Faculty of Public Health - Andalas University - OCS, 13th IEA SEA Meeting and ICPH - SDev

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Decentralization and District Health Sector Reform: Civil Servant’s' Perception of the Practice and Anti-Corruption Commitment in Local Government Health Agencies in Indonesia
Faisal Mansur

Last modified: 2018-08-17


Background : This paper discusses the practice of corruption in the context of Indonesian decentralization and regional autonomy administration. Government officials become inseparable part of local politics. To be chosen as the head of government agency, government officials should serve as the political supporters for a politician who want to run for governor or mayor. If selected as a department head position, they work more as part of the party loyalist whose interest is to maintain their power rather than providing services needed by their people.

The Ministry of Health is one of the major contributors in the case of corruption in Indonesia. Former ministers and officials of the ministry have been imprisoned. This situation shows that corruption is still a common practice in government health institutions. Corruption cases handled by the Anti-Graft Commission are important lessons for health officials, not least in the local government.

This study seeks to find out whether or not there are positive effects of corruption in the health ministry on local government agencies. This study also looks at whether the health institution has governance good spirit, as a result of the anti-corruption movement since 2002.

Materials and methods : The data comes from an e-mailed questionnaire, distributed by 27 April to 17 June 2013. The questionnaire asks about the respondent's perception of corruption and anti-corruption commitment of leaders where they work. Respondents are public servants in local government health agencies who took the MPH program at the University of Gadjah Mada. Respondents are from district health authorities (43%), hospitals (17%), primary health care centers (15%), MOH health training institutions (15%), or other health related institutions (7%). They come from 29 provinces of Indonesia with the average work experience of 7,9 years, average age of 37 years



Results: Findings are the contrary to what we expect. Institutions perceived to have a high commitment in fighting corruption is only 36%. Forty seven percent of institutions are perceived as “easy to do corruption”. Almost fifty percent have weak regulatory environment to put sanction to corruption practices. Organizations perceived to have high corruption level indicate anti-corruption commitment 2 times stronger than those with low corruption level. Organizations perceived as high corruption level are also 36 times more likely to represent the view that corruption is easy to do in their organizations, and 8 times more likely to have “weak regulatory environment” compared to organizations with lower level perception of corruption.


Conclusions : This study shows that anti-corruption is not yet the spirit of management and policies practices in local health institutions. This is odd because various forms of "reforms" through decentralization is meaningless. Health management appointment mechanisms should be seriously evaluated, particularly in regard to the political contract trend with local governors and majors.