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Jakarta Post

Decentralization helps Bali improve healthcare services

Amid the many failures and deviations when it comes to implementing autonomy in regions throughout Indonesia, Bali has managed to take advantage of the opportunities, a lecturer of state-run Udayana University says

Hyginus Hardoyo (The Jakarta Post)
Sanur
Sat, November 15, 2008

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Decentralization helps Bali improve healthcare services

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mid the many failures and deviations when it comes to implementing autonomy in regions throughout Indonesia, Bali has managed to take advantage of the opportunities, a lecturer of state-run Udayana University says.

The ability to make the most of opportunities, which were made possible after the downfall of the authoritarian New Order administration in the late 1990s, has enabled the local administration to reach their potential in nearly all sectors of development, A.A Gde Muninjaya said Thursday.

Muninjaya spoke at a panel discussion entitled "Decentralization and Autonomy in Bali: Challenges and Opportunities for Community Health", which was part of a three-day conference being held until Saturday by the East-West Center in Sanur, Bali.

Muninjaya said decentralization in response to the passage and implementation of the Autonomy Law in 1999 and 2001, followed by health sector reform, facilitated greater community participation after being dominantly governed by Jakarta.

"Decentralization has encouraged intersectoral cooperation while improving the quality of health services management up to the regency levels," he said.

Muninjaya told The Jakarta Post about two regencies in Bali -- Jembrana and Tabanan -- which were able to take advantage of the decentralized system to provide qualified and affordable health services to locals.

"The Jembrana regency administration, for example, has been able to create a health insurance system, which no longer uses assistance from the central government, but from its own regency budget," he said.

Under the new system the regency administration guarantees all residents, including the poor, access to health services, he said.

Muninjaya said Tabanan regency administration had also been successful in changing the image of state-run hospitals, which used to be shunned by patients due to their dirty and dismal conditions, into convenient hospitals by using money from its own budget.

Muninjaya said the breakthrough was only possible through the work of visionary leaders, who worked to improve people's welfare, and not those who only thought about their own coffers.

Thanks to decentralization, he said, Bali currently enjoyed better health services, with its development indexes being higher on average than the national figures.

"Due to steady health development, life expectancy rate in Bali reached an average of 70.4 years, slightly higher that the national rate of 68.1 years," he said.

Despite the many successes, however, Muninjaya said there were still a number of shortcomings, including the high prevalence of communicable diseases, like dengue fever, HIV/AIDS, TB, tetanus and gastroenteritis.

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