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Introduced and hoisted in public during the Proclamation of Indonesian Independence on August 17th, 1945. The red band represents the courage and blood of Indonesians, while the white band represents purity and the spirits of the people. It is also identical in design to the flag of Monaco.

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1. Economic growth and status overview

2. Infrastructure and Institutional health

3. Human capital utilization

4. Key challenges and future policy recommendations

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1. Key figures

2. Healthcare system

3. Insurance system

4. Problems with Indonesia's healthcare systems and institutions

5. COVID-19 pandemic

6. Policy recommendations

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Health Infrastructure

Number of private hospitals in Indonesia (2019): 1,384

Number of Puskesmas in Indonesia (2019): 10,134

Number of general practitioners in Indonesia (2018): 143,626

Diseases

Number of people diagnosed with AIDS in Indonesia (2018): 114.07 thousand

Estimated number of people living with HIV in Indonesia (2018): 640,000

Number of malaria cases in Indonesia (2018): 1.32 million reported cases

Number of dengue cases in Indonesia (2018): 65,602

Number of death from tuberculosis in Indonesia (2017): 40 per 100,000 people

Number of tuberculosis cases in Indonesia (2018): 204.4 thousand reported cases

Mortality

Under-five child mortality rate in Indonesia: 25, per 1,000 deaths

Infant mortality rate (2019): 20.2 deaths per 1,000 live births

Maternal mortality rate (2017): 177 deaths per 100,000 live births

Life Expectancy in Indonesia (2017)

Males: 69 years old

Females: 73 years old

Health Expenditure as Share of GDP in Indonesia: 2.99%

Number of Health Card Holder in Indonesia (2018): 92.4 million

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1. https://www.statista.com/topics/4873/health-in-indonesia/#dossierSummary

2. https://www.who.int/countries/idn/

3. https://www.worldometers.info/world-population/indonesia-population/#:~:text=The%20current%20population%20of%20Indonesia,the%20latest%20United%20Nations%20data.

4. https://www.statista.com/statistics/294100/total-population-of-indonesia/

5. https://www.populationpyramid.net/indonesia/2021/

6. https://www.thejakartapost.com/news/2014/11/26/another-health-reform-what-do-we-really-need.html

7. https://www.thejakartapost.com/academia/2018/04/06/qa-bpjs-kesehatan-health-for-all-indonesians.html

8. https://www.worldbank.org/en/country/indonesia/overview

9. https://www.heritage.org/index/country/indonesia

10. https://www.imf.org/en/News/Articles/2021/03/03/na030321-indonesia-has-an-opportunity-to-boost-growth

11. https://www.macrotrends.net/countries/IDN/indonesia/maternal-mortality-rate

12. https://apps.who.int/iris/bitstream/handle/10665/254716/9789290225164-eng.pdf

13. http://documents1.worldbank.org/curated/en/717421594076964759/pdf/Indonesia-Systematic-Country-Diagnostic-Update.pdf

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Administered through a decentralized system where central, provincial, and district governments are responsible for their decision-making

Central Ministry of Health is responsible for management of some tertiary and specialist hospitals, provision of strategic direction, setting of standards, regulation, and ensuring availability of financial and human resources.

Provincial governments are responsible for management of provincial-level hospitals, provide technical oversight and monitoring of district health services, and coordinate cross-district health issues within the province.

District/municipal governments are responsible for management of district/city hospitals and the district public health network of community health centres (puskesmas) and associated subdistrict facilities.

Payments to primary care providers are through capitations

Payments to hospital providers are through DRG episodes of service payments (INA-CBGs)

Public staff salaries are funded through budgetary allocations

Puskesmas are primary health centers which act as gatekeepers for medical cases and public health efforts

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Includes:

Hospitals and clinics managed by not-for-profit and charitable organizations

For-profit providers

Individual doctors and midwives who work in the public system, but also have a private practice

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Location: Southeast Asia

Archipelagic country with 17,000-18,000 islands

Fourth most populated country in the world

Form of government: Multiparty republic with two legislative houses

History:

17th century: Colonized by the Dutch

1942-1945: Occupied by Japan

August 17, 1945, gained independence

Cultural Context:

724 languages and dialects

Known for its agricultural conditions and trade

Cultural practices influenced by Buddhism, Christianity, Confucianism, Hinduism, and Islam

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In 2019: 1.119 million

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GNI per capita, Atlas method (Current US$)

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GNI per capita, Atlas method (Current US$)

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In 2019: 4,050 thousand

GNI per capita, PPP (Current international $)
In 2018: 11,310

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World Bank Country Classification by Income Level 

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World Bank Country Classification by Income Level 

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2020-2021: Upper-middle income

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In 2021: 272.25 million inhabitants

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In 2018: 1.1%

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Poverty Headcount Ratio at National Poverty Lines (% of population)

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Poverty Headcount Ratio at National Poverty Lines (% of population)

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In 2019: 9.4%

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In 2018: 106%

Total Primary Completion Rate (% of relevant age group)
In 2018: 1.02%

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January 1, 2014: Jaminan Kesehatan National (JKN) was launched

Ran by Indonesia’s public entity called Badan Penyelenggara Jaminan Sosial-Kesehatan

Largest single-payer system in the world

Total membership (2018): 192.2 million people

Indonesian Health Card (KIS)

Additional program distributed to 92.4 million JKN holders (2018)

Social Safety Net for Health-care

Askeskin

Jamksmas

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In 2018, about 20 million of the population were covered

Major providers include Allianz Care, AXA Indonesia, AIA Financial Indonesia, Prudential Indonesia, and Manu Life Indonesia

Better services for a higher price

Private providers are given a choice to join the JKN program

Medical evacuation to other countries like Thailand, Malaysia, or Singapore for serious cases is still most likely needed and may or may not be covered

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Problems with Indonesia's Healthcare Systems and Institutions

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Problems with Indonesia's Healthcare Systems and Institutions

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Underfinancing and increasing health expenditures

Lagging numbers of primary care providers and hospitals

Limited access to drugs in rural areas

Overall inaccessibility and inequity of care because of varying conditions and quality of facilities across geographical regions

Number of hospital bed and puskesmas to total population of Indonesia is low, below WHO standards, and far behind other Asia-Pacific countries

Communication between the national information system (SIKNAS) and the district-level health information systems (SIKDA) is weakened by decentralization and multiple separate reporting systems

Regulation of providers and hospitals are decentralized to central, provincial, and district governments with the hierarchy of law regulation being different at each level of government

Out-of-pocket expenditures by patients who would rather go to hospitals than puskesmas are above average because referrals by primary care providers are needed to go to hospitals

Spending by workers in the informal sector are catastrophically high due to them not being covered by JKN

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Economic freedom score is 66.9, ranking 56th freest economy in the 2021 Index of Economic Freedom

Largest economy in Southeast Asia, ranks 10th out of 40 East/Southeast Asian countries

20 year economic development plan segmented into four medium-term plans "RPJMN" (Rencana Pembangunan Jangka Menengah Nasional) and are continually sponsored by the current president Joko Widodo

High GDP growth rate of 5.0% (2019), but lower than expected GDP per capita of $4,165.57 (2019)

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Key Exports ($197 billion USD): mineral fuels, animal and vegetable fats, machinery, rubber

Key Imports ($180 billion USD): refined petroleum, telephones, electrical machinery

Boast a positive trade balance of $17 billion USD, however, positively and negatively fluctuates depending on market conditions

Main trading partners are Japan, China, Singapore and South Korea as well as the United States

Inadequate infrastructure due to low optimism climate in investment

Fitch and S&P rate Indonesia with a BBB credit rating (2020), upgrading from CCC and B- in 2001

Weak inter and intra-island trading network prevents infrastructure development

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Unemployment rate of 4.69% (2019)

Education of population cannot keep up with demand for adequately skilled workers

Gender Parity Index (GPI) increased from 0.89 to 1.00 from 1971-2018

Women tend to outperform men and achieve at a higher level

Math and reading scores are about 100 points below OECD average despite high enrollment rates

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Policy Recommendations for Key Challenges

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Policy Recommendations for Key Challenges

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Economic Growth

Sustained financial support for viable Indonesian firms

Trade and Infrastructure

Reduce barriers to import of goods and services, increase preferential access to key markets, relax restrictions on investment, provide government subsidies to exporting firms

Increase allocation of resources to developing industries and enforce anti-corruption laws by reducing import tariffs and increasing energy subsidies for renewable energy

Human Capital

Improve education sector to improve human capital and returns to education

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Indonesia has managed to moderate poverty and inequality struggles in the span of 2 decades. The nation reached a record low of poverty rate at 9.2 based on national poverty line. In 1996, the poverty rate was at 23.4%; the 2019 value is less than half what poverty rate used to be 20 years ago. However, the pace of poverty reduction has slowed down to half of what it used to be. From 2003 to 2009, Indonesia's poverty reduction rate was at 0.6, post 2010 to latest data indicated that their poverty reduction rate is at 0.3

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Part of the Malay Archipelago, Largest Archipelago in the World

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Part of the Malay Archipelago, Largest Archipelago in the World

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Indonesia's geographical territory is comprised of 18,307 islands (largest estimate). There are an estimated 130 active volcanoes within its boundaries along the Pacific "Ring of Fire". Puncak Jaya is the highest island peak in the world at 4,884 meters (16,024 feet). Mauna Kea is 4,207.3 meters (13,803 feet).

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These are really good. Indonesia producer PT Indofood Sukses Makmur Tbk holds the Official Guinness World Record for the largest pack of instant noodles weighing 664.94 kg (1,465.9 lb) in Bali, 2005, an exact replica of the Mi Goreng flavor.

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In 2011 PPP, the share of population living in extreme poverty ($1.90 per day) was 5.7% which was reduced to 2.9% in 2019 and in moderate poverty ($3.20 per day) was 27.3% which was reduced to 4.7% in 2019. The graphs are as followed respectively.

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Much like poverty in Indonesia, the nation has seen a decline in inequality trends. The consumption Gini index was at 38 in 2019. If you remember the Lorenz curve, much of the decline in inequality is actually due to gains by the middle of the distribution. From the 5th to 8th decile, consumption rose for about 1.8% from 35%.

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2000-2018
Source: World Bank

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2000-2018
Source: World Bank

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Low rates of testing

High community transmission among civilians and healthcare workers with death rates for health care workers being among the highest globally

Health facilities are overwhelmed

Lockdowns are moderately strict and inconsistent, which restricts the health care that the system can provide

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The central government needs to invest more in the health workforce, facilities, and equipment in less developed regions to ensure equity in access to healthcare services

The central government needs to create a more systematic, reliable, and integrated health information system to support planning and decision-making across governments and address interregional disparities with using the JKN system

The JKN system needs more regulation and accountability measures for fraud when dispersing BPJS-K funds to hospitals which will help to reduce inequity

Transparency and accurate public reporting on performance measures need to be taken to avoid corruption and increase confidence in the system by Indonesian people

Collaboration between the public sector and private healthcare providers is essential in the success of JKN due to the limitations of the public sector

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Target social assistance programs and decrease barriers to access basic services.
--increase cash transfers and food vouchers
-- lower barriers to access microcredit

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ATN - Indonesia Policy Recommendtions - ECON 442

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ATN - Indonesia Policy Recommendtions - ECON 442