As of 2010, around 56% of Indonesians were covered by some form of health insurance. However, at this point, coverage was mixed, including government programs for lower-income individuals, private health insurance and coverage for employees of the state. In an effort to fill the gaps and unify the disparate insurance options, the Indonesian government introduced the Jaminan Kesehatan Nasional, its attempt at universal health coverage for Indonesians.

While the new system applies to all Indonesians, there remain gaps as certain health care facilities have declined to accept this new health care system of coverage.

The Pemeriksaan Kesehatan Gratis Program

In Indonesia, the most common causes of death include stroke and heart disease, two conditions whose risks can often be managed with regular checkups. To address this, President Prabowo Subianto fulfilled one of his campaign promises by launching a program that offers free health screenings for all citizens of Indonesia each year on their birthday. The goal of these checkups is early detection of cardiovascular diseases, congenital disorders and other chronic conditions that require regular monitoring.

The program, known as Pemeriksaan Kesehatan Gratis (PKG), was designed to provide free health screenings to more than 280 million citizens of Indonesia. Interestingly, it uses citizens’ birthdays as a cultural connection point to encourage participation in the screenings. In addition to this unique aspect, encouraging Indonesians to keep in mind the importance of the checkup, the program also makes use of the digital program SATUSEHAT, which was promoted during the COVID-19 pandemic.

This would allow people to seamlessly use the already widely downloaded program for not only making appointments, but also offering access to a personal health record.

Shifting Indonesia’s Mindset Toward Preventive Care

While the program primarily targets reducing the impact of major chronic conditions and improving health outcomes, Health Minister Budi Gunadi Sadikin has emphasized another goal. He aims to change Indonesians’ mindset and behavior toward preventive health care through this campaign. When the campaign was launched, Sadikin noted, “Our culture is checking when we’re already sick … that cuts closest to the grave,” describing the behavior of Indonesians as looking to health care for treatment over prevention.

After eight months of the program, the health minister reiterated his stance during an October press conference, highlighting the major risk factors affecting Indonesians. “The easiest examples are high blood pressure, high blood sugar and cholesterol. Indonesians usually ignore these until they suffer a stroke or heart disease,” he said. He appears determined to shift the nation’s view of health care toward preventive care and transform Indonesia’s overall health culture.

Promoting Health Equity Through Free Access

An article in the Lancet magazine additionally comments on the effect of the program on health equity, which is important for improving the health outcomes for Indonesians facing poverty:

• Regular health checkups improve health education, which can empower individuals to manage risk factors and avoid severe health conditions like strokes and heart attacks.
• The program offers free screenings to everyone, regardless of socioeconomic status, which ensures that everyone is receiving the same level of care. Additionally, it allows Indonesians in poverty to have access to health care resources they may have previously been unable to afford.
• The program prioritizes early interventions, especially in at-risk populations. So individuals who may not have previously had access to preventative care are more likely to receive follow-up visits and treatments to ensure their risks are managed for severe health conditions.

Conclusion

Overall, the PKG program is an ambitious initiative that aims to provide free health screenings to all citizens of Indonesia. Its goals include reducing mortality from conditions such as stroke and heart disease and shifting public attitudes toward preventive care. However, the program also has secondary effects that promote health equity. These benefits are especially valuable for Indonesians living in poverty, as they help improve access to health care within limited means.

– Nikhil N Kumar

Nikhil is based in Lexington, MA, USA and focuses on Global Health, Politics for The Borgen Project.

Photo: Flickr