Archives of Medicine and Health Sciences

: 2016  |  Volume : 4  |  Issue : 1  |  Page : 157--158

Diploma nurse: A player or a spectator in ASEAN mutual recognition arrangement?

Joko Gunawan 
 Chulalongkorn University, Bangkok, Thailand

Correspondence Address:
Joko Gunawan
Faculty of Nursing, Chulalongkorn University, Borommaratchachonnani Srisataphat Building, Rama 1 Road, Pathumwan, Bangkok 10330

How to cite this article:
Gunawan J. Diploma nurse: A player or a spectator in ASEAN mutual recognition arrangement?.Arch Med Health Sci 2016;4:157-158

How to cite this URL:
Gunawan J. Diploma nurse: A player or a spectator in ASEAN mutual recognition arrangement?. Arch Med Health Sci [serial online] 2016 [cited 2022 Dec 8 ];4:157-158
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Full Text


The Association of Southeast Asian Nations (ASEAN) Economic Community will begin in the end of this year 2015. Ten ASEAN member countries [Indonesia, Thailand, Brunei Darussalam, Philippine, Singapore, Myanmar, Lao People's Democratic Republic (PDR), Vietnam, Malaysia, and Cambodia] will join hands to make nursing better under the ASEAN Mutual Recognition Arrangement (MRA). This MRA is going to provide a platform for nurses to have “free flow of nurses, migration, or nurse mobility” among the ASEAN countries. It is additionally to exchange information and expertise on standards and qualifications, to promote the adoption of best practices on professional nursing services, and to provide opportunities for capacity building and the training of nurses. This arrangement seems to be a good deal for nurses.[1] But, there are some issues that need to think for consideration, especially for nurse migration.

The issue of free flow of nurses does not seem to be free at all because there are some regulations required, consisting of:

Bachelor's degree as the minimum level of education,Having at least 3 years of experience in nursing practice,No record of malpractice, andCertification by the country of origin, and compliance with satisfaction with professional development.[1]

These requirements, however, become challenges for the countries such as Indonesia, Vietnam, Cambodia, and other countries that still have Diploma nurses as the majority of their nurses' proportion.[2] It points out that free flow of nurses under MRA is not possible to be applied. However, it might not be a challenge for Thailand and the Philippines because they only have bachelor's level for nurses as the basic of their nursing education. But, it still leads to the question whether Thai or Filipino nurses would like to migrate and work in ASEAN countries or not. In addition, Thailand does not have an open policy for foreign nurses nor does it encourage Thai nurses to go abroad.[3] Meanwhile, Filipino nurses like to migrate to Europe and the United States of America, rather than the ASEAN countries.[3] On the other hand, the requirement to pass the national exam in the national language might be another challenge that may burden nurses, for instance, nurses need to pass examinations in the Thai and Indonesian language to work as a nurse in those countries.

Based on those above requirements, the movement of individual nurses to work as a nurse in other countries might not be happening in the end of this year, in 2015 or in the near future. In contrast, nursing education might play a dominant role in ASEAN MRA,[4] because it has been known that MRA expands its scope not just limited to nursing service, but in nursing education and nursing research as well.[1] Therefore, it can be said that diploma nurses can never be players in ASEAN MRA, but would rather be spectators if they do not upgrade their education. So, the author remarks “nurses need to continue their education at least bachelor level as the first degree of professional nurse to take a part in ASEAN MRA.”

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Conflicts of interest

There are no conflicts of interest.


1MRA. ASEAN Mutual Recognition Arrangement on Nursing Services. 2014; Available from: [Last accessed on 2015 Nov 14].
2Aungsuroch Y, Gunawan J. Nurse Preparation towards ASEAN Economic Community 2015. Int J Health Sci Res 2015;5:365-72.
3Matsuno A. Nurse migration: The Asian perspective. ILO/EU Asian Programme on the Governance of Labour Migration Technical Note 2009;1-23.
4Joko G, Yupin A. ASEAN mutual recognition arrangement for Indonesian nurses: Is it a promise? Int J Community Med Public Health 2015;2:77-8.