SummaryBackgroundAs Indonesia moves to provide health coverage for all citizens, understanding patterns of morbidity and mortality is important to allocate resources and address inequality. The Global Burden of Disease 2016 study (GBD 2016) estimates sources of early death and disability, which can inform policies to improve health care.MethodsWe used GBD 2016 results for cause-specific deaths, years of life lost, years lived with disability, disability-adjusted life-years (DALYs), life expectancy at birth, healthy life expectancy, and risk factors for 333 causes in Indonesia and in seven comparator countries. Estimates were produced by location, year, age, and sex using methods outlined in GBD 2016. Using the Socio-demographic Index, we generated expected values for each metric and compared these against observed results.FindingsIn Indonesia between 1990 and 2016, life expectancy increased by 8·0 years (95% uncertainty interval [UI] 7·3–8·8) to 71·7 years (71·0–72·3): the increase was 7·4 years (6·4–8·6) for males and 8·7 years (7·8–9·5) for females. Total DALYs due to communicable, maternal, neonatal, and nutritional causes decreased by 58·6% (95% UI 55·6–61·6), from 43·8 million (95% UI 41·4–46·5) to 18·1 million (16·8–19·6), whereas total DALYs from non-communicable diseases rose. DALYs due to injuries decreased, both in crude rates and in age-standardised rates. The three leading causes of DALYs in 2016 were ischaemic heart disease, cerebrovascular disease, and diabetes. Dietary risks were a leading contributor to the DALY burden, accounting for 13·6% (11·8–15·4) of DALYs in 2016.InterpretationOver the past 27 years, health across many indicators has improved in Indonesia. Improvements are partly offset by rising deaths and a growing burden of non-communicable diseases. To maintain and increase health gains, further work is needed to identify successful interventions and improve health equity.FundingThe Bill & Melinda Gates Foundation.
Introduction: The level of human immunodeficiency virus (HIV) transmission from mother to child in Indonesia ranks first worldwide. Newborn babies in Indonesia are at greater risk of experiencing the burden of HIV infection than babies born in other countries. Objectives: To explore the full extent of Prevention of Mother to Child Transmission (PMTCT) in South Sulawesi Province in 2020 and to discuss program and policy implications for PMTCT. Methods: This is a health system analysis study with a qualitative approach using focus group discussion, in-depth interviews, and observations in primary health centers and hospitals. Results: There is no local policy and guidelines for PMTCT programs and services; the coverage of HIV testing in pregnant women has not achieved 100% according to the target. There are limitations to human resources in public and private services to conduct the program. The assistance’s activities to ensure antiretroviral (ARV) adherence are limited, and HIV-positive women faced stigma and discrimination, not only from the community but also from health workers. Recommendations: Some recommendations are to improve the HIV test coverage to 100% in pregnant women as well as the coverage and quality of ARV treatment.
The persistent problem faced by Indonesia is in adequate in number and maldistribution of health workers in Primary Health Centre (PHC) has resulted in disrupted health services to the community. The aims of this study is describe health workers in ratio PHC per 100,000 population and health workers distributionbyregions. This research is descriptive analytic. The data used are secondary data from the health workers in government health care facilities in the district/city and province in Indonesia collected by Sub Centre data and information of health ministry in June 2018 and analyzed using the chi-square. The fact that inadequate numbers and maldistributionare remaining problems of health workers in PHC. The ratio of physiciansis 10,17, midwifes 84,73, nurses 83, Public health services 11,09 and nutritionists 8,30 per 100,000 populations while Government standards are higher. Maldistributions of health workers in PHC occurred in central and east regions of Indonesia. The highest number of health workers at PHC in Indonesian is midwives and nurses, while the smallest workforce is dentists. As in adequate numbers and maldistribution are the remaining problems of health workers in PHC, the recruitment of health workers should fulfil the community needs, geographic and avalaibility of health services. Providing the government scholarship to the locals in health schools with commitment to work for local government after graduation is one of the solution for this problem. E-health service is another solution, health service consultation can be carried out effectively and efficiently with remote health experts by taking the advantage of the internet.
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