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Session 6 :

Impact of climate change on dynamic of diseases I

Evolution of health situation in


Papua and East Indonesia
Dr. dr. Hermanus Suhartono, SpOG(K)
Divisi Fertility , Endocrine and Reproductive
Dept. Obsteri-gynaecologi, Faculty of Medicine,
UNIVERSITY CENDRAWASIH / RSUD JAYAPURA PAPUA
I N D O N E S I A

Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

Indonesia's republican form of government includes an


elected legislature and president. Indonesia has 34
provinces, of which five have Special Administrative
status.

Indonesia consists of hundreds of distinct native ethnic


and linguistic groups.

According to the 2010 national census, the population


of Indonesia is 237.6 million with high population
growth at 1.9%. 58% of the population lives in Java, the
world's most populous island. Indonesia's population is
expected to grow to around 269 million by 2020 and
321 million by 2050.

Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

There

are around 300 distinct native ethnic


groups in Indonesia, and 742 different
languages and dialects. Most Indonesians
are descended from. Austronesian-speaking
peoples whose languages can be traced to
Proto-Austronesian, which possibly
originated in Taiwan.

Another major grouping are Melanesians,


who inhabit eastern Indonesia.

Melanesians

have 240 etnic and different


languages in Papua

Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

East Indonesia

Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

In October 2010, the Ministry of Health (MoH) of the


Republic of Indonesia issued a new decree providing
general guidelines on the development of Desa Siaga
Aktif, a programme designed to promote Active Alert
Villages.

These were defined as villages capable of providing basic


health care services and safe water and basic sanitation
services, undertaking community-based disease
surveillance, encouraging healthy lifestyles and using
community empowerment to respond to health
emergencies and natural disasters (MoH 2010).

The MoH has set itself a target of 80% of its current 75 410
villages achieving Desa Siaga Aktif status by 2015 (MoH
2010)
Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

Indonesian healthcare has traditionally been


fragmented: private insurance schemes for those who
could afford it, basic state provision for the very
poorest, and NGOs in specialised areas providing
support in between.
However, in January last year, Indonesias government
launched an ambitious project: to establish a
compulsory national health insurance system with the
aim of making basic care available to all by 2019. The
scheme, Jaminan Kesehatan Nasional (JKN), was
implemented by the newly-formed social security
agency Badan Penyelenggara Jaminan Sosial
Kesehatan (BPJS). It sought to improve the situation
for citizens stuck in the middle of healthcare
provision too poor to afford health insurance but
deemed not poor enough for government help.

Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

Papua
Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

As

more people sign up for health insurance


offered to indigenous people in Indonesia's
Papua province, a public health system
already struggling with too few health
workers and substandard services is coming
under greater strain.

KPS

( Kartu Papua Sehat / Health Papua


Card) is the insurance for Papua Comunity

Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

Papua is the largest province in Indonesia located


to the eastern side of the archipelago.
It has the highest rate of poverty in Indonesia with
the lowest income per capita for health and
education.
36.8% of the population in Papua Province lives
below the poverty line.
In 2006 UNICEF estimated that IMR in Papua was
between 60 100 per 1000 live births, and MMR
reached 1000 per 100,000 living birth.

Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

The number population of Papua in 2007


are 2.1 millions people. The number of
origin people are 1,75 million.

In 2012 Papua had a ratio of two doctors


and 17 nurses per 10,000 people, above
the national average of 1.4 doctors and
five nurses, but Health Ministry data
show that health personnel are not
evenly distributed.

Some Papuan districts have less than


one doctor and five nurses per 10,000
people

Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

About

30% of children under age 5 suffer


from malnutrition.

17%

of people live in poverty, in Papua, it is


estimated that at least 30% of residents are
poor.

Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

Papua

Province is one of the


most alarming parts of
Indonesia, especially in
maternal health.

Papua

Province maternal
mortality ratio is
disconcertingly higher than
the national average.

Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

There

are many remote, outlying villages


which have no access to health services,
health centres nor clinics.

Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

Pneumonia

accounts for 26% of infant


death, diarrhoea 19%, and malaria 11%.
According to an international church NGO,
the major underlying cause is clearly
malnutrition with over 20% of the
population.
The percentage of immunised children is
40.8, below the national average of 60.3.
Papua has the lowest life expectancy of all
Indonesian provinces, particularly for
women, who have a life expectancy of 50.3
years compared to the national average of
62.7.
Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

Access

to clean water is a
problem for 75 percent of
the rural population.

Low

income levels make


medical financing very
difficult; affordability and
availability of medicines.

Prominent

causes for limited


success in maternal health
care were both in the
demand and supply sides of
the health system.

Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

As

a developing country, the


Indonesian nations overall
levels of health and
development are less than
ideal.

The

physical health crisis they


now face is the consequence
and personification of this
process.

Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

Conclusions.
PAPUA have many problems :
Topography
Education
Health
Socio-economi
Enviroment
Lifestyles
Infrastructur
Tri-National scientific meeting, Bogor-Indonesia, 28-29 October 2015

THANK YOU

Tri-National scientific meeting, Bogor-Indonesia, 28-30 October 2015