As a manifestation of the Health Development Policy Agency (BKPK)'s contribution to supporting national health development, various policy recommendations have been produced throughout 2023. This page presents a summary of strategic policies based on evidence-based studies and analyses, to encourage informed decision-making in the health sector.
Executive Summary : Reflecting on the Atypical Acute Progressive Renal Failure (AGPA) case, this bi-weekly analysis emphasizes the importance of active pharmacovigilance for drugs already distributed in Indonesia. Recommendations are directed to the Food and Drug Authority (BPOM) and the Ministry of Health to further refine the implementation of existing pharmacovigilance.
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Executive Summary : The government's limited capacity to implement the health system is one of the reasons why private sector implementers are emerging. To address this, the government is required to utilize various funding alternatives, one of which is a development cooperation scheme involving the private sector, known as a Public Private Partnership (PPP). Facts show that 268 (52,14%) regencies/cities have implemented Public Private Partnerships (PPPs), both at low, medium, and high fiscal levels.
Collaboration in hospitals generally takes the form of operational cooperation (KSO), while in community health centers, it is incidental in the form of Corporate Social Responsibility (CSR) cooperation with companies in their respective areas. The Ministry of Health has issued Ministerial Regulation No. 40 of 2018 and Ministerial Regulation No. 27 of 2022, which serve as the basis for implementing government-private sector cooperation in both infrastructure and non-infrastructure sectors in the provision of healthcare services in Indonesia.
In an effort to accelerate the implementation of government-private partnerships to support health financing and services, particularly in the non-health infrastructure sector, it is recommended to immediately establish a Public-Private Partnership (PPP) Management Committee.
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Collaboration in hospitals generally takes the form of operational cooperation (KSO), while in community health centers, it is incidental in the form of Corporate Social Responsibility (CSR) cooperation with companies in their respective areas. The Ministry of Health has issued Ministerial Regulation No. 40 of 2018 and Ministerial Regulation No. 27 of 2022, which serve as the basis for implementing government-private sector cooperation in both infrastructure and non-infrastructure sectors in the provision of healthcare services in Indonesia.
In an effort to accelerate the implementation of government-private partnerships to support health financing and services, particularly in the non-health infrastructure sector, it is recommended to immediately establish a Public-Private Partnership (PPP) Management Committee.
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Executive Summary : Indonesia continues to face a chronic shortage of healthcare workers, particularly doctors and specialists, for a long time. The government is targeting the addition of approximately 130.000 doctors to achieve the target ratio of 1 per 1000 residents. However, achieving this is still hampered by three main obstacles. First, the database on the availability, needs, and educational quotas of doctors and specialists from upstream to downstream has not been integrated as a basis for planning. Second, communication and coordination in the clinical learning process have not been optimal. Third, there is no regulatory framework that addresses the role of regional governments and other important stakeholders. This study recommends a transformative policy, namely strengthening readiness to adapt to the policy of increasing the educational quota for doctors and specialists, especially from the perspective of educational institutions and regional governments. The operational strategies for this policy are: 1) Verify the need for doctors and specialists in the region; 2) Faculties of Medicine send students to educational institutions according to the capacity of teaching hospitals; 3) Faculties prioritize students from health facilities with shortages of doctors and specialists; and 4) Regional heads, directors of teaching hospitals, and deans of Faculties of Medicine make a written commitment to regulate the implementation of plans for the utilization of doctors and specialists.
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Executive Summary : The Community Health Center is led by a Head of the Community Health Center in accordance with statutory provisions. The Head of the Community Health Center is responsible for all activities at the Community Health Center, personnel development within the work unit, financial management, and the management of buildings, infrastructure, and equipment. The Head of the Community Health Center is appointed and dismissed by the regent/mayor.
One of the requirements stipulated in the Minister of Health Regulation Number 43 of 2019 concerning Community Health Centers (Puskesmas), to be appointed as a Head of a Community Health Center, one must meet the requirement of having management skills in the field of public health. Through the integration of primary health care services, which supports the transformation of primary care and the transformation of human resources for health, the role of the Head of the Community Health Center as the person responsible for health services in their work area becomes increasingly important. Therefore, strengthening and developing the competency of the Head of the Community Health Center requires attention and support from the Regional Government, both in management and technical competencies.
For the implementation of health center management training, the Minister of Health Regulation Number 44 of 2016 has been stipulated based on the Minister of Health Regulation Number 75 of 2014 concerning Health Centers which has been revoked by the Minister of Health Regulation Number 43 of 2019. In addition, for technical training of regional apparatus organizations, the Minister of Health Regulation Number 10 of 2020 concerning Technical Competency Standards for Regional Apparatus Officials in the Health Sector has been stipulated. The results of the study "Strengthening the Role of Regions in Developing the Competence of Heads of Health Centers" carried out by the Health Decentralization Working Team, Center for Health Financing and Decentralization Policy.
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One of the requirements stipulated in the Minister of Health Regulation Number 43 of 2019 concerning Community Health Centers (Puskesmas), to be appointed as a Head of a Community Health Center, one must meet the requirement of having management skills in the field of public health. Through the integration of primary health care services, which supports the transformation of primary care and the transformation of human resources for health, the role of the Head of the Community Health Center as the person responsible for health services in their work area becomes increasingly important. Therefore, strengthening and developing the competency of the Head of the Community Health Center requires attention and support from the Regional Government, both in management and technical competencies.
For the implementation of health center management training, the Minister of Health Regulation Number 44 of 2016 has been stipulated based on the Minister of Health Regulation Number 75 of 2014 concerning Health Centers which has been revoked by the Minister of Health Regulation Number 43 of 2019. In addition, for technical training of regional apparatus organizations, the Minister of Health Regulation Number 10 of 2020 concerning Technical Competency Standards for Regional Apparatus Officials in the Health Sector has been stipulated. The results of the study "Strengthening the Role of Regions in Developing the Competence of Heads of Health Centers" carried out by the Health Decentralization Working Team, Center for Health Financing and Decentralization Policy.
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Executive Summary : Coronary heart disease (CHD) is the leading cause of death worldwide and the second leading cause in Indonesia in 20191. Stent placement with Percutaneous Coronary Intervention (PIKP) procedures has cost approximately IDR 1,45 trillion per year with an average of 36.248 procedures in 2018-20202. The Ministry of Health has conducted the first assessment in Indonesia to evaluate the feasibility of stent placement using Appropriate Use Criteria (AUC) for coronary revascularization in patients with Acute Coronary Syndrome (ACS) and Stable Angina Pectoris (APS). 3 Based on this evidence, the Health Technology Assessment Committee (PTK) recommended the implementation of an AUC instrument to improve the feasibility/appropriateness of stent placement, including the arrangement of a heart disease data registration system. To date, CHD management guidelines have not specifically included an assessment of the appropriateness of stent placement in the form of a score. PERKI and PAPDI have an important role in developing the AUC instrument in Indonesia. As a primary step, the Ministry of Health needs to immediately establish a PNPK APS (National Health Protocol for the Prevention of Infectious Diseases) in collaboration with the professional organizations PERKI (National Health Protocol for the Prevention of Infectious Diseases) and PAPDI (National Health Protocol for the Prevention of Infectious Diseases). The PNPK APS must include clinical points and examinations required to assess the appropriateness of IKP procedures, referring to the AUC instrument used in HTA.
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Executive Summary : As a new province under the decentralized governance of Indonesia, the province of Southwest Papua needs to strengthen its health system transformation, particularly primary health care, ensuring that everyone everywhere has the right to achieve the highest level of health. The public health of West Papua, as the parent province of Southwest Papua, has not shown good results when viewed from health indicators, such as maternal mortality, infant and toddler mortality, and stunting, which are above the national average. This paper aims to present a situational analysis using the WHO six building blocks related to primary health care in Southwest Papua as a basis for health development planning. The coverage of almost all priority primary health care programs in Southwest Papua does not reach the Strategic Plan targets and/or national figures, and much data is incomplete. The pillars of the health system in Southwest Papua are still considered weak and require strengthening and support from the central government. The priority of health development in Southwest Papua should be focused on primary health care through the fulfillment of governance, basic infrastructure, and resource guarantees, supported by community empowerment, as well as full assistance and support from the central government.
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Executive Summary : Currently, there is an uneven distribution of specialist doctors, which has an impact on suboptimal public health services at the referral service level. The Ministry of Health has implemented an adaptation program for specialist doctors from non-resident Indonesian citizens (WNI) whose goal is to address this issue. The utilization of non-resident Indonesian citizens (WNI) health workers, especially specialist doctors, is expected to be an option for the government in efforts to equalize and meet the need for referral health services nationally. Ministerial Regulation of the Minister of Health Number 14 of 2022 concerning the Utilization of Specialist Doctors of Indonesian Citizens (WNI) Graduated Abroad (LLN), states that one of the rights of dr.Sp.WNI LLN is to receive incentives, in addition to service fees (Article 21). The proposed policy recommendation is that the Director General of Health Workers needs to issue regulations on incentive standards for specialist doctors for civil servants, non-civil servants, and specialist doctors from non-resident Indonesian citizens (WNI) graduated abroad. The incentive standards are prepared by considering regional fiscal capacity, DTPK/difficult/unpopular working areas, cost-of-living allowances, availability of cases handled, and scarcity of specialists. Incentive standards/regulations will encourage increased distribution and retention of specialist doctors in the regions. It is also necessary to revise Article 21 or Article 30 of the Minister of Health Regulation No. 14 of 2022 by the Director General of Health Workers. This regulation, which originally only regulated incentives from central government funding, includes the addition of additional language regarding incentives for specialist doctors from regional government funding as a reference for future regions. This effort is expected to narrow the take-home pay gap between specialist doctors of the same type with different statuses (civil servant specialist doctors, PGDS, and non-Indonesian citizen specialist doctors).
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Executive Summary : The role of health financing in the implementation of the Minimum Service Standards (SPM) for health in the disaster sector is still not a priority, even though the SPM is a mandatory government affair for basic services as a regional priority, as mandated by Law No. 23/2014 concerning Regional Government and funding support, as mandated by Government Regulation No. 2/2018 concerning Minimum Service Standards. Minister of Home Affairs Regulation No. 59/2021 explains that the Minimum Service Standards for health in the disaster sector are the responsibility of the province. Furthermore, there is a division of disaster emergency status, according to Law No. 24/2007 concerning disaster management, divided into three levels: district, provincial, and national disaster status.
At the district/city level, only the district/city is responsible for disaster management, not the province, so the disaster SPM cannot be implemented. Based on this, it is necessary to submit policy recommendations on the role of health financing in supporting the implementation of the SPM for Health in the Field of Disasters in the Region based on the results of field studies. The solution, so that the role of financing in the implementation of the SPM for Health in the disaster sector fulfills the mandate of Permendagri 59/2021, is to require the SPM as a regional priority program supported by funding in sufficient amounts and appropriate allocations. The revision of Permendagri No. 59/2021, Article 3 letter c concerning disaster management, states that provincial responsibility must become the responsibility of the district/city. This is in accordance with the provisions of the BPBD district/city responsible for disaster management at the district/city disaster status level. Alternatively, there needs to be guidelines/SOPs for the division of duties and authorities between the provincial and district/city governments.
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At the district/city level, only the district/city is responsible for disaster management, not the province, so the disaster SPM cannot be implemented. Based on this, it is necessary to submit policy recommendations on the role of health financing in supporting the implementation of the SPM for Health in the Field of Disasters in the Region based on the results of field studies. The solution, so that the role of financing in the implementation of the SPM for Health in the disaster sector fulfills the mandate of Permendagri 59/2021, is to require the SPM as a regional priority program supported by funding in sufficient amounts and appropriate allocations. The revision of Permendagri No. 59/2021, Article 3 letter c concerning disaster management, states that provincial responsibility must become the responsibility of the district/city. This is in accordance with the provisions of the BPBD district/city responsible for disaster management at the district/city disaster status level. Alternatively, there needs to be guidelines/SOPs for the division of duties and authorities between the provincial and district/city governments.
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Executive Summary : Cataracts are the leading cause of blindness in Indonesia. Blindness due to cataracts can be prevented with cataract surgery. One cataract surgery technique is phacoemulsification. In the National Health Insurance (JKN) program, cataract surgery is included in the guaranteed benefits package, with phacoemulsification being the recommended technique. This has led to higher utilization and financing of phacoemulsification compared to other types of cataract surgery, such as Extra Capsular Cataract Extraction (ECCE). An Economic Evaluation study reviewing phacoemulsification versus ECCE techniques found that phacoemulsification was proven to be more cost-effective than ECCE, with improvements in best uncorrected visual acuity (UCVA) outcomes 1-2 months postoperatively.1 However, there are challenges in implementing phacoemulsification, namely the issue of service equity. Phacoemulsification is more commonly performed in large cities in western Indonesia, such as East Java, Central Java, West Java, and Jakarta. Phacoemulsification procedures are still limited in eastern Indonesia, despite the high rate of cataract blindness in the region. The uneven distribution of phacoemulsification equipment and eye health professionals is one reason for this. Therefore, equitable distribution of phacoemulsification services is needed, including the availability of eye health professionals and phacoemulsification equipment (including its components).
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Executive Summary : The transformation of primary care requires that HRH needs be met in primary care facilities. Many HRH planning policies have been formulated, but they have not been able to address the need for health workers. The emerging problems tend to be static, namely the lack of synchronization between planning and availability, resulting in ongoing shortages of health workers and maldistribution. Therefore, HRH planning policies are needed to be updated to meet needs and adapt to existing changes. The question of what form such updates will take is a crucial formulation that requires in-depth study and discussion. A HRH planning transformation policy is needed through a revision of technical regulations related to HRH planning, as stipulated in Minister of Health Regulation Number 33 of 2015, as the main policy umbrella for the emergence of local policies that can accommodate the specifications of each region.
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Executive Summary : MSME performance data as revealed in the 2013 and 2018 Riskesdas are still far below the targets of the National Medium-Term Development Plan (RPJMN) and the Health Strategic Plan (Renstra), for example, complete basic immunization coverage (IDL), Tuberculosis Case Detection Rate (CDR TB), antenatal services, and others).
The provision of incentives is expected to increase motivation and enthusiasm for staff at community health centers and become one of the factors that can improve health indicators that have been less than satisfactory over the past decade.
First, the Minister of Health and the Secretary General of the Ministry of Health stated that in addition to providing appreciation to Community Health Center staff, the provision of incentives is expected to improve the performance of UKM programs, especially priority programs (KIA, nutrition, disease control, environmental health and health promotion).
The first UKM incentive calculation calculates the incentives obtained for the health center by considering the performance of budget realization, UKM achievements in 12 SPM Services, population and the level of remoteness of the area from the health center, then the results are divided among the health center staff with a composition of 15% for management activities and 85% for activities outside the field. The distribution of incentives per individual considers how many management activities and frequency of fieldwork are carried out, education level, main position and additional positions. The provision of incentives for field health center staff is expected to balance the increasing workload of UKM services in the field.
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The provision of incentives is expected to increase motivation and enthusiasm for staff at community health centers and become one of the factors that can improve health indicators that have been less than satisfactory over the past decade.
First, the Minister of Health and the Secretary General of the Ministry of Health stated that in addition to providing appreciation to Community Health Center staff, the provision of incentives is expected to improve the performance of UKM programs, especially priority programs (KIA, nutrition, disease control, environmental health and health promotion).
The first UKM incentive calculation calculates the incentives obtained for the health center by considering the performance of budget realization, UKM achievements in 12 SPM Services, population and the level of remoteness of the area from the health center, then the results are divided among the health center staff with a composition of 15% for management activities and 85% for activities outside the field. The distribution of incentives per individual considers how many management activities and frequency of fieldwork are carried out, education level, main position and additional positions. The provision of incentives for field health center staff is expected to balance the increasing workload of UKM services in the field.
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Executive Summary : Telemedicine and Telehealth are innovations in the use of information technology in the world of medical services. Telemedicine is a medical practice that uses technology or telecommunications devices to provide care remotely. On the other hand, Telehealth has a broader definition and refers to long-distance health services, both clinical and non-clinical. As a country actively involved in international relations in various fields, including technology, Indonesia has collaborated with several countries, especially in health technology, such as technology in telemedicine. To ensure the implementation of cooperation in terms of piloting health technology projects in general can be carried out well, in accordance with the existing system, and the results can be optimally utilized both the tools, technology and service systems, it is necessary to prepare good governance. Some technologies from foreign countries that have been utilized related to telehealth or telemedicine services in hospitals in Indonesia include tele ICU (Intensive Care Unit) at the University of Indonesia Hospital, in collaboration with JICA (Japan International Cooperation Agency), tele robotic surgery (still in the process of technological development) including at Hasan Sadikin General Hospital, Bandung, in collaboration with Iran, and Telemedicine with the Sadra device at Dr. Soetomo General Hospital. Kariadi Semarang, a collaboration with Iran. The study revealed that several policies related to monitoring and evaluation, financing systems, data management, and regulations are still needed.
Therefore, in order to achieve the health development goals, the Ministry of Health has established 6 pillars of health transformation, namely: transformation of primary services that prioritize health promotion, transformation of secondary services, transformation of the health resilience system, transformation of the health financing system, transformation of health human resources (HR), and transformation of health technology.
The application of technology in healthcare, characterized by widespread digitalization, optimization, and the use of artificial intelligence, is creating significant changes in healthcare. Increasingly sophisticated medical technologies (such as artificial narrow intelligence, robotics, and genomics); the revolution in hardware and software in healthcare, telemedicine, virtual and augmented reality; the penetration of internet access, mobile phones, and smartphones; the abundance of health information from various sources; an increasingly aware and intelligent society; and the increasing cost of providing modern healthcare services are all challenges that arise in this disruptive era. Disruption is defined as fundamental change that replaces all old ways of working with fundamental innovations. Future healthcare is expected to be increasingly connected (hyperconnected healthcare). Digital-based innovations in healthcare, along with breakthrough technologies (cloud computing, supercomputing, big data, and the Internet of Things – IoT) will increasingly play a crucial role in healthcare.
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Therefore, in order to achieve the health development goals, the Ministry of Health has established 6 pillars of health transformation, namely: transformation of primary services that prioritize health promotion, transformation of secondary services, transformation of the health resilience system, transformation of the health financing system, transformation of health human resources (HR), and transformation of health technology.
The application of technology in healthcare, characterized by widespread digitalization, optimization, and the use of artificial intelligence, is creating significant changes in healthcare. Increasingly sophisticated medical technologies (such as artificial narrow intelligence, robotics, and genomics); the revolution in hardware and software in healthcare, telemedicine, virtual and augmented reality; the penetration of internet access, mobile phones, and smartphones; the abundance of health information from various sources; an increasingly aware and intelligent society; and the increasing cost of providing modern healthcare services are all challenges that arise in this disruptive era. Disruption is defined as fundamental change that replaces all old ways of working with fundamental innovations. Future healthcare is expected to be increasingly connected (hyperconnected healthcare). Digital-based innovations in healthcare, along with breakthrough technologies (cloud computing, supercomputing, big data, and the Internet of Things – IoT) will increasingly play a crucial role in healthcare.
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Executive Summary : The Ministry of Health has currently established six pillars of health system transformation. Health surveillance is needed to improve health data and information management capabilities. Therefore, a system is needed to ensure regular, continuous, and valid data and information are available. Therefore, a study is being conducted to provide input to stakeholders on how to create a community-based surveillance system that is applicable and integrated.
The results of the study found several problems at each institutional level, including those related to regulations, guidelines, human resources, and knowledge. Therefore, a solution is needed, namely the Revision of Minister of Health Regulation Number 45 of 2014 concerning Health Surveillance by clarifying the roles, duties, functions, rights and obligations of supporting human resources, accelerating the preparation and dissemination of community-based surveillance guidelines by involving all relevant stakeholders and harmonizing and integrating health surveillance information systems, including community-based surveillance, with the ASIK platform for recording reports inside and outside the building and their analysis. However, there is no certainty whether it will be integrated with ASIK. Meanwhile, primary services are currently piloting Posyandu Prima as its flagship in the primary service integration program (ILP). In order to realize the six pillars of health transformation, especially health technology transformation, as stated in the Revised Strategic Plan of the Ministry of Health for 2020-2024, the Ministry of Health launched the SatuSehat Program and the My Healthy Indonesia Application (ASIK).
This platform and application will be used across all healthcare facilities in an integrated manner. At the same time, the Directorate of Health Surveillance and Quarantine of the Directorate General of Disease Prevention and Control (P2P) is strengthening the “Community-Based Surveillance” program, which is one of the implementations of the Minister of Health Regulation Number 45 of 2014 concerning Health Surveillance. Program data reporting, which is one of the strategies in implementing the transformation of the health security system, is planned to be integrated with the Early Warning and Response System (SKDR) and the Community Health Center Management System (SIMPUS) applications. Health transformation, especially ILP and the health security system (Community-Based Surveillance), must of course learn from the classic problems of similar community-based health information systems such as the Healthy Indonesia Program with a Family Approach (PIS-PK).
Several obstacles to the management of PIS-PK which was launched in 2016, according to monitoring and evaluation data from the Directorate of Primary Health Services in May 2022, showed that the 2 health centers that carried out implementation with 100% coverage of family intervention, data collection, data analysis, and data utilization were respectively 47%, 85% and 77% of all health centers that had been trained.
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The results of the study found several problems at each institutional level, including those related to regulations, guidelines, human resources, and knowledge. Therefore, a solution is needed, namely the Revision of Minister of Health Regulation Number 45 of 2014 concerning Health Surveillance by clarifying the roles, duties, functions, rights and obligations of supporting human resources, accelerating the preparation and dissemination of community-based surveillance guidelines by involving all relevant stakeholders and harmonizing and integrating health surveillance information systems, including community-based surveillance, with the ASIK platform for recording reports inside and outside the building and their analysis. However, there is no certainty whether it will be integrated with ASIK. Meanwhile, primary services are currently piloting Posyandu Prima as its flagship in the primary service integration program (ILP). In order to realize the six pillars of health transformation, especially health technology transformation, as stated in the Revised Strategic Plan of the Ministry of Health for 2020-2024, the Ministry of Health launched the SatuSehat Program and the My Healthy Indonesia Application (ASIK).
This platform and application will be used across all healthcare facilities in an integrated manner. At the same time, the Directorate of Health Surveillance and Quarantine of the Directorate General of Disease Prevention and Control (P2P) is strengthening the “Community-Based Surveillance” program, which is one of the implementations of the Minister of Health Regulation Number 45 of 2014 concerning Health Surveillance. Program data reporting, which is one of the strategies in implementing the transformation of the health security system, is planned to be integrated with the Early Warning and Response System (SKDR) and the Community Health Center Management System (SIMPUS) applications. Health transformation, especially ILP and the health security system (Community-Based Surveillance), must of course learn from the classic problems of similar community-based health information systems such as the Healthy Indonesia Program with a Family Approach (PIS-PK).
Several obstacles to the management of PIS-PK which was launched in 2016, according to monitoring and evaluation data from the Directorate of Primary Health Services in May 2022, showed that the 2 health centers that carried out implementation with 100% coverage of family intervention, data collection, data analysis, and data utilization were respectively 47%, 85% and 77% of all health centers that had been trained.
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Executive Summary : One of the pillars of health transformation is health technology transformation, where activities are translated through the development and utilization of technology, digitalization, and biotechnology in the health sector. The COVID-19 pandemic that has hit the world since early 2020 has revealed the importance of interoperability in health services. Therefore, by using HL7FHIR, the Ministry of Health, through the Digital Transformation Office (DTO), developed the integration of patient medical records data at health care facilities into a single Indonesia Health Services (HIS) platform called SATU SEHAT, which was inaugurated by the Minister of Health on July 28, 2022. One of SATU SEHAT's products is the expansion of the Peduli Lindungi (PL) application features, which include Electronic Personal Health Records and the addition of child immunization/vaccination data. This feature can digitally view a child's immunization status and, in the future, can also view the user's health history, including disease history, treatment, and examination results from health workers. Some potential issues that could arise from this platform expansion include patient data protection, health care facility readiness in implementing the SATU SEHAT platform, and public awareness in using the application. A study has been conducted on the acceptance and utilization of these features in the community, and it was found that 3 out of 4 people welcomed the expansion of the PL application features, but 68,8% of respondents with low education did not download the PL application on their smartphones. Therefore, a communication strategy is needed to disseminate information to the low-educated community, so that the use of the platform developed by the Ministry of Health can be enjoyed by all levels of society, along with regulatory support to support the application's development.
Patients might use a web portal or mobile device to confirm their vaccination status, for example, or a patient with a cough might interact with a bot to contact the appropriate doctor. COVID-19 has demonstrated the critical importance of Information Technology (IT) for delivering disease care and research. The stakes are not only managing the pandemic but also developing a foundation for using technology to redefine care in the years to come. The Ministry of Health, through the DTO, recently launched a unified Indonesia Health Services (HIS) platform called SATU SEHAT, which integrates patient medical records across healthcare facilities (1). This development aligns with the Ministry of Health's 2020-2024 Strategic Plan (Renstra) on Health Information System (SIK) integration and the 2020-2024 Medium-Term Development Plan (RPJM) on improving healthcare delivery (2,3). In addition to connecting healthcare facilities, patients can also access test results through the PL application, which will be developed into the Citizen Health Application (CHA). In addition to building a support platform for data input, electronic patient medical records are also mandatory for healthcare facilities, as regulated by Ministerial Regulation No. The recently issued Ministerial Regulation No. 24 of 2022 updates Ministerial Regulation No. 269 of 2008 concerning Medical Records, which includes additional regulations, such as regulations regarding digital technology and the implementation of electronic medical records.
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Patients might use a web portal or mobile device to confirm their vaccination status, for example, or a patient with a cough might interact with a bot to contact the appropriate doctor. COVID-19 has demonstrated the critical importance of Information Technology (IT) for delivering disease care and research. The stakes are not only managing the pandemic but also developing a foundation for using technology to redefine care in the years to come. The Ministry of Health, through the DTO, recently launched a unified Indonesia Health Services (HIS) platform called SATU SEHAT, which integrates patient medical records across healthcare facilities (1). This development aligns with the Ministry of Health's 2020-2024 Strategic Plan (Renstra) on Health Information System (SIK) integration and the 2020-2024 Medium-Term Development Plan (RPJM) on improving healthcare delivery (2,3). In addition to connecting healthcare facilities, patients can also access test results through the PL application, which will be developed into the Citizen Health Application (CHA). In addition to building a support platform for data input, electronic patient medical records are also mandatory for healthcare facilities, as regulated by Ministerial Regulation No. The recently issued Ministerial Regulation No. 24 of 2022 updates Ministerial Regulation No. 269 of 2008 concerning Medical Records, which includes additional regulations, such as regulations regarding digital technology and the implementation of electronic medical records.
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Executive Summary : In Indonesia's G20 presidency, the COVID-19 pandemic has entered its third year. The world is experiencing an economic slowdown due to international transportation restrictions and border closures, hampering the movement of goods and people between and within countries. For example, foreign tourists dropped drastically by 72-73% in 2020-2021 compared to 2019. Quarantine processes implemented by each country are not uniform and are time-consuming and costly, so efforts are needed to create a system that is acceptable to all countries and can be implemented globally. In accordance with the provisions of the IHR, international travel can be carried out if a health certificate is accessed in each country, thereby reducing and facilitating international travel bureaucracy. Indonesia's position is crucial in seeking this agreement. Indonesia's position is used. The theme of the first G20 Working Group is Harmonizing Global Health Protocol Standards.
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Executive Summary : The Covid-19 pandemic has taught us the importance of resilience and independence in the domestic pharmaceutical sector. The President of the Republic of Indonesia has mandated efforts to fulfill and increase the competitiveness of pharmaceutical preparations as one of the government's tasks, as outlined in the 2020-2024 National Medium-Term Development Plan (RPJMN). The Ministry of Health has followed up on pharmaceutical and medical device independence as a strategy for health system reform. In addition to government support, pharmaceutical and medical device independence also depends on the support of the industry ecosystem. Several things need to be prepared to address the challenges and issues of domestic drug raw material independence, including human resources and technology, as well as partnerships between the government and the national pharmaceutical industry.
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Executive Summary : TB under-reporting is common in private healthcare facilities. Although the Ministry of Health has issued regulations requiring all healthcare facilities providing TB services to record and report cases in the Tuberculosis Information System (SITB), as of June 2022, the number of reports was still below the target (less than 30% of the 48% target). Field confirmation conducted in Malang Regency and Kendari City identified the root causes of under-reporting by healthcare facilities in the SITB, including the healthcare facility's commitment to recording and reporting in the SITB, monitoring and evaluation by the Health Office, integration of TB case data in healthcare facilities with in-house applications, and the large number of private healthcare facilities that do not yet have a TB service MoU with the Health Office.
Based on the root of the problem, the proposed policy recommendations are short-term policy recommendations specifically for private health facilities, especially Clinics/DPMs that do not yet have a TB service MoU and do not yet have a SITB account, the District/City Health Office in collaboration with the District Health Office, Community Health Centers and involving the PPM team to conduct continuous socialization and supervision regarding TB services and the obligation to record in SITB and encourage them to have a TB service MoU. Specifically for private health facilities whose SITB recording and reporting coverage is still low, the Health Office needs to conduct regular supervision and monitoring (quarterly) to increase the capacity of officers by providing technical support and guidance for TB officers. In addition, hold an annual supervision workshop to discuss problems encountered in the use of SITB in each health facility, and find appropriate solutions.
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Based on the root of the problem, the proposed policy recommendations are short-term policy recommendations specifically for private health facilities, especially Clinics/DPMs that do not yet have a TB service MoU and do not yet have a SITB account, the District/City Health Office in collaboration with the District Health Office, Community Health Centers and involving the PPM team to conduct continuous socialization and supervision regarding TB services and the obligation to record in SITB and encourage them to have a TB service MoU. Specifically for private health facilities whose SITB recording and reporting coverage is still low, the Health Office needs to conduct regular supervision and monitoring (quarterly) to increase the capacity of officers by providing technical support and guidance for TB officers. In addition, hold an annual supervision workshop to discuss problems encountered in the use of SITB in each health facility, and find appropriate solutions.
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Executive Summary : Pneumonia cases in Indonesia remain high, necessitating a PCV vaccine for toddlers. PCV vaccine development is currently in the fill-and-finish stage. Obstacles encountered include the lack of success in mRNA-based vaccine development technology, 90-95% import of material supply, no donor country interested in developing a PCV vaccine, limited clinical trials with GCP, and a lack of standardization of facilities and infrastructure. Capacity building is needed for technology transfer from the European Union and the United States, and clinical trial standards are needed in terms of facilities and infrastructure. GCP training is needed for healthcare workers in hospitals and universities.
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Executive Summary : During Indonesia's presidency at the G20, Indonesia acknowledged that the COVID-19 pandemic had provided important lessons, highlighting several challenges that need to be addressed to address future pandemics. The first issue is the limited availability of funding, preventing countries with weak economies from fully funding pandemic response. Second, access to medicines, vaccines, laboratory equipment, and personal protective equipment (PPE) during the pandemic was hampered by embargoes from several producing countries to meet their own needs. Finally, there is a lack of surveillance for genomic data. Therefore, it is proposed that a global fund be established to address future pandemics. The innovations should not be duplicated but complement those of the Joint Finance-Health Task Force (FHTF). Second, the ability to rapidly mobilize vaccines, medicines, reagents, and personal protective equipment (PPE) globally is enhanced, ensuring equal access for both low- and middle-income countries. Third, the establishment of a platform to enhance reliable genomic surveillance that can be utilized by all G20 members. All recommendations will be advocated to all G20 members attending the second G20 Working Group in Lombok. With the hope that it will provide input for the G20 Bali Summit and be a result of Indonesia's G20 Presidency, the theme of the Second G20 Working Group is Building Global Health System Resilience.
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