Indonesia | Key Development Challenges and Policy Recommendations by Alemarie Ceria https://padlet.com/alemarie/lz0ja848goyp48a7 Group: ATN (Alemarie Ceria, Tia Lana Mallarme, and Noah Ryan) en-us 2021-05-04 04:41:01 UTC 2023-04-15 06:13:17 UTC hello@padlet.com https://padlet.net/icons/png/1f304.png alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1493502305
  • Key figures
  • Healthcare system
  • Insurance system
  • Problems with Indonesia's healthcare systems and institutions
  • COVID-19 pandemic
  • Policy recommendations
    • ]]>     2021-05-05 12:39:06 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1493502305     alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494116573 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
    ]]>     2021-05-05 14:45:28 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494116573     alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494197669
  • https://www.statista.com/topics/4873/health-in-indonesia/#dossierSummary
  • https://www.who.int/countries/idn/
  • https://www.worldometers.info/world-population/indonesia-population/#:~:text=The%20current%20population%20of%20Indonesia,the%20latest%20United%20Nations%20data.
  • https://www.statista.com/statistics/294100/total-population-of-indonesia/
  • https://www.populationpyramid.net/indonesia/2021/
  • https://www.thejakartapost.com/news/2014/11/26/another-health-reform-what-do-we-really-need.html
  • https://www.thejakartapost.com/academia/2018/04/06/qa-bpjs-kesehatan-health-for-all-indonesians.html
  • https://www.worldbank.org/en/country/indonesia/overview
  • https://www.heritage.org/index/country/indonesia
  • https://www.imf.org/en/News/Articles/2021/03/03/na030321-indonesia-has-an-opportunity-to-boost-growth
  • https://www.macrotrends.net/countries/IDN/indonesia/maternal-mortality-rate
  • https://apps.who.int/iris/bitstream/handle/10665/254716/9789290225164-eng.pdf
  • http://documents1.worldbank.org/curated/en/717421594076964759/pdf/Indonesia-Systematic-Country-Diagnostic-Update.pdf
    • ]]>     2021-05-05 15:01:56 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494197669     Key Figures alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494205053 2021-05-05 15:03:24 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494205053 Health Topics alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494224287 2021-05-05 15:07:01 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494224287 Healthcare System alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494267759 2021-05-05 15:15:33 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494267759 Insurance System alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494271335 2021-05-05 15:16:14 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494271335 alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494599280 2021-05-05 16:18:37 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494599280 GDP (Current US$) alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494659064 In 2019: 1.119 million]]> 2021-05-05 16:30:40 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494659064 Total Population (Millions) alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494687351 In 2021: 272.25 million inhabitants]]> 2021-05-05 16:36:30 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494687351 GNI per capita, Atlas method (Current US$) alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494726085 In 2019: 4,050 thousand

    GNI per capita, PPP (Current international $)
    In 2018: 11,310]]>     2021-05-05 16:44:25 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494726085     Poverty Headcount Ratio at National Poverty Lines (% of population) alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494735834 In 2019: 9.4%]]> 2021-05-05 16:46:24 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494735834 Primary School Enrollment (% gross) alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494748187 In 2018: 106%

    Total Primary Completion Rate (% of relevant age group)
    In 2018: 1.02%]]>     2021-05-05 16:48:55 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494748187     Brief Background alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494766093
  • 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

    • ]]>     2021-05-05 16:52:31 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494766093     Public Health Insurance alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494841109
  • 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
    • ]]>     2021-05-05 17:08:18 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494841109     Population Growth (Annual %) alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494917471 In 2018: 1.1%]]> 2021-05-05 17:23:35 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494917471 Age Structure (2021) alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494963321 2021-05-05 17:32:25 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1494963321 World Bank Country Classification by Income Level alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1495013903 2020-2021: Upper-middle income]]> 2021-05-05 17:42:22 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1495013903 Problems with Indonesia's Healthcare Systems and Institutions alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1495025969 2021-05-05 17:44:51 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1495025969 alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1495027756
  • 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
    • ]]>     2021-05-05 17:45:10 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1495027756     Economic Status Overview noahirya https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496057959
  • 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)

    • ]]>     2021-05-05 23:35:39 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496057959     Economy and Infrastructure Topics noahirya https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496094585 2021-05-05 23:55:36 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496094585 noahirya https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496095605
  • Economic growth and status overview
  • Infrastructure and Institutional health
  • Human capital utilization
  • Key challenges and future policy recommendations 
    • ]]>     2021-05-05 23:56:11 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496095605     Trade and Infrastructure noahirya https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496581956
  • 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
    • ]]>     2021-05-06 03:37:18 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496581956     Human Capital and Labor Market noahirya https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496626389
  • 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 
    • ]]>     2021-05-06 04:07:55 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496626389     Policy Recommendations for Key Challenges noahirya https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496755915 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
    ]]>     2021-05-06 05:26:58 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496755915     POVERTY OVERVIEW https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496758187 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]]> 2021-05-06 05:28:08 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496758187 Indomie Mi Goreng noodles noahirya https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496805148 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. ]]> 2021-05-06 05:52:46 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496805148 Part of the Malay Archipelago, Largest Archipelago in the World noahirya https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496808065 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).]]> 2021-05-06 05:54:14 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496808065 alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496812907 2021-05-06 05:56:36 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496812907 Flag noahirya https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496813857 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.]]> 2021-05-06 05:57:05 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496813857 Public System alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496817800
  • 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
    • ]]>     2021-05-06 05:58:56 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496817800     Private Providers alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496833005 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
    ]]>     2021-05-06 06:05:53 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496833005     SHARE OF POPULATION LIVING IN POVERTY https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496836422 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. ]]> 2021-05-06 06:07:18 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496836422 https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496877854 2021-05-06 06:23:47 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496877854 INEQUALITY https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496902710 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%. ]]> 2021-05-06 06:33:13 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496902710 GINI INDEX https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496950490 2000-2018 
    Source: World Bank]]>     2021-05-06 06:50:06 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496950490     POVERTY HEAD COUNT RATE https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496961174 2000-2018 
    Source: World Bank]]>     2021-05-06 06:53:55 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496961174     Private Health Insurance alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496982632
  • 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

    • ]]>     2021-05-06 07:02:02 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1496982632     COVID-19 Pandemic alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497009039 2021-05-06 07:12:06 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497009039 alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497010316 2021-05-06 07:12:33 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497010316 alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497012453 2021-05-06 07:13:18 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497012453 alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497018719
  • 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
    • ]]>     2021-05-06 07:15:39 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497018719     Policy Recommendations alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497026204
  • 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
    • ]]>     2021-05-06 07:18:23 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497026204     KEY INDICATORS https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497067681 2021-05-06 07:34:43 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497067681 POLICY RECOMMENDATIONS https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497071497 Target social assistance programs and decrease barriers to access basic services.
    --increase cash transfers and food vouchers
    -- lower barriers to access microcredit]]>     2021-05-06 07:36:15 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497071497     alemarie https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497235595 2021-05-06 08:39:36 UTC https://padlet.com/alemarie/lz0ja848goyp48a7/wish/1497235595