Indonesian policymakers shone the spotlight on how their country is transforming its health system through reforms that promote health equity and improve health outcomes during a side meeting of the (PMAC 2024) in Bangkok. Senior officials from the Ministry of Health, Ministry of Home Affairs, and National Health Insurance Agency (BPJS-K), briefed participants about the reforms the country has been undertaking to transform its health system and grapple persistent challenges. supports the analytics and technical assistance that have been contributing to Indonesia¡¯s ongoing health system transformation agenda.
Despite its upper middle-income status, increased prioritization of health expenditure in recent years, and dramatic achievements in expanding social health insurance coverage, Indonesia¡¯s health sector remains a developmental enigma. The country faces persisting challenges of maternal mortality and communicable diseases, struggles with improving child health and nutrition outcomes, and increasing burden of chronic lifestyle related diseases. Like other large countries with decentralized contexts, Indonesia also needs to address substantial regional disparities in access to and quality of essential health services.
Its transformation agenda works on these problems around six pillars¡ªprimary care, secondary care, health resilience, health financing and system, health workforce, and health technology. During the side session, senior Indonesian policymakers reflected on four thematic areas: community-level primary care, health infrastructure, digital health, and evidence-based policymaking.
Among the senior policymakers was Maria Endang Sumiwi, director general of public health at the Health Ministry, who spoke on the theme Integrated PHC¡ªStrengthening Health and Nutrition Service Delivery at the Frontlines. ¡°In 2022, Indonesia set three objectives for transforming primary care: shifting focus towards lifecycle-based primary care, bringing health services closer through care networks within the village and hamlet, and strengthening local area monitoring through a digitized health dashboard system from the village-level," she said.
Zulvia Dwi Kurnaini, director of the procurement bureau at the Ministry of Health (MoH), gave an overview presentation on the theme Health Infrastructure: Investing in Access, Equity and Sustainability. She outlined how the Indonesia Health Systems Strengthening Project will comprehensively tackle disparities in health service delivery by improving public health and laboratory facilities across all of Indonesia¡¯s 6,500 inhabited islands. ¡°The project will also disrupt the status-quo with innovative health sector procurement methods and ensure equity by targeting lagging areas of the country,¡± she noted.
In his keynote remarks, Setiaji, senior advisor to the minister for health technology, MoH, spoke on the theme Digital Health: Indonesia¡¯s Transformative Strides. He said the ministry¡¯s digital transformation effort met with three key challenges¡ªinsufficient IT knowledge, absence of regulations and reluctance to embrace digitization, and infrastructure deficiency. ¡°By addressing these obstacles head-on, we have successfully transformed the MoH into a more digitally capable and efficient organization,¡± he said.
Ali Ghufron Mukti, president director of the national health insurance agency (BPJS-K), spoke about digital health deployment in the national health insurance program (JKN) and how managing information technology has been its backbone. He said that JKN has developed an integrated digital ecosystem that embraced everything from payment contributions, digital claims management, and teleconsultation, to an integrated queuing system, bed availability, and even surgery schedule availability.
Speaking on the theme Evidence-Based Policymaking: Building National Capacity for Health Policy, Syarifah Liza Munira, head of the health development policy agency (BKPK), said the ministry set up her agency in 2022 to build its capacity for making evidence-based health policies. BKPK served three core functions: as a think tank to provide evidence-based research and analysis to inform the development of all health policies, as a clearing house for all policies and regulations to ensure uniformity of structure and strategy and provide a policy evaluation process to see if programs and regulations are being implemented as intended and what impacts they are having.
Noting the importance of cross-country learning, Nguyen Khanh Phuong, director of Vietnam¡¯s Health Strategy and Policy Institute, and Angkana Lekagul of Thailand¡¯s International Health Policy Program, also shared their experiences. Their agencies study health policies and research health systems to generate scientific evidence and knowledge for formulating health policies in their respective countries. They also collaborate with international partners on knowledge exchange and training.