Indonesia Health System Essay

Health System Assignment 1
Improving Health Access in the Remote Areas of Indonesia

Introduction
Right to health is one of the basic human rights without distinction of ethnicity, religion, race or socio-economic conditions. As a consequence, all of people have the same right to the highest attainable standards of health both physically and mentally including access to various medical services with affordable and proper quality (WHO, 2008). Furthermore, the government should ensure the availability of health facilities to improve health conditions for all citizens. In fact, disparities in access to health services often occur in many countries (Barten, Mitlin, Mulholland, Hardoy, & Stern, 2007). One of the main factors that trigger such

With population of 250 million in 2014, Indonesia becomes the fourth most heavily populated country in the world (BPS, 2015). In addition, Indonesia has socio-cultural diversity in which more than 300 distinct ethnic groups are widely distributed (Nguyen et al., 2011). Having a large geographical distance combined with various ethnicities presents many challenges to the government in delivering health care services and improving access to all population (Kurniati, Rosskam, Afzal, Suryowinoto, & Mukti, 2015). As a consequence, the health inequities in health status and access to health services possibly occur in distant areas. In 2007, the national vaccination uptake for measles in rural and remote areas was administrated to only 68.5% of the children compared to 80.1% of those in urban areas. Besides the lack of parental education, such condition occurs due to discrepancy in accessing health facilities and skilled health professionals (Fernandez, Awofeso, & Rammohan,

Ideally, each health center in a district level should have a physician, a dentist, nurses, midwives, and a pharmacist assistant to deliver comprehensive and integrative primary health care including the outreach activities. However, the health center performance is relatively low because most of the local governments have little experience in providing health facilities equipped with trained health personnel. Some health centers in remote area, especially in Eastern Indonesia, have no general practitioners, nurses or midwives. A report showed that 31% out of 1165 health centers were located in remote area, about half of 31% health centers were reported having no GPs, 18% were without nurses, and 12% had no midwives, compared to the urban areas in which only 5% health centers were without physicians (Ferry Efendi et al., 2012). Most of the health staffs are reluctant to work in the remote areas and tend to work in the cities based on economic reasons. In addition, living in the remote areas with limited access of transportation and electricity is quite difficult for most of the health workers. Therefore, such conditions could