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Jakarta- Mohamad Ikhsan and Yulius of Faculty of Economics and Business, Universitas Indonesia, article entitled:” Strengthening Indonesia’s Health Security amid Pandemic” was published in Jakarta Post on July 9, 2020. Here is the article.
Providing access to comprehensive, quality healthcare services is essential to promoting and maintaining health for all Indonesians. However, recent healthcare studies have put Indonesia behind other rapidly developing countries.
The COVID-19 pandemic is the latest in a series of wake-up calls for the global health community that has occurred in the last few decades.
An analysis by The Economist predicts that countries with better healthcare systems will transition faster to the new reality post COVID-19. They will also provide a stronger foundation for resilience against and recovery from future pandemics, which are likely to emerge with greater frequency.
If Indonesia is to prepare for this new reality, we need to embrace a comprehensive and systematic approach to improve our healthcare system. This will require commitment to five key priorities:
In Indonesia, 73 percent of all deaths are caused by noncommunicable diseases with links to lifestyle problems such as tobacco use, physical inactivity and high blood pressure. And yet, preventative intervention is not viewed as integral to health care, and there is still limited knowledge and public awareness of healthy lifestyles.
Healthy lifestyle behaviors such as following a good diet, exercising regularly and not smoking may substantially reduce the prevalence of chronic diseases and thus significantly cut healthcare costs. It is also true that the healthier an individual, the better their potential outcome during a pandemic like COVID-19.
The Singaporean government introduced a policy to identify “healthier choice” foods in shops and provide informed access to better nutrition. In the United States, a study to reduce tobacco consumption found that financially incentivized abstinence reduced tobacco use over six months, with the effects persisting in a 12-month study. Such initiatives could provide valuable inspiration for Indonesia, where a World Health Organization analysis showed that more than 60 percent of males aged above 15 were smokers.
Raising awareness of chronic diseases and health risks can also encourage people to live healthier lives. Preventive care such as medical screening and vaccinations can contribute to early diagnosis and reduce the risk of disease. The government can promote public awareness of healthy lifestyles and subsidize preventive care and early diagnosis.
The Singaporean government, for example, has implemented a “Screen for Life” program that encourages its citizens to go for regular health screenings at subsidized rates, while the service is free for the elderly. In addition to providing sponsored check-ups, Singapore also runs nationwide awareness campaigns on healthy lifestyles and preventive care via multiple digital and partnership platforms.
Indonesia has a current shortage of hospitals and healthcare professionals, averaging just 3.77 doctors per 10,000 people according to the WHO, compared to more than eight doctors per 10,000 people in Thailand. This average hides substantial differences between Java and more rural provinces.
Adopting a value-based healthcare model could help improve the accessibility and affordability of health services. Under value-based care agreements, healthcare providers are remunerated for evidence-based outcomes in helping patients improve their health, reduce the effects and incidences of chronic disease, and live healthier lives. This can deliver significant benefits across the health ecosystem.
Sweden’s healthcare sector, for example, has developed several disease registries: vast repositories of data on the outcomes of different treatments. The data helps providers identify evidence-based treatment protocols that have led to improvements in both healthcare efficiency and patient outcomes.
Implementing a value-based model to Indonesia’s healthcare system would require streamlining health IT systems as well as establishing centralized patient information management and automated reimbursement systems.
The shortage of quality health workers is another challenge for Indonesia, especially in rural areas. Offering financial aid and scholarships to promising low-income medical students is one option. Building more nursing schools will further support enhanced access and quality.
The government also needs to improve dormitory and housing facilities for health workers and develop more localized health workforce to provide basic health care in rural areas. Providing low-cost medical equipment to rural practitioners is also important. This feeds into the wider need to improve Indonesia’s rural healthcare infrastructure. Innovative digital and mobile technology platforms can create a valuable opportunity to support this journey.
The pharmaceutical and medical technology industries are critical to maintaining healthcare security. Countries such as India and China have implemented policies to boost the growth of these industries that can offer insights for Indonesia:
Until an effective vaccine for COVID-19 is developed, we need to prepare for potential waves of infection. At the same time, we need to build health resilience for any future pandemics.
We should learn from the success of Hong Kong, which leveraged a Preparedness and Response Plan following previous SARS outbreaks in the territory. The plan defined clear response levels and command structures to establish a framework on agreed and coordinated response. Hong Kong also took effective proactive steps, including ramping up production of protective masks, using big data analytics and employing its databases to track and stop transmission of the disease.
Data and analytics can provide game-changing opportunities toward healthcare security. Centralized electronic health records (EHR) and claims processing systems should be established to support healthcare services with robust data and analytics.
These systems offer insights into disease progression, prevalence, incidence and survival that are vital to informed decision-making in health care. In documenting diagnostic investigations and treatments, as well as enhancing physician communication, the systems can significantly reduce practitioner workload.
Digital health platforms offer innovative ways to deliver health care, such as mobile prescriptions with 24/7 treatment consultation and telemedicine to unlock access in underserved rural areas.
Concerted public-private partnership efforts, supported by sound government policies, can significantly accelerate Indonesia’s development toward healthcare security. The actions above are not exhaustive, and should offer inspiration as well as aspirations for policymakers and industry decision-makers to deliver accessible, affordable, resilient health services in the new reality post COVID-19.
Mohamad Ikhsan is economics professor at the University of Indonesia and chief economist at the State-Owned Enterprises Ministry; Yulius is managing director and senior partner at the Boston Consulting Group’s Jakarta office.
Resources : Daily Jakarta Post July 09, 2020