Health in Indonesia

Last updated

Health in Indonesia is affected by a number of factors. Indonesia has over 26,000 health care facilities; 2,000 hospitals, 9,000 community health centres and private clinics, 1,100 dentist clinics and 1,000 opticians. [1] The country lacks doctors with only 0.4 doctors per 1,000 population. [1] In 2018, Indonesia's healthcare spending was US$38.3 billion, 4.18% of their GDP, and is expected to rise to US$51 billion in 2020. [2]

Contents

In 2014, Indonesia introduced its universal healthcare program, the Jaminan Kesehatan Nasional (JKN), which is provided by BPJS Kesehatan (Badan Penyelenggara Jaminan Sosial Kesehatan, Health Social Security Agency). [3] It is currently covering over 200 million people. Around 20 million people in Indonesia is covered by private health insurance. [1]

The Human Rights Measurement Initiative [4] finds that Indonesia is fulfilling 84.1% of what it should be fulfilling for the right to health based on its level of income. [5] When looking at the right to health with respect to children, Indonesia achieves 93.5% of what is expected based on its current income. [6] In regards to the right to health amongst the adult population, the country achieves only 87.1% of what is expected based on the nation's level of income. [7] Indonesia falls into the "very bad" category when evaluating the right to reproductive health because the nation is fulfilling only 71.9% of what the nation is expected to achieve based on the resources (income) it has available. [8]

Population

As of September 2020, Indonesia has a population of 247 million and a population density of 151 per km2. [9] 29% of the population of Indonesia are under 15 years old, and only 5% are over 65. More than 28 million live below the poverty line of US$17 a month and about half the population have incomes not much above it.

Life expectancy

Life expectancy in Indonesia since 1927 Life expectancy in Indonesia.svg
Life expectancy in Indonesia since 1927
Life expectancy in Indonesia since 1960 by gender Life expectancy by WBG -Indonesia.png
Life expectancy in Indonesia since 1960 by gender
PeriodLife expectancy in
years
PeriodLife expectancy in
years
1950–195541.751985–199061.29
1955–196045.071990–199563.32
1960–196548.181995–200065.16
1965–197051.052000–200566.40
1970–197554.022005–201068.31
1975–198056.692010–201570.01
1980–198559.212015–202071.41

Source: United Nations [10]

Mortality rate

Observed deaths per 1000 live births1990200020102019
Under 28 days30.622.817.412.4
Under 1 year61.8412820.2
Under 5 years8452.233.923.9

Source: The World Bank [11]

Fertility

YearBirths per womenRate
20172.3461.1% decline from 2016
20182.3201.11% decline from 2017
20192.3000.86% decline from 2018
20202.2800.87% decline from 2019

Source: Macrotrends [12]

Maternal and child healthcare

Newly certified midwives in South Sulawesi, Indonesia Indonesian midwives.jpg
Newly certified midwives in South Sulawesi, Indonesia

The 2010 maternal mortality rate per 100,000 births for Indonesia is 240. This is compared with 228.6 in 2008 and 252.9 in 1990. The under 5 mortality rate, per 1,000 births is 41 and the neonatal mortality as a percentage of under 5's mortality is 49. In Indonesia the number of midwives per 1,000 live births is unavailable and the lifetime risk of death for pregnant women is 1 in 190. [13]

The 2012 maternal mortality rate per 100,000 live births is 359 deaths, a significant increased from 2010 data with 220 deaths and far from the MDGs goal of 102 deaths by the end of 2015. The main cause of deaths are severe post-natal bleeding due to lack of pregnancy regular control, although National Family Planning Coordination Board and the Central Statistics Agency data showed improvement from 93 percent of women received prenatal care in 2007 increased to 96 percent in 2012. [14]

Quality and lifestyle

Climate change

The effect of climate change can also be seen in the health of people in Indonesia (heat-related illnesses, [15] respiratory disease, [16] vector-borne disease, [17] waterborne disease, [18] malnutrition [19] ). There have been several studies, which show the correlation between the effect of climate change on health issues like the respiratory system, [20] malaria transmission, [21] and increased risk of vector-borne disease. Other factors like bad water and air quality, and malnutrition are other indirect effects that climate change has on people's health. [22]

Collectively, these studies demonstrate that urgent action is necessary both to limit further damage from climate change and to adapt current public health strategies accordingly. [23] [24]

Water quality

Unsafe drinking water is a major cause of diarrhoea, which is a major killer of young children in Indonesia. [25] According to UNICEF diarrhoea caused by untreated drinking water contributed to the death of 31% of children between the age of 1 month to a year, and 25% of children between a year to 4 years old. [26]

Air quality

1997 Southeast Asian haze, 2006 Southeast Asian haze, 2013 Southeast Asian haze and 2015 Southeast Asian haze - In all countries affected by the smoke haze, an increase of acute health outcomes was observed. Health effects including emergency room visits due to respiratory symptoms such as asthma, upper respiratory infection, decreased lung function as well as eye and skin irritation, were caused mainly by this particulate matter.

Unhealthy diet

At least 1 in 3 children under five are either undernourished or overweight in Indonesia. [27] According to UNICEF, 7 million children under-five are stunted, 2 million are wasted and 2 million are overweight or obese. Also, 1 in 4 adolescents are anaemic, most likely due to deficiency in vitamins and nutrients such as iron, folic acid and vitamin A. [28]

Tobacco and drug use

Indonesia is the fifth largest tobacco market in the world and does not have very strict rules on smoking. Every year, more than 200,000 people are killed by tobacco caused diseases. However, more than 469,000 children (10–14 years) and 64 million adults (15+ years) continue to use tobacco products every day. [29]

Drug use and selling drugs is completely illegal and can result in the death penalty. In 2015, 4.5 million Indonesians need to be rehabilitated due to illicit or illegal drug use and around 45 young people die each day due to drug use. [30]

Mental health and suicide

There is a high stigma against mental illness in Indonesia. The Indonesian government currently uses 1% of its total health budget on mental health with only 48 mental hospitals and 269 psychiatric wards. The conditions of these places are unhygienic and overcrowded with inmates regularly shackled to prevent violence. [31]

Suicide is a problem in Indonesia and in 2018 ranks 65 with 2.9 suicides per 100,000. Suicides are often unreported due to stigma, approximately 10,000 people commit suicide per year. [32]

Diseases

In 2005 there were 303 reported cases of polio in Indonesia. Polio worldwide 2005.png
In 2005 there were 303 reported cases of polio in Indonesia.

Communicable diseases

HIV/AIDS has posed a major public health threat since the early 1990s. [25] In 2003 Indonesia ranked third among ASEAN nations in Southeast Asia, after Myanmar and Thailand, with a 0.1 percent adult prevalence rate, 130,000 HIV/AIDS cases, and 2,400 deaths. [25] In Jakarta it is estimated that 17 percent of prostitutes have contracted HIV/AIDS; in some parts of Papua, it is thought that the rate of infection among village women who are not prostitutes may be as high as 26 percent. [25]

Three other health hazards facing Indonesia in 2004 were dengue fever, dengue haemorrhagic fever (DHF) and avian influenza. [25] All 30 provincial-level units were affected by dengue fever and DHF, according to the WHO. The outbreak of highly pathogenic avian influenza (A/H5N1) in chickens and ducks in Indonesia was said to pose a significant threat to human health. [25]

By 2010, there were three malaria regions in Indonesia: Nusa Tenggara Barat with 20 cases per 1,000 citizens, Nusa Tenggara Timur with 20–50, and Maluku and Papua with more than 50 cases per thousand. The medium endemicity in Sumatra, Kalimantan and Sulawesi, whereas low endemicity is in Java and Bali which almost 100 percent of malaria cases have been confirmed clear. [33] At 1990 malaria average incidence was 4.96 per 1,000 and declined to 1.96 per 1000 at 2010. The government is targeting to rid the country of malaria by 2030 and elimination means to achieve less than 1 incidence per 1,000 people. [34]

Noncommunicable diseases

Noncommunicable diseases are estimated to account for 73% of all deaths in Indonesia. Diabetes is increasing at a rate of about 6% a year. [35]

DiseaseProportional mortality
Cardiovascular diseases35%
Communicable, maternal, perinatal and nutritional conditions21%
Other noncommunicable diseases12%
Cancers12%
Chronic respiratory diseases6%
Diabetes6%
Injuries6%

Vaccination

While the Ikatan Dokter Anak Indonesia-IDAI (Indonesian Pediatric Society) recommends vaccinating against 16 different diseases, only five are mandatory and free for all national health insurance (BPJS) participants. The mandatory vaccinations are: Tuberculosis (TB), Hepatitis B, Polio, DTP (diphtheria, tetanus, pertussis) and Measles. [36] Almost 60% of Indonesians are BPJS participants. [37] Unfortunately, this means that herd immunity is low in Indonesia.

See also

Related Research Articles

<span class="mw-page-title-main">Health in Nigeria</span> Overview of health in Nigeria

In Nigeria, there has been a major progress in the improvement of health since 1950. Although lower respiratory infections, neonatal disorders and HIV/AIDS have ranked the topmost causes of deaths in Nigeria, in the case of other diseases such as monkeypox, polio, malaria and tuberculosis, progress has been achieved. Among other threats to health are malnutrition, pollution and road traffic accidents. In 2020, Nigeria had the highest number of cases of COVID-19 in Africa.

In terms of available healthcare and health status Sierra Leone is rated very poorly. Globally, infant and maternal mortality rates remain among the highest. The major causes of illness within the country are preventable with modern technology and medical advances. Most deaths within the country are attributed to nutritional deficiencies, lack of access to clean water, pneumonia, diarrheal diseases, anemia, malaria, tuberculosis and HIV/AIDS.

Healthcare in Laos is provided by both the private and public sector. It is limited in comparison with other countries. Western medical care is available in some locations, but remote areas and ethnic groups are underserved. Public spending on healthcare is low compared with neighbouring countries. Still, progress has been made since Laos joined the World Health Organization in 1950: life expectancy at birth rose to 66 years by 2015; malaria deaths and tuberculosis prevalence have plunged; and the maternal mortality ratio (MMR) has declined by 75 percent.

<span class="mw-page-title-main">Health in Niger</span>

Niger is a landlocked country located in West Africa and has Libya, Chad, Nigeria, Benin, Mali, Burkina Faso, and Algeria as its neighboring countries. Niger was French territory that got its independence in 1960 and its official language is French. Niger has an area of 1.267 million square kilometres, nevertheless, 80% of its land area spreads through the Sahara Desert.

<span class="mw-page-title-main">Health in the Democratic Republic of the Congo</span>

Health problems have been a long-standing issue limiting development in the Democratic Republic of the Congo.

The current population of Myanmar is 54.05 million. It was 27.27 million in 1970. The general state of healthcare in Myanmar is poor. The military government of 1962-2011 spent anywhere from 0.5% to 3% of the country's GDP on healthcare. Healthcare in Myanmar is consistently ranked among the lowest in the world. In 2015, in congruence with a new democratic government, a series of healthcare reforms were enacted. In 2017, the reformed government spent 5.2% of GDP on healthcare expenditures. Health indicators have begun to improve as spending continues to increase. Patients continue to pay the majority of healthcare costs out of pocket. Although, out of pocket costs were reduced from 85% to 62% from 2014 to 2015. They continue to drop annually. The global average of healthcare costs paid out of pocket is 32%. Both public and private hospitals are understaffed due to a national shortage of doctors and nurses. Public hospitals lack many of the basic facilities and equipment. WHO consistently ranks Myanmar among the worst nations in healthcare.

Benin faces a number of population health challenges. Apart from modern medicine, traditional medicine plays a big role too.

<span class="mw-page-title-main">Health in Burkina Faso</span>

A landlocked sub-Saharan country, Burkina Faso is among the poorest countries in the world—44 percent of its population lives below the international poverty line of US$1.90 per day —and it ranks 185th out of 188 countries on UNDP's 2016 Human Development Index. Rapid population growth, gender inequality, and low levels of educational attainment contribute to food insecurity and poverty in Burkina Faso. The total population is just over 20 million with the estimated population growth rate is 3.1 percent per year and seven out of 10 Burkinabe are younger than 30. Total health care expenditures were an estimated 5% of GDP. Total expenditure on health per capita is 82 in 2014.

<span class="mw-page-title-main">Health in the Central African Republic</span>

Health in the Central African Republic has been degraded by years of internal conflict and economic turmoil since independence from France in 1960. One sixth of the country's population is in need of acute medical care. Endemic diseases put a high demand on the health infrastructure, which requires outside assistance to sustain itself.

<span class="mw-page-title-main">Health in Chad</span>

Health in Chad is suffering due to the country's weak healthcare system. Access to medical services is very limited and the health system struggles with shortage of medical staff, medicines and equipment. In 2018, the UNHCR reported that Chad currently has 615,681 people of concern, including 446,091 refugees and asylum seekers. There is a physician density of 0.04 per 1,000 population and nurse and midwife density of 0.31 per 1,000 population. The life expectancy at birth for people born in Chad, is 53 years for men and 55 years for women (2016). In 2019 Chad ranked as 187 out of 189 countries on the human development index, which places the country as a low human development country.

The Human Rights Measurement Initiative finds that Equatorial Guinea is fulfilling 43.5% of what it should be fulfilling for the right to health based on its level of income. When looking at the right to health with respect to children, Equatorial Guinea achieves 64.4% of what is expected based on its current income. In regards to the right to health amongst the adult population, the country achieves only 58.8% of what is expected based on the nation's level of income. Equatorial Guinea falls into the "very bad" category when evaluating the right to reproductive health because the nation is fulfilling only 7.3% of what the nation is expected to achieve based on the resources (income) it has available.

<span class="mw-page-title-main">Health in South Africa</span>

Health in South Africa touches on various aspects of health including the infectious diseases, Nutrition, Mental Health and Maternal care.

<span class="mw-page-title-main">Health in Tanzania</span>

The 2010 maternal mortality rate per 100,000 births for Tanzania was 790. This is compared with 449 in 2008 and 610.2 in 1990. The UN Child Mortality Report 2011 reports a decrease in under-five mortality from 155 per 1,000 live births in 1990 to 76 per 1,000 live births in 2010, and in neonatal mortality from 40 per 1,000 live births to 26 per 1,000 live births. The aim of the report The State of the World's Midwifery is to highlight ways in which the Millennium Development Goals can be achieved, particularly Goal 4 – Reduce child

The WHO's estimate of life expectancy for a female child born in Guinea-Bissau in 2008 was 49 years, and 47 years for a boy. in 2016 life expectancy had improved to 58 for men and 61 for women.

<span class="mw-page-title-main">Health in Rwanda</span>

The quality of health in Rwanda has historically been very low, both before and immediately after the 1994 genocide. In 1998, more than one in five children died before their fifth birthday, often from malaria. But in recent years Rwanda has seen improvement on a number of key health indicators. Between 2005 and 2013, life expectancy increased from 55.2 to 64.0, under-5 mortality decreased from 106.4 to 52.0 per 1,000 live births, and incidence of tuberculosis has dropped from 101 to 69 per 100,000 people. The country's progress in healthcare has been cited by the international media and charities. The Atlantic devoted an article to "Rwanda's Historic Health Recovery". Partners In Health described the health gains "among the most dramatic the world has seen in the last 50 years".

Zambia is a landlocked country in Sub Saharan Africa which experiences a burden of both communicable and non-communicable diseases. In line with WHO agenda for equity in health, it has adopted the Universal Health Coverage agenda to mitigate the challenges faced within the health sector. The Ministry of Health (MOH) provides information pertaining to Zambian health. The main focus of the Ministry of Health has been provision of uninterrupted care with emphasis on health systems strengthening and services via the primary health care approach.

<span class="mw-page-title-main">Health in Papua New Guinea</span>

Life expectancy in Papua New Guinea (PNG) at birth was 64 years for men in 2016 and 68 for women.

<span class="mw-page-title-main">Healthcare in Madagascar</span>

Hospitals and small medical centers and posts are found throughout the island of Madagascar, although they are concentrated in urban areas and particularly in Antananarivo. In addition to the high expense of medical care relative to the average Malagasy income, the prevalence of trained medical professionals remains extremely low.

<span class="mw-page-title-main">Health in Albania</span> Aspect of life in Albania

Life expectancy in Albania was estimated at 77.59 years, in 2014, ranking 51st in the world, and outperforming a number of European Union countries, such as Hungary, Poland and the Czech Republic. In 2016 it was 74 for men and 79 for women. The most common causes of death are circulatory diseases followed by cancerous illnesses. Demographic and Health Surveys completed a survey in April 2009, detailing various health statistics in Albania, including male circumcision, abortion and more.

References

  1. 1 2 3 "Indonesia's Healthcare Industry: Growing Opportunities for Foreign Investors". ASEAN Business News. 30 July 2020. Retrieved 30 September 2020.
  2. "Healthcare Resource Guide: Indonesia". 2016.export.gov. Archived from the original on 8 August 2022. Retrieved 30 September 2020.
  3. Susanto, Gabriel Abdi (31 December 2013). "Pertanyaan-pertanyaan Dasar Seputar JKN dan BPJS". liputan6.com (in Indonesian). Retrieved 18 January 2022.
  4. "Human Rights Measurement Initiative – The first global initiative to track the human rights performance of countries". humanrightsmeasurement.org. Retrieved 18 March 2022.
  5. "Indonesia - HRMI Rights Tracker". rightstracker.org. Retrieved 18 March 2022.
  6. "Indonesia - HRMI Rights Tracker". rightstracker.org. Retrieved 18 March 2022.
  7. "Indonesia - HRMI Rights Tracker". rightstracker.org. Retrieved 18 March 2022.
  8. "Indonesia - HRMI Rights Tracker". rightstracker.org. Retrieved 18 March 2022.
  9. "Indonesia Population (2020) - Worldometer". www.worldometers.info. Retrieved 30 September 2020.
  10. "World Population Prospects - Population Division - United Nations" . Retrieved 16 July 2017.
  11. "Indonesia | Data". data.worldbank.org. Retrieved 30 September 2020.
  12. "Indonesia Fertility Rate 1950-2020". www.macrotrends.net. Retrieved 30 September 2020.
  13. "The State Of The World's Midwifery". United Nations Population Fund. Archived from the original on 17 November 2019. Retrieved 30 November 2019.
  14. Gokkon, Basten (29 January 2014). "Indonesia Still Haunted by High Number of Maternal and Post-Natal Deaths". Jakarta Globe . Archived from the original on 30 January 2014.
  15. Kjellstrom, Tord; Holmer, Ingvar; Lemke, Bruno (11 November 2009). "Workplace heat stress, health and productivity – an increasing challenge for low and middle-income countries during climate change". Global Health Action. 2: 2047. doi:10.3402/gha.v2i0.2047. ISSN   1654-9880. PMC   2799237 . PMID   20052422.
  16. Haryanto; Budi; Akhtar; Rais (2023). Climate Change and Urban Air Pollution Health Impacts in Indonesia. Springer. ISBN   978-3-319-61345-1.
  17. World Health Organization, Regional Office for South-East Asia. (8–10 March 2010). South-East Asia regional conference on epidemiology (PDF). New Delhi. ISBN   978-92-9022-392-4.{{cite book}}: CS1 maint: location missing publisher (link)
  18. Setiawati, Martiwi Diah; Jarzebski, Marcin Pawel; Miura, Fuminari; Mishra, Binaya Kumar; Fukushi, Kensuke (2022), Chatterjee, Uday; Akanwa, Angela Oyilieze; Kumar, Suresh; Singh, Sudhir Kumar (eds.), "The Public Health Risks of Waterborne Pathogen Exposure Under a Climate Change Scenario in Indonesia" , Ecological Footprints of Climate Change : Adaptive Approaches and Sustainability, Springer Climate, Cham: Springer International Publishing, pp. 607–624, doi:10.1007/978-3-031-15501-7_24, ISBN   978-3-031-15501-7 , retrieved 13 May 2023
  19. Yusman, Syaukat (2011). The Impact of Climate Change on Food Production and Security and its Adaptation Programs in Indonesia. Indonesia: Department of Resource and Environmental Economics.
  20. Aditama, Tjandra Yoga (2000). "Impact of haze from forest fire to respiratory health: Indonesian experience". Respirology. 5 (2): 169–174. doi:10.1046/j.1440-1843.2000.00246.x. ISSN   1323-7799. PMID   10894107. S2CID   37870030.
  21. Rejeki DSS; Nurhayati N; Aji B; Murhandarwati EEH; Kusnanto H (2018). "A Time Series Analysis: Weather Factors, Human Migration and Malaria Cases in Endemic Area of Purworejo, Indonesia, 2005–2014". Iranian Journal of Public Health. 47 (4): 47(4):499–509. PMC   5996329 . PMID   29900134.
  22. Ady Wirawan, Made (2010). "Public Health Responses to Climate Change Health Impacts in Indonesia". Asia-Pacific Journal of Public Health. 22 (1): 25–31. doi:10.1177/1010539509350912. ISSN   1010-5395. PMID   20032032. S2CID   208340646.
  23. D'Amato, Gennaro; Pawankar, Ruby; Vitale, Carolina; Lanza, Maurizia; Molino, Antonio; Stanziola, Anna; Sanduzzi, Alessandro; Vatrella, Alessandro; D'Amato, Maria (2016). "Climate Change and Air Pollution: Effects on Respiratory Allergy". Allergy, Asthma & Immunology Research. 8 (5): 391–395. doi:10.4168/aair.2016.8.5.391. ISSN   2092-7355. PMC   4921692 . PMID   27334776.
  24. "Health and climate change: country profile 2015: Indonesia". www.who.int. Retrieved 13 May 2023.
  25. 1 2 3 4 5 6 Indonesia country profile. Archived 26 February 2005 at the Wayback Machine . Library of Congress Federal Research Division (December 2004). This article incorporates text from this source, which is in the public domain.
  26. "IssueBriefs: Water, sanitation & hygiene" (PDF). UNICEF Indonesia. October 2012. Archived from the original (PDF) on 24 January 2013. Retrieved 4 February 2017.
  27. "The State of the World's Children 2019". www.unicef.org. 15 October 2019. Retrieved 30 September 2020.
  28. "Poor diets damaging children's health worldwide, warns UNICEF". www.unicef.org. Retrieved 30 September 2020.
  29. "Indonesia". Tobacco Atlas. Retrieved 30 September 2020.
  30. Stoicescu, Claudia (5 February 2015). "Indonesia uses faulty stats on 'drug crisis' to justify death penalty". The Conversation. Retrieved 30 September 2020.
  31. "The future of mental health care in Indonesia". Inside Indonesia. Retrieved 30 September 2020.
  32. "Some Facts about Suicide in Indonesia". International Policy Digest. 30 September 2018. Archived from the original on 22 January 2021. Retrieved 30 September 2020.
  33. Leksono, Ageng Wibowo (23 April 2011). "Malignant malaria still haunts Indonesia". Antara . Retrieved 4 February 2017.
  34. "Govt to rid RI of malaria by 2030". The Jakarta Post . 26 April 2011. Archived from the original on 27 April 2011.
  35. Britnell, Mark (2015). In Search of the Perfect Health System. London: Palgrave. p. 49. ISBN   978-1-137-49661-4.
  36. dafluff (12 March 2018). "Vaccination for Children in Indonesia: Things you need to know!". Expat Indo. Retrieved 30 September 2020.
  37. "Q&A: BPJS Kesehatan, health for all Indonesians". The Jakarta Post. Retrieved 30 September 2020.