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Indonesia is in need of a health care reset
The next government needs to take a systems approach that includes the upstream societal determinants to revitalize the country's health system toward achieving universal health care.
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A health worker holds up an informational poster about mpox, formerly called monkeypox, on Nov. 1, 2023 at the Puskesmas (community health center) in Kedaung, South Tangerang, Banten. (Antara/Sulthony Hasanuddin)
Indonesians face considerable health challenges. This includes the second highest tuberculosis (TB) burden globally, an increasing prevalence of noncommunicable diseases and high maternal mortality and stunting in children under 5 years.
Even with national health insurance, access and quality care remain elusive for many. The quantity, quality and distribution of the health workforce serve as a key barrier to progress, as do the numerous social and commercial drivers of ill health.
Until today, the prevailing perspective on health care is merely as a collection of services delivered to eliminate a list of diseases. It is time to take a systems approach that includes upstream determinants. The new administration next year can generate renewed political momentum on Universal Health Coverage (UHC) to ensure that quality care is available for all, even if supply side reform might take years to reach the required standards of care.
Resetting also means mobilizing resources to invest in the system, such as through new taxes on tobacco and sugar-sweetened beverages and redirecting lethal fuel subsidies.
As the three candidate pairs prepare for the first presidential debate on Tuesday organized by the General Elections Commission (KPU), they have included health in their vision and mission statements, although their commitment is yet to be convincing.
It is good to see that these statements incorporate maternal health, stunting and attention to primary health care. All three pairs have also pledged to increase the availability of health services, including in remote areas of the archipelago.
Two candidates have pledged to broaden UHC, but none mention governance of public financing.
