Better treatment, less burden: WHO and MoH speed up JKN redistributionBetter treatment, less burden: WHO and MoH speed up JKN redistribution


The World Health Organization (WHO), the Indonesian Ministry of Health (MoH), and important stakeholders reached a consensus on a plan on October 11, 2024, to improve access to comprehensive, high-quality primary health care (PHC) for all Indonesians. The proposal, which was finalized following a three-day meeting in South Kuta, Bali, is to more effectively allocate patients and resources across various PHC providers.

In accordance with WHO recommendations, PHC is key to attaining universal health coverage (UHC) in Indonesia's Health Transformation Agenda, which was introduced in 2022. UHC guarantees that everyone, everywhere, has unrestricted access to necessary medical care. Both state (puskesmas) and private PHC facilities in Indonesia offer vital health services such palliative care, illness prevention, treatment, rehabilitation, and health promotion.

 The National Health Insurance (JKN) program lies at the heart of Indonesia's PHC reorientation. At puskesmas, about 80% of JKN participants are registered. Although this shows how successful JKN has been and how much the public trusts puskesmas services, it also runs the risk of overburdening these institutions and lowering the standard of treatment. As required by Presidential Decree No. 59 of 2024 and BPJS-K Regulation No. 4 of 2019 on JKN Redistribution, a task-sharing mechanism allows patients to move between PHC facilities, but only with their permission.

Representatives from the Ministry of Home Affairs, the Indonesian Clinic Association, the National Health Insurance Agency (BPJS Kesehatan), the MoH's Directorate of Primary Care Services, and officials from ten provinces and sixteen cities or districts came together in Bali to assist in the scheme's implementation. Together, the participants shared best practices from Yogyakarta, Bangli, Maros, and Makassar while debating rules and quality standards to facilitate redistribution and guarantee equitable workloads across PHC providers.

According to Dr. Obrin Parulian, Director of Primary Health Care Services, MoH, Government of Indonesia, "empowering people should be the top priority." "People's experiences will be better and serve as a kind of quality control for us if they are informed about their right to select healthcare facilities according to their needs or preferences."

The necessity of identifying target facilities and making sure they adhere to set criteria and provide consistently high-quality care was acknowledged by the participants. Doctor-to-patient ratios, operating hours, and reassessing the capability of healthcare workers are important considerations. In order to bridge gaps in the quality and accessibility of care, participants also underlined the necessity of legislation that improve cooperation between local governments, healthcare providers, and the private sector.

Participants then emphasized the vital significance of outreach and public awareness initiatives. People will choose PHC providers that suit their needs and enroll in health care as a result of these activities. Additionally, they will increase confidence in the redistribution system, allowing people to choose or switch PHC providers with confidence.

Lastly, participants concurred that ongoing assessment and monitoring will support the maintenance of service quality and tackle issues like unfairness or member discontent. Importantly, this needs to cover situations in which patients ask to go back to their original PHC location.

Prof. Roderick Salenga, Ag. Team Lead for Health Systems Strengthening, WHO Indonesia, stated that the redistribution plan is essential to guaranteeing equitable access and lessening the stress on overworked facilities. "We can raise the standard of care everywhere by balancing our resources. WHO is prepared to help Indonesia bring this to fruition.

At the end of the conference, participants committed to important deadlines and milestones and agreed on next steps to direct redistribution efforts. In order to guarantee that every Indonesian has access to high-quality PHC for better lifestyles and that no one is left behind, WHO Indonesia is dedicated to helping MoH actively monitor the plan's implementation in 2024 and 2025.

Source who.int

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