The Sketch of

Indonesia
Medicine
Sugma AP,MD,MARS
sigmahealthconsult@gmail.com

Indonesia Characteristic
Located on the meet point of
earths crust

Contain of thousand islands
that separated by the sea
Supermarket of disasters
There are so many volcanoes
Many Forests
Climate change extremely
Access
Adequate Transportation
Earthquake
Landslide
Tsunami
Indonesia Characteristic
The 4
th
rank of the most populated
country in the world
The inhabitant doesnt spread evenly
Various of socio-economical status
vs
Contain of many ethnics, religions, cultures
Indonesia Health Condition
The Shift of the pattern of disease from infectious to
degenerative disease:
Acute respiratory syndrome.
Tuberculoses of lungs (the 3
rd
rank in the world).
Skin disease.
Diarrhea.
Diabetes mellitus.
Hypertension.
The major cause of death:
Vascular disturbance (heart disease or stroke)
Tuberculoses
Respiratory infectious disease (pneumonia),
etc.
Indonesia Health Condition
Indonesia Health Condition
The Maternal mortality rate is 307 per
100,000Lb ()
The Infant mortality rate is 45 per 1,000Lb ()
The Under five mortality rate is 64 per 1,000Lb

The Crude death rate 7.4 per 1,000p ()
The increase of life age expectancy 66.2ys ()
The malnutrition prevalence of under five
children is 25.8% ()
Indonesia Health Condition
Indonesia Health Condition
The Incidence rate of Malaria is still high
especially at the provinces outside of Java and
Bali (the east of Indonesia)22.3 per 1,000p
The cure rate of lung TB with BTA+ 70.23%
with new case finding 76,230p.

The HIV prevalence estimates >500,000p, AIDS
was reported as 5,321 cases in 2005 ()
The Incidence rate of DHF is about 62 per
100,000p () (2007)
Indonesia Health Condition
National Health System
Ministry of Health
Health official at province level
Health official at district level
Functional unit
Secondary & Tertiary Healthcare
Primary Healthcare
Subdistrict level
District level
The strategies are:
Empowering the citizens to live in a healthy way
and to give contribution for their health
improvement.
Increasing the people access to the high quality
health provider.
Upgrading the surveillance, monitoring and
health information system.
Increasing the health expense.

National Health System
Inhabitant
Health behavior
Environment
Resources
policy
Strategy
Missions
Health programs
Health provider with
quality improvement
and good management
Healthy
Indonesia
2015
National Health System
Health Resources
Health worker
General Physician 8 : 100,000p
Dentist 2 : 100,000p
Specialist 3 : 100,000p

Nurse 49 : 100,000p
Pharmacist 3 : 100,000p
Midwife 26 : 100,000p
Public health 1 : 100,000p
Sanitarian 1 : 100,000p
Nutritionist 3 : 100,000p
Health Educational Institution
We have the Faculty of Medicine in state and private
university.
The state Faculties of Medicine are mostly located at the
capitals of province.
The private are usually located nearby the state ones.
There are 45 state faculties of medicine that produced
about 5,000 doctors per year and specialist 1,700 per year.
We have 32 Health polytechnics and
598 health academy (state and
private) that produced about 23,000
nurses per year.
Theyre mostly located at big cities.

In 2004, Asia pacific had
contributed to 25% of total
scientific papers from all over
the world. ()
In ASEAN, Indonesia is at the
4
th
position and has contributed
5781 papers. It is under
Singapore position.
Japan is on the top position.

In 2004, 522 scientific papers of Indonesian
Researcher had been published.
Especially in Medicine, it contributed 50 papers to
National Journal and less than 5 to International
Journal.
Research on medical science expense is just 0.5%
from total Research and Development (Government)
expense.

Health Services
Based on the kinds of service:
Primary healthcare.
Secondary healthcare.
Tertiary healthcare.
Based on the owner status:
State provider.
Private provider.

Health Services
Primary Healthcare
Basic Seven Program
Health Promotion
Mother & Child Healthcare
Contraception
Communicable disease
controlling
Environmental health
Nutrition
Treatment center
(curative)
Community Health Center
Health Services
Primary Healthcare
Extended Program
Methadone
Harm reduction
Geriatric
Healthcare
VCT
Etc.
Community Health Center
PHC Program
We have 7,309 Community Health Centers (Puskesmas)
with ratio 3.46 per 100,000p (1 CHC for 29,000p).
Basic seven program is a health program that is provided
by PHC.
The program is arranged based on community health
needs and its convinced to be able to elevate the health
status of Indonesian people.
PHC Program
Extended program is a program that is
arranged based on local health needs. For
example: In Jakarta, the CHC has
developed VCT clinic for HIV/AIDS
patients and methadone or harm
reduction program for the drug users.
Health Promotion
Leaflets and brochures
Community elucidation
Specific Protection
Under five children
immunization
BCG
Polio
DPT
Hepatitis B
Measles

Preventive and Curative
Tetanus Toxin for Pregnancy woman
Treatment
Laboratory
Communicable Disease Controlling
3M+ Action, epidemiological investigation and
fogging focus for DHF vector eradication.
Empowering local inhabitants for participating
health activities of PHC
Mother & Child Healthcare
Posyandu (Integrated service center)
Under five children:
Implant contraception
Mobile CHC
Car
Boat
Mobile CHC
Health workers come to local residence
to provide the health services
Health Services
Secondary & Tertiary Healthcare
It focuses on curative and rehabilitative
health services.
The preventive service is provided by the
form of medical check up.
Hospital is the form of secondary and
tertiary healthcare.
In secondary level, the hospital has at
least 4 major of specializations (internist,
surgery, pediatric, obstetric).

Hospital
In tertiary level, besides the condition
at secondary level, the hospital should
be supported by sub-specialization
experts.
There are three classes of the hospital
in Indonesia at general (A, B, C).
We have 1,215 hospitals (state and
private) which is used by people as
78.99% for inpatient and 7.41% for
outpatient.
Secondary & Tertiary Healthcare
International Hospital
Facilities
4-Dimension USG
64-slices CT-scan
MRI
PET-scan
Services
Support
Specialized Hospital
Heart Center Hospital
Surgery Hospital
Woman and Children Hospital



Cryosurgery
Cephal-cephalopagus separation surgery
Facelift surgery
Eye Center Hospital
Mental Health Hospital
Dental Care Hospital
Specialized Hospital
Lasic technology
Nuclear medicine is used for diagnostic,
therapeutic, and research purpose.
This field develops fast and uses for many
purposes in community.
Nowadays, almost all of big cities in Java
island have at least one hospital equipped
by nuclear medicine unit.
Nuclear Medicine