Jakarta – Etik Retno Wiyati, Secretary of the Health Development Policy Agency (BKPK) of the Indonesian Ministry of Health, officially opened the second online Health Policy Analyst Learning Community on Tuesday (April 22). The event, themed "Policy Issues in the Main Units of the Ministry of Health," aims to strengthen the role of policy analysts in supporting national health transformation.
In his remarks, Etik said that Indonesia is currently at a critical point in the process of transforming the national health system. "In the past six months, we have jointly implemented various government priority programs in the health sector, from free health checks to building hospitals in various districts/cities," he said.
According to Etik, the free health check-up program is part of efforts to strengthen promotive and preventive services, which aims to increase early detection and intervention against disease risks in the community.
Etik emphasized the importance of the role of policy analysts in providing data-based input and evaluation results from the implementation of priority programs. "Through this learning community, it is hoped that all Ministry of Health personnel will understand strategic issues and be able to formulate policy recommendations that have a direct impact on the community," he added.
Regulation and Simplification of Health Rules
The first resource person, Iwan Kurniawan – Associate Expert Legislative Regulation Designer from the Legal Bureau of the Ministry of Health’s Secretariat General – explained that in the current health legal system there are various types of regulations, such as Laws (UU), Government Regulations in Lieu of Law (Perpu), Government Regulations (PP), Presidential Regulations (Perpres), and Regulations of the Minister of Health (PMK).
Iwan said that in 2023, Law Number 17 concerning Health was issued, which includes six pillars of health transformation. This law was then followed up with Government Regulation Number 24 of 2024 as implementing regulations. Based on the mandate of the Law and Government Regulation, it is necessary to compile 162 PMK and 71 Decrees of the Minister of Health (KMK).
However, Iwan also highlighted that there are currently 514 regulations (Ministry of Health Regulations and Ministerial Regulations) still in effect, which risk overregulation and policy disharmony. Therefore, the Ministry of Health has begun simplifying regulations by drafting 14 draft Ministerial Regulations and Ministerial Regulations, six of which have been enacted.
Primary Health Challenges and the Role of Transformation
Furthermore, the Secretary of the Directorate General of Primary and Community Health, Niken Wastu Palupi, explained the health challenges still faced by Indonesia, such as the Maternal Mortality Rate (189 per 100.000 live births) and the Infant Mortality Rate (16,8 per 1.000 live births), based on BPS 2020 data. Although on track with the 2024 target, Indonesia is still lagging behind other ASEAN countries.
Data from the 2023 Indonesian Health Survey (SKI) also shows that stunting occurs in 1 in 5 toddlers, and wasting in 1 in 12 toddlers. Therefore, strengthening primary health services is the main focus of the 2025–2029 RPJMN, including through free health checks, reducing stunting rates, and reducing maternal and child mortality.
"The transformation of primary health services will integrate services at Puskesmas, Pustu, Posyandu, and home visits," said Niken. At the village level, all health service posts will be united in the Village/Sub-district Health Service Unit (UPKDK), and Posyandu will provide health services that are in accordance with the community's life cycle.
The free health check-up program (PKG) will target all age groups with various check-up packages, including for infants, toddlers, school children, adults, and pregnant women.
In addition, strengthening primary services is also supported by the Strengthening of Primary Health Care of Indonesia (SOPHI) and Indonesia Public Laboratory System Strengthening (InPULS) programs , for the procurement of medical and laboratory equipment at Community Health Centers (Puskesmas), Community Health Posts (Pustu), Integrated Health Posts (Posyandu), and public health laboratories.
Advanced Healthcare Transformation
The last resource person, Ruri Purwandani from the Secretariat of the Directorate General of Advanced Health, conveyed the direction of advanced health policy in the 2025–2029 RPJMN which focuses on services for 10 catastrophic diseases and the highest causes of death, including cancer, heart disease, stroke, diabetes, and maternal and child health.
Equalization of referral services will be carried out through a network of hospitals for cancer, heart, stroke, and uronephrology (KJSU) services. The target is that by 2027 all districts/cities will have adequate KJSU referral services.
Hospitals will also be classified into Madya, Utama, and Paripurna according to their service capacity and resources. The need for facilities and human resources has been calculated in detail to support service expansion.
The Ministry of Health also launched the Specialist Doctor Education Program Based on Primary Teaching Hospitals (RSP-PU) in 2024 to address the shortage of specialist doctors in various regions. Ten Ministry of Health hospitals will function as primary university-based teaching hospitals.
Another flagship program is upgrading the quality of regional general hospitals (RSUD) from Class D to Class C, with intermediate service competencies. This program targets 66 RSUDs , with 32 to be upgraded by 2025 and the remaining 34 by 2026, through various funding sources and support from local governments.
Closing Event
As the closing of the webinar, Wiendra Waworuntu as the Principal Expert Policy Analyst expressed his hope that participants would gain in-depth insights into the transformation of primary and secondary health services, and could play an active role in providing policy recommendations that are beneficial to the community.
(Author: Fachrudin Ali, Editor: HDI and MIK Team)
