learning principles. By aligning with the global trend of competency-based educa-tion, we can actively move toward the goal of co-creation and resource sharing</p> <p> </p>

Hiring in the Pediatric Hospital Medicine Board Certification Era: PHM Leader Perspectives.

The designation of pediatric hospital medicine (PHM) as a board-certified (BC) subspecialty has led to uncertainty about the importance of PHM board certification in hiring pediatric hospitalists and ambiguity in counseling trainees interested in PHM careers about the decision to pursue fellowship. We sought to determine the importance of PHM board eligibility or certification in hiring practices. We conducted an online, cross-sectional, survey-based study of individuals who self-identified as PHM division leadership utilizing the PHM Division Director Listserv and participant recruitment at a national meeting. A total of 86 responses were received. A total of 64% (30/47) of university-setting hospitals, 77% (17/28) of community hospitals, and 100% (11/11) of combined settings reported that they will hire applicants who are not board-eligible (BE) or BC (P = .83). Of the hospitals who will be hiring non-BE hospitalists, 50% of university settings, 77% of community settings, and 55% of combined settings plan to give equal consideration to both BE and non-BE applicants (P = .21). A total of 57% (21/37) of programs with a PHM fellowship felt that fellowship training was an important or very important consideration in hiring, compared with 27% (13/49) of programs without a PHM fellowship (P = .04). Programs with a PHM fellowship were significantly more likely to believe that fellowship training is an important consideration in hiring hospitalists. PHM board certification and fellowship training are perceived as more important by university-based programs, although all settings will consider hiring applicants who are not BC or BE.

The Development of Clinical Sociology in Malaysia

This article discusses the significant contributions made by Wan Halim Othman in the advancement of clinical sociology in Malaysia. Wan Halim, introduced as the progenitor of Clinical Sociology in Malaysia, has played a pivotal role in social issue management and his unique approaches have had a lasting social impact in the country. This article starts with the backdrop of the country and the main figure - Wan Halim Othman, and then discusses the various innovative and impactful initiatives that he has spearheaded using the clinical sociology approach. Programmes such as PINTAS and the social clinic exemplify the profound capacity of clinical sociology to address intricate societal issues. Wan Halim has effectively empowered marginalized communities and promoted social cohesion by implementing new strategies, like community mediation and support groups specifically designed for single moms. Though clinical sociology is gaining traction in Malaysia, much needed to be done to further recognize and institutionalize this discipline. Among the proposed next steps include the formalization of clinical sociology by implementing comprehensive curricula, hands-on training, and professional certification. The author emphasizes the significance of fostering collaboration among academia, government, and civil society in order to establish clinical sociology as an institutionalized field and effectively tackle urgent societal issues.

Survey-based analysis of cybersecurity awareness of Turkish seafarers

In recent years, vessels have become increasingly digitized, reflecting broader societal trends. As a result, maritime operations have become an attractive target for cyber threat actors. Despite the limited cybersecurity training seafarers receive, they are expected to operate within technologically advanced environments. The importance of cybersecurity awareness is evident, but the extent of seafarers’ knowledge in this area remains uncertain. This article investigates three primary aspects: (1) the current state of cybersecurity onboard cargo vessels, (2) seafarers’ cybersecurity awareness, and (3) potential improvements in seafarers’ cybersecurity awareness. To accomplish this, a literature review is conducted to collect and analyze current research, supplemented by a questionnaire survey targeting Turkish seafarers. Our findings support increased investment in awareness and training programs, including organizational-wide cybersecurity awareness efforts, more frequent training, mandatory training for all seafarers through the Standards of Training Certification and Watchkeeping (STCW), and the appointment of a cybersecurity Officer (CySO) to ensure satisfactory cybersecurity levels onboard. Since this article focuses on high-level topics by assessing the general state of maritime cybersecurity and seafarers’ cybersecurity awareness, it does not delve into detailed considerations of awareness and training programs. Nevertheless, it lays the foundation for future research in this area.

Modeling the unsteady wake of an impulsively started circular cylinder using refined potential flow theory

Cylindrical structures find usage in many engineering applications including tethered oil drums and engine canisters slung beneath helicopters in flight. The motion of air around such circular cylindrical structures and the helicopter presents interesting phenomena including flow separation, wakes and turbulence. The physics of these are enshrined in the continuity equation and the Navier–Stokes equations. Therefore, their studies are not only important in mathematics and physics, but they are also required for efficient helicopter operations. In practice, reduced-order models of these operations that take in aerodynamics models of the tethered loads are utilized for stability analysis, flight certification and pilot training because of the prohibitive cost of experimentation and computational analyses of these configurations. However, there is a dearth of realistic analytical models of finite cylinder flows because of the Navier–Stokes problem. Classical potential flow theory provides an avenue to develop such models, but the extant gaps in its predictions significantly preclude its usage for engineering applications. Attempting to bridge these gaps, this article introduces refined potential flow theory in which the governing equations and boundary conditions are satisfied. Viscous effects, fluctuations of the mean flow and three-dimensional effects are also incorporated. For characterization, refined potential flow theory is employed on an incompressible flow over an impulsively started circular cylinder for Reynolds numbers and non-dimensional times in the range 30<Re<104 and 0.2 ≤ T ≤ 77, 047 respectively. There is an excellent prediction of 0.209 for the Strouhal number at Re=3,900 . At this transitional Reynolds number, the harmonics of the Strouhal frequency are also captured, and the characteristic irregular fluctuations at sub-Strouhal frequencies are discernible in the velocity spectra. As the flow becomes more turbulent, these become more pronounced at Re=9,500 when the predicted Strouhal number is within 10% of experimental result. In the fully developed stage, spectra analyses of the wake velocity components at some downstream locations also display Kolmogorov's Five-Thirds law of homogeneous isotropic turbulence. The present model can thus aid the development of reduced-order models of helicopter operations that feature tethered cylindrical loads.

Competency Mapping of Key Stakeholders in Procurement and Contracting of the National Tuberculosis Elimination Program Goods and Services in an Eastern Indian State

Abstract Background: The National Tuberculosis Elimination Program is a complex program, and the program officers are involved in the procurement and contracting of goods and services under it. A competency mapping was conducted to highlight the current capacity gaps in contract management at state and district levels under the program. Materials and Methods: A descriptive cross-sectional design was adopted with 15 participants involved in procurement and contracting in two districts of the state using a semi-structured questionnaire, and results were presented using the descriptive statistical analysis. Results: A total of 15 different stakeholders from the National Health Mission, State and District Tuberculosis (TB) Cell, State TB Training and Demonstration Centre, and State Medical Corporation participated in the study. The participants had an average of 10.3 years of experience in contracting, and 20% of them had received some training on contracting. The capacity of these respondents varied based on their involvement, previous training (s) received, and technical background. It was further observed that most of the respondents suggested an in-person physical training instead of virtual training. Most of the respondents requested to issue training certificate. Some of the topics that the participants requested for further training include Digital Signature Certification, Government e-Marketplace, General Financial Rule, Public Financial Management System, monitoring of performance indicators, and bid evaluation techniques. Moreover, 92% of the respondents felt that there is a training need on procurement and contracting. Conclusions: Many a time, the program officers come from a technical background not relevant to the contracting and procurement of goods and services and require regular on-the-job support and training to aid in effective program delivery.

Certification issues in training economic personnel for AIC

The goal is to analyze literary sources interpreting the term “certification” and develop recommendations aimed at professional growth and career of graduates of agricultural universities. Methods – comparisons, generalizations. Results – the essence of the concept of “certification” is revealed. The role of this process for students of Kazakh universities is shown in view of development of agricultural economy in the republic, taking into account such principles as economic orientation, internationalization, transformation and autonomy in modern conditions, characterized by the formation of competitive environment focused on meeting the needs of labor market. The main requirements and trends related to organization of certification in this industry, set out in the relevant government documents (concepts, regulations, etc.), are presented. The example of M. Kozybaev North Kazakhstan University, in which Certification Training Center has been opened to train students in 1C software products, with further expansion of employment opportunities and promotion prospects for graduates of economic educational programs based on application of digital competencies in the field of accounting (accounting in agricultural enterprise). Mastering these disciplines will provide solid knowledge and allow students to successfully pass the qualifying exam and subsequently receive the “1C: PROFESSIONAL” certificate. Statistics on the work of the Center, the number of trained students who received certificates and jobs at enterprises in agricultural sector are presented. The authors note that certification is one of the most important areas of activity of any university, which helps a young specialist to be effective and successful in agricultural market for job vacancies. Conclusions – gaining of knowledge on the basis of non-formal education will contribute to the effective implementation of the 3L concept in employment in various sectors of economy and provision of competitive personnel.

State Civil Apparatus Welfare of Public Elementary School Teachers in Bandar Lampung City

Teacher welfare is an important aspect that affects the standard, quality of life, and work of teachers. The components of welfare for the Indonesian State Civil Servant (ASN) are basic salary, allowances, work environment, security aspects in granting civil servant (PNS) status, awards, work-life balance between working hours and workload, and the development of certified teacher professionalism. The study population was ASN SDN teachers totaling 1466 people. Sampling using purposional sampling random method based on the lottery obtained a sample size of 155 people. The research objective was to determine the effect of consumption expenditure, education level, training, work experience, and teacher certification on the welfare of ASN SDN teachers in Bandar Lampung City. The estimation method used Ordinary Least Square (OLS). The findings are that the level of education, training, work experience, and teacher certification have a positive and significant effect on the welfare of ASN primary school teachers in Bandar Lampung City, while consumption expenditure has a negative and significant effect on the welfare of ASN primary school teachers in Bandar Lampung City. In the future, it is necessary to improve education, training, and experience, as well as teacher certification to improve welfare. In addition, it is necessary to maintain the purchasing power of teachers' income so that it is not eroded by inflation which reduces purchasing power.

The Roles of NGOs in Skill Development of The Street Food Vendors for Hygienic Food Preparation and Serving in Bangladesh

This paper tried to explore the roles of non-government organizations in developing the skills of street food microentrepreneurs in health and safe food preparation and servicing in the western part of Bangladesh. The study utilized a qualitative approach, using a purposive sampling method to select respondents for in-depth interviews, key informant interviews, and focus group discussions. The street food vendors and stakeholders were selected from the project team, and the research tools included in-depth interviews with 20 vendors, interviews with 8 key stakeholders, and two focus group discussions with customers and entrepreneurs. The researcher discovered that NGO plays a critical role in skill development for street food vendors in Bangladesh. Prior to the project, vendors were unfamiliar with safety, hygiene, cleanliness, and sustainable promotion. The project improved their skills in safety and security, market promotion, hygiene maintenance, cleanliness, and sustainable development by implementing various activities like training, meetings, workshops, food festivals and fairs, market linkage, stakeholder involvement, online and offline market promotion, and so on. The project also increased restaurant customers and market creation. However, the study found that food safety NGO workers and street food programs have collaborated to raise awareness about food safety, health, hygiene, and environmental issues. These initiatives have improved health and lifestyles, improved food quality, increased client numbers, and increased business profits. The stakeholders gathering in Bogura and Rajshahi focused on promoting product certification, with some microenterprises pursuing it. Microenterprises received work-based training on food safety and hygiene, leading to advancements in food packaging, safe raw materials, cleanliness, and hygiene practices. Product certification training increased stakeholders’ understanding of the importance of certification, and some MEs are now following it. The NGO organized a fair to highlight reputable food businesses and raise awareness of environmental sustainability, hygiene, and food safety. The entrepreneurs know how to prepare healthy dishes, increasing sales and revenue. This awareness have been raised due to the NGO’s interventions implemented for street food vendors in the study area.

Advances in Pediatric Telehealth Education and Training: A National Survey.

Background: The COVID-19 pandemic accelerated the formal integration of telehealth into education curricula and training programs, prompting the need to reevaluate the current landscape and inform a research agenda. We developed a survey to assess telehealth education and training curriculum, competencies, certification, and research across pediatric medical centers. Methods: Questions were derived from a previously published national survey and de novo. The survey was distributed across national pediatric professional associations. Results: In total, 32 respondents representing medical centers (86.5%) were providing telehealth education and/or training. Most were internally developed didactic (78.6%) and experiential (64.3%) curricula. Respondents who included education and/or training in telehealth research protocols and conducted telehealth research (74%) reported mandatory or optional training in tele-research. A form of certification was preferred by most organizations (>60%). Conclusion: Telehealth education and training are key factors within current and future service development, provision, and research to demonstrate competencies and positively impact patient care.

The evaluation and enhancement strategies of core competencies for older adult caregivers in integrated medical and older adult care institutions.

The study aimed to understand the main skills of older adult caregivers and find ways to improve these skills. We selected participants using a method called random cluster sampling, where caregivers from 17 different medical and nursing care facilities across seven districts in Hangzhou were chosen. We collected 492 valid questionnaires and conducted interviews with 150 people. To analyze the data, we used T-tests and Analysis of Variance (ANOVA) to identify what factors affect caregivers' skills. We also performed multiple regression analysis to explore these factors in more depth. The analysis showed that age (p = 0.041), annual income (p < 0.001), and having a training certificate (p < 0.001) significantly influence the skills of older adult caregivers. Specifically, caregivers' age and whether they had a training certificate were linked to how competent they were, with income being a very strong factor. The study highlighted a gap between the caregivers' current skills and the skills needed for high-quality care. This gap shows the need for training programs that are specifically tailored to the caregivers' diverse needs and cultural backgrounds. Medical and eldercare facilities should adjust their work and educational programs accordingly. It's also important to look at how caregivers are paid to make sure their salary reflects their skills and the quality of care they provide. Finally, it's crucial to integrate a comprehensive training program that leads to certification within eldercare organizations.

Analysis of Implementation of City Policy for Children Basic Health and Child Welfare Cluster in Makssar City

Background: Implementation of the child-friendly city policy in the basic health and child welfare cluster is a step towards realizing a child-friendly city, through fulfilling children's rights to basic health and child welfare carried out by the Makassar City Government together with the business world and the community. Objective: The aim of this research is to analyze the implementation of child-friendly city policies in Makassar City in the basic health and child welfare cluster. Method: The research method used was a qualitative-exploratory approach using observation, in-depth interviews and literature study of all research informants selected using purposive sampling. The theory used is the implementation theory of Van Metter and Van Horn. Results: The results of this research indicate that the implementation of the child-friendly city policy in the basic health and child welfare cluster in Makassar City has been successful but has not run optimally. Human resources are sufficient but not of high quality, the budget is still limited and there is no clear time target. Characteristics of implementing agents who are less firm in implementing policies. The attitude/tendency of the implementing agent has shown acceptance. Communication and coordination between organizations has not been established well. The economic, social and political environment is not yet conducive. Conclusion: Although human and financial resources are sufficient, the lack of certification training and coordination between implementing agencies as well as the low economic level of the community hinder the effective implementation of this policy.