New Insights Into the Provision of Health Services in Indonesia

Book excerpt: Over the past decade, Indonesia has implemented significant health sector reforms that include decentralizing responsibilities for service delivery, designing incentives for health providers, increasing the supply of midwives in remote areas, and analyzing demographic and epidemiological transitions causing changes in the patterns of disease prevalence. Financial protection against catastrophic expenditures has improved substantially, and legislation has been enacted to improve the quality of physician training and patient care.Despite the progress, substantial challenges remain and include comparatively low resources for the health sector, limitations in the supply of providers at the primary and hospital levels, inefficient payment systems, shortcomings in the quality of maternal and child and adult care, lack of oversight and effective licensing in an expanding private health sector, and ineffective planning for and recruitment and retention of health workers.Given the slow pace in improving health outcomes and limited evidence linking health performance and the health workforce, the need to make more information available about past experiences to inform future policy changes is pressing. Few studies have been undertaken to measure the actual impact of the reforms and the remaining challenges. 'New Insights into the Provision of Health Services in Indonesia: A Health Workforce Study' begins the process, providing real time evidence-based inputs to facilitate the Government of Indonesia's comprehensive health sector review. The authors' analysis of panel data from households and health providers will assist the government's assessment of the impact of past health work force policies and its consideration of policy changes.