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Universal health coverage in Indonesia: concept, progress, and challenges.
Rina Agustina1, Teguh Dartanto2, Ratna Sitompul3
1Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr Cipto Mangunkusumo General Hospital, Jakarta, Indonesia; Human Nutrition Research Centre, Indonesian Medical Education and Research Institute, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Lancet (London, England)
|December 24, 2018
Summary
Indonesia
Area of Science:
- Global Health
- Health Systems Research
- Public Health Policy
Background:
- Indonesia's diverse geography and population present unique health system challenges.
- Centralized health systems achieved some gains but exacerbated inequities.
- Decentralization further increased health system heterogeneity.
Purpose of the Study:
- To describe Indonesia's innovative Universal Health Coverage (UHC) initiative.
- To outline the roadmap for achieving sustainable development goals by 2030.
- To analyze the successes and challenges of the UHC system.
Main Methods:
- Review of Indonesia's health system evolution and UHC implementation.
- Analysis of UHC system growth, coverage, and equity.
- Identification of emerging challenges and future needs.
Main Results:
- Indonesia's UHC system, launched in 2014, is the world's largest single-payer scheme, covering 203 million people.
- The UHC system has improved health equity and service access.
- Challenges include the 'missing-middle' enrollment group and low coverage for young children.
Conclusions:
- Indonesia's UHC initiative demonstrates innovative adaptation to diversity.
- Addressing non-communicable diseases and investing in digital health infrastructure are crucial.
- A clear roadmap is needed to meet 2030 sustainable development goals.
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