Indonesia: Indonesia Health Profile

HEALTH & DEVELOPMENT

Ministry of Health (MoH RI) developed a new Strategic Plan 2010–2014 containing a vision of self reliance and fairness in healthy communities. Its mission is to enhance health status by implementing community empowerment involving private sector and civil society, preventing and overcoming health problems faced by the community through availability of comprehensive and equitable health services and health resources supported by good governance.

Strategies to be implemented in the period of 2010-14 are: improve health and nutritional status in the community, decrease morbidity rate due to communicable diseases, implement non-communicable diseases control programme, increase public budget for health to reduce financial risk for health problems - especially for deprived people and communities. Furthermore, implement the Minimum standards of health services in all districts, and address need of human resources for health in underdeveloped or remote areas or island provinces.

Regarding Health Services, at primary health care level, Indonesia is generally regarded as having relatively adequate levels of provision, with one public health centre for every 30 000 people on average. However, these averages conceal large variations in geographic access, with people in remote interior or small island locations having particularly poor access. Human resources in health have deficiencies in numbers, distribution and quality of the health workforce, and reportedly low productivity. Ministry of Health RI and partners are continuing to undertake a major effort to build a sustainable, nationwide system of emergency preparedness and response. Development of regional crisis centres - linked to the Ministry’s central crisis centre - is at the heart of this.

Communicable diseases are a major cause of morbidity and mortality in Indonesia. Nearly 250 people die of tuberculosis (TB) every day, with over half a million new cases estimated to occur every year (WHO GTB 2009). Malaria remains a major vector-borne disease in large parts of Indonesia. Large scale outbreaks of dengue haemorrhagic fever are reported every year. Although leprosy has been eliminated at national level, Indonesia ranks third in terms of the global burden. Case fatality rates for avian influenza in 2008 were nearly 81%. Significant efforts continue to be invested in prevention and control of avian influenza and emerging infectious diseases, with pandemic preparedness at its core. The re-introduction and spread of poliomyelitis in 2005 in several provinces, after a period of 10 years, and reported measles and diphtheria outbreaks pointed to weaknesses in the routine expanded programme of immunization. At the end of 2006, an estimated 293,200 Indonesians were living with HIV-AIDS (National AIDS Commission Publication, 2009). An epidemiological transition towards noncommunicable diseases (NCDs) is a challenge for Indonesia. Chronic conditions such as cancer, cardiovascular diseases, metabolic disorders and tobacco dependence represent a real burden to the country in terms of cost, suffering and human lives. Mental health has long been neglected; despite an estimated 12.3% loss of productive days was due to mental and neurological disorders. This situation was further aggravated by the tsunami of 26 December 2004 which substantially impacted on the mental health of affected populations. Environmental determinants of health are an important issue in Indonesia including air and water pollution, leaded gasoline and indoor air pollution.

OPPORTUNITIES

Government’s strong commitment to health and work towards attainment of UN Millennium Development Goals (MDGs) is reflected inter alia in Ministry of Health RI’s Strategic Plan 2010 – 2014.
• National initiatives to address the problems arising from decentralization are reflected in new law and regulations regarding implementation of decentralization.
• Relatively adequate provision at primary health care level, with one public health centre for every 30,000
people on average, and health care service contribution from private sector and non
governmental organizations (NGOs).

CHALLENGES
• Government commitment for tobacco control efforts and support provided from Bloomberg philanthropies
• Strengthen health system to address problem of implementation of decentralization.
• Reduction of diseases burden.
• Improving community access to health care through social mobilization and community empowerment and quality of health services.
• Improving capacity of medical personnel and its distribution. Improving availability and affordability of essential medicine.
• Accede to WHO Framework Convention on tobacco control and advocacy on tobacco control to attain a
majority in Indonesia’s Parliament to join the Framework Convention