This latest study, most comprehensive ever conducted, provides critical insights as Indonesia gears up for universal health coverage next year
Since 1995, Indonesia has made many advances in healthcare, helping to increase overall life expectancy by ten years and also lowering rates of many common infectious diseases like tuberculosis and diarrheal disease. But the country is now facing a new and expensive wave of health threats ranging from diabetes, ischemic heart disease, autoimmune diseases, brain strokes, and many other non-communicable diseases.
Indonesia is facing a ‘double burden’ of infectious diseases that are affecting both mothers and their infants. Former Indonesian health minister Dr. Nafsiah Mboi led the research team that found healthcare coverage becomes even more complicated as Indonesians are now living longer lives and facing a complex scenario with combinations of multiple diseases.
The study by Dr. Mboi is part of the Global Burden of Disease (GBD) study by the Indonesian health board to compare better and quantify healthcare domestically and internationally. As part of the study, Dr. Mboi collaborated with other Indonesian scientists working for the National Institute of Health Research and Development, University of Indonesia, Ministry of Health, The National Social Health Insurance Scheme, The Central Bureau of Statistics, the Eijkman Oxford Institute and the National Planning Board. The diverse team reviewed over 380 causes of death and medical disability in Indonesia and compared them to eight other countries. To date, this is the most extensive joint effort ever to examine current Indonesian health trends and their underlying causes.
The good news is that Indonesians today are living longer than ever before, with an overall life expectancy of 72.7 years in 2019 compared to 64.6 years in 1995. The research shows that Indonesian women live a bit longer than Indonesian men, and the team believes this rapid increase in overall life expectancy grew as the result of many coordinated medical efforts targeting nutritional deficiencies, communicable diseases, maternal care, and better neonatal preparation. In 1995 the top three causes of death in Indonesia were lower respiratory infections (LRI), diarrhea, and tuberculosis (TB). In 2020, tuberculosis disease was down to being the fifth, while diarrhea-related diseases and lower respiratory infections were no longer in the top ten.
Despite substantial improvements in overall healthcare, several new diseases pose significant health challenges. Today, rates of death due to diabetes and cardiovascular diseases and have skyrocketed in the past 30-plus years, mainly due to high blood pressure, poor fast-food diets, tobacco, and high blood sugar levels. Type II Diabetes has shown the fastest rising condition with death and disability related to diabetes type 2, increasing from 39.5% since 2004. Such rapid growth across the population will inevitably place a significant strain on the country’s healthcare system for decades to come.
Other non-communicable conditions showing rapid growth include Injuries from automobile and motorcycle accidents, lower back and neck pain due to a sedentary lifestyle, hearing, and vision loss, which are often related to diabetes. The new research findings come at a crucial time for Indonesia as more than 185 million citizens (72% of the population) have enrolled in the countries national insurance program known as “Jaminan Kesehatan Nasional.” The progressive healthcare program was launched in 2015 to provide quality healthcare for all Indonesian citizens, with the government helping to pay the medical premiums of people considered living in poverty. The Indonesian government has set a very ambitious goal of enrolling 96% of the population by the end of 2020, effectively hoping to achieve universal health coverage for the nation.
This fast expansion of national healthcare requires strategic investments, and studies like this will help government officials make informed investments in healthcare and healthcare policies through the next decade. Dr. Nafsiah reiterated that the government needs to continue the research efforts so that they can both monitor the changes to policy and also help increase the nation’s understanding of current health trends, especially in the outer provinces that are often overlooked.