SYSTEMATIC
REVIEW ANALYSIS OF GOVERNMENT POLICY IMPLEMENTATION OF COVID 19 PROVISION
INCENTIVES IN INDONESIA
Marianus Ruba*, Ede
Surya Darmawan
Faculty of Public Health, Universitas Indonesia, Jakarta, Indonesia
Email: [email protected]*
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Article Information |
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ABSTRACT |
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Received:
December 12, 2022 Revised:
December 25, 2022 Approved: January 03, 2023 Online: January 07, 2023 |
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The emergence of the COVID-19 pandemic has had a significant impact on
health workers, who are on the front lines of the COVID-19 fight. The issue
of health worker incentives persists to this day. The occurrence of the
COVID-19 pandemic has greatly impacted health workers as the front line in
the fight against COVID-19. The problem of incentives for health workers
continues to this day. Many factors must be considered by regulators and
executors at the national and regional levels, as coordination of providing
incentives for health workers is deemed ineffective. These include a failure
to absorb the budget allocated for health worker incentives, particularly at
the regional level, a large number of health workers complaining that
incentives have not been distributed, and a reduction in incentives for those
at the forefront of dealing with the COVID-19 pandemic. Furthermore, changing
regulatory issues in accelerating the provision of COVID-19 health worker
incentives are one of the factors that cause delays in paying health worker
incentives. Even though the COVID-19 pandemic is over, it is critical to pay
attention to the evaluation of policies for providing health workers
incentives for COVID-19 that are not only focused on the time of the COVID-19
pandemic but also on the agenda for providing health workers incentives in
general. Google Scholar was used to conduct a systematic review. Articles are
then found in the search results that meet the criteria. A systematic search
turned up eight articles that best matched the study objectives. The study
design, perspective, and results of the evaluation of the COVID-19 health
worker incentive policy vary greatly. The COVID-19 incentive program for
health workers may be a solution to improving health workers' performance in
health services. Delays, regulatory issues, and the availability of funds are
all issues that must be addressed at a later date. So that the program's
success can reflect the government's success in dealing with COVID-19. |
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Keywords |
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Policy Evaluation, COVID-19, Incentives, Health Workers |
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INTRODUCTION
In
early January 2020, the world was shocked by a serious outbreak caused by a
virus called Coronavirus Disease (COVID-19) (Hadi et al., 2020). This virus is believed to have first appeared on
November 31, 2019 in the city of Wuhan, China. This epidemic has spread to
several countries so that it becomes a global pandemic. (COVID-19) entered
Indonesian territory in early 2020 which resulted in many people being infected
with the virus. In Indonesia, the government declared the COVID-19 pandemic as
a national disaster on Saturday, March 14, 2020 (RI, 2020).
Circumstances
beyond the predictions of the COVID-19 disease outbreak have brought urgent
changes to various sectors. The development of the virus quickly spread
throughout the world. Every day data in the world reports the increasing
coverage and impact of COVID-19 (Junaedi & Salistia, 2020). Indonesia is also in a state of national emergency.
The number of deaths due to Corona has continued to increase since it was first
announced that there were people who were positive for the COVID-19 virus.
With
the outbreak of this virus, the demand for health services has increased. The
impact is that many people infected with the virus died, not only the community
as patients but also health workers (health workers) who were affected by this
virus also died due to this pandemic due to the Covid-19 virus infection factor
and the fatigue factor due to the booming number of patients.
Health
development is inseparable from the participation of health workers. Health
workers are the main key to success, where the achievement of health
development goals and contributions is up to 80% (Sjafari et al., 2020). Health workers are the group most instrumental in the
examination and treatment of suspected and confirmed positive patients
Coronavirus Disease 2019 (COVID-19).
Since
the beginning of the pandemic, the President of the Republic of Indonesia has
expressed his commitment to provide protection in the form of incentives to
health workers who provide services for Covid-19 cases. This is stated in the
Decree of the Minister of Health (KMK) RI No. HK. 01. 07/Menkes/2539/2020 which
states that all health workers who provide services to Covid-19 patients are
entitled to incentive funds and if they die are entitled to death compensation.
The
provision of incentives seems to be one of the attractions for health workers
to continue to work during this COVID-19 pandemic, this is in line with the
purpose of providing incentives, one of which is to retain employees so that
there is no employee turnover that is too frequent. Incentives are a form of
compensation in the form of direct rewards paid to employees because their
performance exceeds the specified standard (Rivai & Sagala, 2009). Incentives from the government to health workers can
provide moral encouragement to health workers to work harder in serving
patients exposed to the corona virus, as well as a motivational tool that is
expected to improve the performance of health workers (Ministry of Health, 2018)
Previous
research related to the effect of incentives on retention of health workers on
special assignments at DTPK in Papua province in 2011 is obtained an
illustration that incentives are not the main factor affecting retention of
health workers on special assignments in DTPK where government policy factors
are more decisive retention of health workers in DTPK (Fitriani et al., 2020).
The
Effect of the Provision of Covid-19 Incentives on the Performance of Healthcare
Workers at Hospital X which was researched by Rosita and Simamora (2021) showed that the provision of incentives had a
positive and significant effect on the performance of health workers.
Therefore, the provision of incentives for COVID-19 health workers is very
important and needs special attention to the COVID-19 pandemic is over
Based
on the problems and some of the conditions above, it is very necessary to
evaluate policies related to the provision of incentives for health workers for
COVID 19 which will be used as the basis for government preparedness and as a
reference for the success of the program, both during the pandemic and the
continuation of similar programs in the future.
METHODS
The study used qualitative approach with systematic
review using database: Google Scholar.
There are Inclusion Criteria and Exclusion Criteria in
examining the data source (Creswell & Poth, 2016).
Article inclusion criteria used:
1) an
article that describes the Evaluation of Health Worker Incentive Policies;
2) the
article is written in Indonesian;
3) published
articles have complete sections;
4) published
in 2020
Article exclusion criteria include:
1) do
not use Indonesian.
2) the
composition of the articles is not complete.
RESULTS
Search
results using the keyword "COVID 19 Incentive Evaluation of Health
Workers" using the electronic Google Scholar database. Search results
using these three keywords yielded 263 articles. Then filtered articles with
inclusion and exclusion criteria obtained 127 articles. Selection of the next
article by eliminating duplication of articles with the results of 16 articles.
Furthermore, the elimination of articles based on a complete arrangement of 8
articles was carried out.
Figure 1. Prism Diagram
Table 1
Article Extraction Results
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Author(s), year |
Number of Subjects Study |
Results |
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Library search
techniques (literature study) |
The
resulting policy alternatives include: a) Clarify
the time limit for disbursement of incentives through joint circulars with
the Minister of Health, Minister of Home Affairs & Minister of Finance, b) Provide
routine assistance from the Ministry of Health's Human Resources Development
and Empowerment Agency (BPPSDM) for Hospitals/Health Service Facilities in
inputting COVID-19 incentive data 19 c) c)
Increase the number of officers who enter data into the application and
provide appropriate rewards |
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76 Health workers
as research sample |
Based
on the validation test, reliability test, simple linear regression test,
correlation coefficient test, coefficient of determination test and t test,
it can be concluded that there is a significant influence between Covid-19
incentives on the performance of health workers at Hospital X by 34.7% which
has been tested |
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Object of research
are 55 people |
The
results of this study found that there was a significant influence between
training on employee performance in medical personnel, there was a
significant effect between giving incentives to employee performance in
medical personnel, there was a simultaneous effect between training and
providing incentives on the performance of home medical personnel. |
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Head of UPTD
Blahbatuh Health Center I, Covid-19 Sensitive Verification Team I UPTD Health
Center Blahbatuh I, doctors and nurses who treat Covid-19 patients |
The
results of this study indicate that there are several benefits obtained by health
workers with this incentive, namely health workers feel appreciated for the
work they do. Covid-19 Health Workers are more enthusiastic at work and have
a better work ethic after receiving incentives. The Covid-19 incentive is
also used to help families who are not working due to being affected by the
pandemic so that the benefits of the Covid-19 incentive are not only for
yourself, but also for others. The Covid-19 incentive received is IDR
5,000,000, with the nominal said that the incentive has met the principle of
eligibility because it exceeds the Gianyar Regency Minimum Wage standard in
2021. Although it has met the principle of eligibility, the Covid-19
incentives have not met the principle of justice because there is no nominal
difference between health workers' professions. Doctors, nurses, midwives,
and other health workers receive the same nominal amount of incentives, even
though each health worker has their own responsibilities and SOPs. A
supporting factor in the implementation of the Covid-19 incentive, namely the
I-Nakes application made by the government, has functioned well and can make
it easier for verifiers to find out how much the nominal incentive can be
disbursed. Meanwhile, several inhibiting factors in implementing the Covid-19
incentives are (1) announcements from the Health Office are often rushed to
the deadline, and (2) there are too many reports that must be made and are
often collected collectively. |
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The writing of
this article uses a qualitative approach by utilizing descriptive analysis
methods. Library method |
The
important findings of this paper are, first, negative narratives and the
government's slow response to the spread of COVID-19 in Indonesia shows no
sense of crisis that threatens to slow down decision-making. Second, weak
coordination between stakeholders, especially between the central government
and local governments. or citizens' disobedience to government advice. As a
result, the handling effort has stalled because it is not supported by the
wider community. The combination of these three factors complicates the
government's efforts to control the spread of COVID-19 in Indonesia |
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Education
and training center financial manager Yogyakarta Finance |
The
results show that the refocusing of budget reallocation activities is in
accordance with the regulations. There were obstacles at the beginning
because there is still no decision regarding the training that can be carried
out. |
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Normative Law
Research |
The results showed
that the P value was 0.06, it was concluded that there was no relationship
between incentives and motivation of health workers who provided services
during covid-19 |
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ASN who work as
Nursing Paramedics as many as 374 people |
The
results of this study are work life balance partially positive and partially significant
effect on the work engagement of nurses at Pirngadi Hospital to the work
engagement of nurses at Pirngadi Hospital |
DISCUSSION
Based
on the eight articles above, the research sites are all located in Indonesia,
namely Yogyakarta, Bali and Central Java. The population in this study on
average is health workers who serve covid 19 patients. The eight articles above
use both qualitative methods with in-depth interviews and quantitative methods
by filling out questionnaires. The results of the research all refer to
problems related to incentives, both the process of distributing incentives and
the process of receiving incentives for COVID-19 health workers.
A. Influence of Incentive Policy
for Health Workers
The purpose of providing
incentives is essentially to increase employee motivation in an effort to
achieve organizational goals (Handoko, 2010).
This is intended to encourage employees to work more actively and better, so
that employee performance can increase, which in turn will ultimately achieve
the company's goals. With incentives, it is expected that someone will have
high performance
Based on the above, it can be
concluded that incentives are very influential on the performance of an
employee. Therefore, it is very appropriate in the midst of the COVID-19
pandemic, the government issued a policy of COVID-19 Incentives for Health
Workers.
B. The urgency of incentives to
improve performance
Incentives or compensation
are considered to be able to motivate employees and in the end will have implications
for improving employee performance and at the same time are expected to improve
organizational performance. In general, incentives can be understood as rewards
from organizations for the performance of their employees (Perry
et al., 2009).
Incentives are various tools
or techniques used to meet employee needs, to ensure employee job satisfaction
and at the same time realize organizational goals (Druskienė & Šarkiūnaitė, 2018).
Incentives are related to financial incentives (monetary incentives) and moral
incentives (moral incentives). Mukherjee (1998)
provides another opinion on the components of compensation and rewards that are
specifically related to Civil Servants.
C. Adequacy of budget for health
worker incentive payers
The next thing that needs to
be considered in evaluating the policy for providing incentives for health
workers is the availability of the budget. The total budget that can be
reallocated for the COVID-19 response is IDR 425 trillion. This does not
include the budget for meetings in each agency and service which of course are
not utilized, working visits, both domestically and abroad, food and drink
budgets, and so on. These budgets can be allocated to purchase PPE for health
workers or to buy more accurate swab kits so that mass tests can be carried out
immediately. Or if you have to do a regional quarantine, the budget can be
allocated as an incentive for informal workers who do not get income during the
COVID-19 outbreak with the Cash Direct Assistance mechanism.
D. Based on the above, it is
clear that the available budget for handling COVID-19 is very adequate
The Problem of Incentives for
Health Workers COVID 19 in Indonesia Analysis of the problem of delays in
payment of incentives for health workers handling COVID-19 using the fishbone
method, where there are 5 main problem identifications, namely policy issues,
governance, implementation, budgeting, and supervision. Regulatory issues
between regulations regarding payment schemes which changed in the middle of
the fiscal year, governance related to the process of submitting and verifying
data, budget problems, namely the budget reallocation process requires its own
time and procedures, so that the implementation of these provisions is hampered
by incentives for health workers to handle COVID-19.
E.
Evaluation
of the success of the COVID 19 incentive program for health workers
The results of the evaluation
of the provision of COVID 19 incentives to health workers found several things,
including; 1) Incentive late payment issues 2) Fluctuating regulatory issues
and, and 3) the problem of Availability of Budget provided by the government
The COVID 19 incentive program for health workers can
be a solution to improve the performance of health workers in health services.
The problem of delays, regulatory problems and also the availability of the
budget are things that need to be evaluated at a later date. So that the
success of the program can reflect the government's success in handling
COVID-19.
REFERENCES
Agustino, L. (2020). Analisis
Kebijakan Penanganan Wabah Covid-19 : Pengalaman Indonesia Analysis Of Covid-19
Outbreak Handling Policy : The Experience Of Indonesia. Junal Borneo
Administrator, 16(2), 253–270. Google Scholar
Creswell,
J. W., & Poth, C. N. (2016). Qualitative inquiry and research design:
Choosing among five approaches. Sage publications. Google Scholar
Dewi,
L. P. S. K. (2021). Evaluasi Penerapan Insentif Tenaga Kesehatan COVID-19
(Studi pada UPTD Puskesmas Blahbatuh I). Accounting and Business Information
Systems Journal, 10(1). Google Scholar
Druskienė,
A., & Šarkiūnaitė, I. (2018). Motivational incentives of civil servants in
Lithuanian municipalities. Viešoji Politika Ir Administravimas, 17(3),
344–370. Google Scholar
Fitriani,
I., Maidin, A., Zulkifli, A., & Maidin, A. M. R. (2020). Analysis of
medical specialist satisfaction of Mokopido Hospital Tolitoli and Undata
Hospital Palu about national health insurance’s implementation. Enfermería
Clínica, 30, 436–438. Google Scholar
Ginting,
I. R., Maulida, F., Ulfah, I. A., Elfiyani, N. K., Dara, P., & Pratomo, H.
(2020). Analisis Kebijakan Global Travel Warning Selama Pandemi Covid-19 Dan
Implementasinya Di Indonesia: Analysis Of The Global Travel Warning Policy
During The Covid-19 Pandemic And Its Implementation In Indonesia. Quality:
Jurnal Kesehatan, 14(2), 85–100. Google Scholar
Hadi,
A., Werge, M., Kristiansen, K. T., Pedersen, U. G., Karstensen, J. G., Novovic,
S., & Gluud, L. L. (2020). Coronavirus disease-19 (COVID-19) associated
with severe acute pancreatitis: case report on three family members. Pancreatology,
20(4), 665–667. Elsevier
Insan,
M. Y., Batubara, S. S., & Wulandari, N. (2022). Determinasi Faktor yang
Mempengaruhi Keterikatan Kerja Perawat di RSUD Pirngadi Medan Pada Era Covid
19. Maneggio: Jurnal Ilmiah Magister Manajemen, 5(1), 11–19. Google Scholar
Junaedi,
D., & Salistia, F. (2020). Dampak Pandemi COVID-19 Terhadap Pertumbuhan
Ekonomi Negara-Negara Terdampak. Simposium Nasional Keuangan Negara, 2(1),
995–1013. Google Scholar
Lestyowati,
J., & Kautsarina, A. F. (2020). Implementasi Realokasi Anggaran Dan
Refocussing Kegiatan Di Masa Pandemi Covid-19 Studi Kasus Bdk Yogyakarta. Simposium
Nasional Keuangan Negara, 2(1), 424–439. Google Scholar
Perry,
J. L., Engbers, T., & Jun, S. Y. (2009). Back to the future. Performance-Related
Pay, Empirical Research, and the Perils of Persistence. Public Administration
Review, 69(1), 39–51. Google Scholar
Rivai,
V., & Sagala, E. J. (2009). Manajemen sumber Daya Manusia untuk Perusahaan,
edisi kedua. Penerbit: Rajawali Pers, Jakarta. Google Scholar
Rosita,
R., & Simamora, T. M. (2021). Penyelenggaraan Pelayanan Kesehatan Ibu dan
Anak di Puskesmas Terpencil dan Sangat Terpencil di Masa Pandemi Covid-19. AN-NUR:
Jurnal Kajian Dan Pengembangan Kesehatan Masyarakat, 1(2), 225–238. Google Scholar
Rositoh,
R., Oktavia, G. G., & Putri, V. A. (2021). Pengaruh Pemberian Insentif
Covid-19 terhadap Kinerja Nakes Di RS X. Jurnal Health Sains, 2(7),
949–955. Google Scholar
Silalahi,
A., & Kurniawan, A. (2021). Akselerasi Pembayaran Insentif Tenaga Kesehatan
Penanganan COVID-19. Jurnal Analis Kebijakan, 5(2), 187–194. Google Scholar
Sjafari,
A., Nugroho, K. S., & Arenawati, A. (2020). Analisis Peningkatan Indeks
Pembangunan Bidang Kesehatan di Provinsi Banten. JIPAGS (Journal of
Indonesian Public Administration and Governance Studies), 4(1). Google Scholar
Suwandi,
S., Wibasuri, A., & Magdalena, B. (2021). Pengaruh Pelatihan Dan Pemberian
Insentif Terhadap Kinerja Tenaga Medis. Jurnal Ilmiah Ekonomi Manajemen:
Jurnal Ilmiah Multi Science, 12(2), 104–118. Google Scholar