Incentive and Compensation Advocacy Data Update Report

Volume VI Period 1 August 2021 2 September 2021

This report contains updated data on the sixth receipt of incentives for health workers in Indonesia. LaporCovid-19 together with health professional organizations and Indonesia Corruption Watch have collected data on receipt of incentives and compensation to health workers during the ongoing pandemic since early 2021. We are making this effort to ensure the government protects health workers and fulfills the mandate of Minister of Health Decree No. 4239 of 2021 concerning Providing Incentives and Compensation to Health Workers.

Providing incentives for health workers who handle Covid-19 is like an endless polemic. Within a period of one month, namely from 1 August 2021 to 2 September 2021 (via following form), LaporCovid19 received at least 131 complaints regarding incentive funds. Meanwhile, the 131 reports received were spread across both government and private health service facilities.

This report was obtained from health workers (nakes) spread across various provinces, including: East Java, West Java, DKI Jakarta, North Sumatra, Banten, and Papua.

Problems in Providing Incentives for Health Workers

The problems in providing incentives for health workers are quite diverse. Starting from not receiving it, the distribution being irregular, the amount not being in accordance with the KMK technical guidelines, to incentives being cut.

Figure 1. Types of incentive problems based on distribution status

The graph in Figure 1 shows that as many as 51% of reports or 67 reports state that health workers have not received any incentives that should be their right. Meanwhile, other reports show that incentives have been received by health workers. However, providing these incentives does not always run smoothly. Of the 64 reports stating that incentives had been received, 35 of them complained about problems in providing these incentives.

Figure 2. Distribution of reports that health workers have not received incentives by province

In the graph in Figure 2, it can be seen that East Java, West Java and DKI Jakarta are the regions with the highest number of health worker incentives that have not been received. However, reports regarding incentives have also spread to other regions such as North Sumatra, Banten and Papua. The number of reports received does not necessarily indicate the actual situation, it could be that there are many similar incidents that other health workers have experienced but have not reported to LaporCovid-19.

The following are examples of reports from residents who complain about incentives that have not been received by health workers:

• Haven't got it at all. My friend in the same profession has got it. My 2 friends and I couldn't get it because my KTP couldn't be input by the system, even though in other systems our KTP could be used. Please help, this is really unfair because our work is equally hard and equally risky. Thank You. (Laboratory Analyst, Hospital, Batam, 27 August 2021)

Figure 3. Details of types of incentive problems

The graph in Figure 3 shows the complexity of providing incentives for health workers. Not only is the problem of incentives not yet being received, but when these incentives are given to health workers there are also problems. 31 reports showed that the provision of incentives was often irregular according to schedule, some of them even complained that the provision of incentives suddenly stopped even though the handling of Covid-19 was still running as usual.

We still received other reports such as incentives being cut by the Health Facilities management so that the amount of incentives obtained did not comply with the technical guidelines of Minister of Health Decree 4239/2021 this month. This means that there have been no efforts to improve supervision and monitoring in providing incentives for health workers, which should have been running for more than a year.

The following are several examples of reports from residents who complained about problems in providing incentives for health workers:

• May to August 2020: Rp. 454,545, September 2020 to July 2021 (currently) not yet available. I work in the emergency room where every Covid patient is treated or goes home at their own request. However, based on the policy here, it is only based on the number of days exposed to patients who ARE TREATED divided by 14 times the appropriate number even though almost every shift is exposed because they are in the ER. Please help to take action, it has not been disbursed for 10 months but there has been no follow-up from the local government/health department/director of the local hospital. (Doctor, Hospital, South Kalimantan, 16 August 2021)

• January until now but the amount of funds coming in is not appropriate. I have reported it to the hospital HRD but until now I have not received a definite answer. And the incentive funds in November 2020 have not been paid until now. There is no further news at all (Nurse, Hospital, Banten, 6 August 2021)

• I was only submitted for 2020, I was not submitted for 2021 even though I work in the Covid unit (Doctor, Hospital, Bali, 16 August 2021)

Safety Threatened, Incentives Never Obtained

Health workers, whether they handle Covid-19 patients directly or indirectly, certainly have a high risk of exposure to Covid-19. In fact, quite a few of them ended up being infected with Covid-19. Therefore, protection is needed extra to maintain stamina and enthusiasm in the services provided for patient care and recovery.

However, even though health workers have been fighting at the forefront in handling Covid-19, not all of them have received protection extra as should be guaranteed by the Government. Many health workers have been/are currently confirmed positive for Covid-19, but they do not receive incentives. Those infected with Covid-19 are dominated by health workers who provide direct services to Covid-19 patients.

Of the 67 health workers who have not received incentives, 29 of them reported having/are currently infected with Covid-19. Most of them are tasked with directly handling Covid-19.

Figure 4. Number of health workers who have not received incentives who are infected with Covid-19

Figure 5. Types of services provided by health workers who are infected with Covid-19 and have not received incentives.

Recommendation:

For this reason, LaporCovid-19, together with a number of health professional organizations, urges:

1. Once again, the Central Government and Regional Governments should not delay the distribution of incentives for health workers, especially for health facilities that have proposed and provided supporting administrative documents.
2. The government must determine the final deadline for distribution so that no health workers experience delays in distribution and have to wait without certainty.
3. The Central Government and Regional Governments need to increase supervision of incentive governance in both government and private health facilities, including allegations of incentives being cut or other abuses.
4. The government is to impose sanctions on health facilities that are proven to have misused/abused health workers' incentives.

About ReportCovid-19

LaporCovid-19 is a forum (platforms) fellow citizens to share information regarding the number of incidents related to COVID-19 around us. A bottom-up approach through citizen reporting or crowdsourcing so that every citizen can participate in conveying information about cases related to COVID-19. For more information, visit:

Website: www.laporcovid19.org ,
IG: @laporcovid19,
Twitter: @laporcovid,
FB: Citizens' Coalition to Report Covid-19