Strengthening Indonesia's reproductive health education and training system: Progress to date

This paper describes the actions taken to strengthen Indonesias reproductive health education and training system. The paper was presented at a pre-congress seminar entitled "Learning Without Walls" that was held on October 13-14 1995 in Bali Indonesia in conjunction with the XVth Asian and Oceanic Congress of Obstetrics and Gynecology. A small group of decision makers was given the opportunity to update its knowledge of the "information revolution" and to explore the possible impact on health care education and training. Indonesia aims to make available basic high-quality reproductive health services. Indonesias health system lacks a sufficient number of health care personnel with reproductive health clinical skills and knowledge needed to provide appropriate services. Service deficiencies are particularly serious in villages and small health care centers (Puskesmas). Improvements are dependent on lowering maternal mortality through reductions in high-risk pregnancies (increased availability of modern contraception) and through increased availability of obstetric services. Indonesia has well-established and referenced competency standards of medical training that stress information transfer rather than skill transfer. In 1992 a model for change that incorporated competency-based clinical training was implemented. The supervised national training network included a national resource center for development of training modules provincial clinical training centers and district clinical training centers. Refresher training packages are now available for IUD and implant insertions and infection prevention and about 1000 service providers were trained. A standardized resource document on the development of training materials was developed. Trainers and training sites are available for expanding the use of CBT in medical and midwifery education and training.