The Struggle for Nursing Professionalization in Indonesia: Colonial Era to Reformasi

Political constraints and professional aspirations have shaped the history of nursing in Indonesia. This study traces this history from the end of the Dutch colonial period to the Reformasi period. This narrative history draws on published scholarship, statutory texts, and contemporaneous Indonesian press reporting. However, under Guided Democracy and the New Order, corporatist control of professional associations left them no route to legislation, and ministerial decree fixed their status. The fall of the New Order restored freedom of association. It produced a legislature with a genuine power of initiative, although regime change was a necessary condition and not a sufficient one. The Indonesian National Nurses Association (PPNI) used that opening across three parliamentary terms, combining insider lobbying of Commission IX with mass mobilization, including a demonstration by thousands of nurses at the parliament building on May 21, 2013, and secured passage on September 25, 2014. The Law No. 38 of 2014 concerning Nursing is the first Indonesian statute to define nursing as a profession and to establish education standards, registration, and licensing for nurses. Under this law, nurses gained authority to treat common illnesses only where no physician is posted and under a government assignment, and the proposed independent council was placed under another council shared with other health professions. The history examined here has implications for understanding how professional recognition is achieved in low- and middle-income countries where colonial medical hierarchies have never been fully dismantled.