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Indonesia: On the Way to Universal Health Care

a
Nafsiah Mboi
a
Minister of Health of the Republic of Indonesia, (2012–2014)
Accepted author version posted online: 03 Mar 2015.

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 Health Systems & Reform, 1(2):91–97, 2015
Copyright Ó 2015 Taylor & Francis Group, LLC
ISSN: 2328-8604 print / 2328-8620 online
DOI: 10.1080/23288604.2015.1020642

Commentary

Indonesia: On the Way to Universal Health Care

Nafsiah Mboi*
Minister of Health of the Republic of Indonesia, (2012–2014)

CONTENTS
Abstract—Indonesia has been building a National Social Security
Introduction System since 2004. Formal action to build the health component in
Social and Health Care Determinants the system (National Social Health Insurance Scheme, or JKN)
Downloaded by [New York University] at 23:46 14 June 2015

JKN Principles and Early Operations started in 2005. In line with the JKN roadmap, full achievement of
References Universal Health Care is not expected until 2019. Preparations
before the launch of JKN on 1 January 2014 involved multi-level
and multi-sector efforts related to issues of equity of access,
coverage, finance, quality of care (infrastructure, pharmaceuticals
and medical devices, medical education), management information,
and fees and tariffs. This commentary by Indonesia’s Minister of
Health examines the preparations and first eight months of JKN,
and briefly discusses these various issues as well as the policy and
practices in place at the time of launch. The article includes
information on the early implementation of JKN and four lessons
learned from the Indonesian experience of developing and
launching national social health insurance: the importance of strong
political commitment; the role of comprehensive analysis of the
national health system; the use of multiparty participation in
developing and implementing the plans; and the importance of
systematic, continuous monitoring and evaluation from technical
and administrative perspectives as well as patient satisfaction, to
assure progress toward Universal Health Care.

Keywords: health reform, Indonesia, Jaminan Kesehatan Nasional, universal
health care (UHC)
Received 31 July 2014; revised 4 November 2014; accepted 10 February
2015.
*Correspondence to: Nafsiah Mboi; Email: nafsiah.mboi2014@gmail.com
INTRODUCTION
In 2004, Indonesia adopted a multipart National Social
Security System (Law 40/2004)1 with the goal of provid-
ing comprehensive social protection to its citizens. The
system was designed to cover health care, work-related
accidents, elderly care, and life insurance. I was
appointed Minister of Health by the President of Indone-
sia in June 2012, joining the cabinet mid-way in its five-
year term (2009–2014) upon the unfortunate and untimely
death of my predecessor. This was 18 months before the
scheduled launch of our National Social Health Insurance
Scheme (1 January 2014; Jaminan Kesehatan Nasional,
or JKN),a the health care component of the new Social
Security System.

91
 92 Health Systems & Reform, Vol. 1 (2015), No. 2
As a medical doctor and civil servant with experience
working in poor, rural Indonesia and in the nation’s capital, I
spent most of my professional career in the Ministry of
Health and then served for six years as Secretary of the
National AIDS Commission. For me, JKN was a great oppor-
tunity to improve access to care and public health in Indone-
sia, and I gratefully accepted to serve as a minister with
priorities to:
 finalize conceptualization and planning for JKN;
 expand health care facilities across the country in vari-
ous ways, among others by advocating with national
and local governments;
 promote the adoption of national service and support,
logistical, and regulatory standards and systems; and
 strengthen continuous training and capacity building of
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health care providers.
I served as Minister during the first year of scale-up of
Indonesia’s national health insurance, moving toward the
goal of universal health care (UHC) scheduled for comple-
tion in 2019.
In this commentary, I review the social and health care
determinants and environment around Indonesia’s health sys-
tem, introduce the principles of JKN, highlight key chal-
lenges in building the scheme, give some information about
the first eight months, and close with lessons learned.
SOCIAL AND HEALTH CARE DETERMINANTS
The Republic of Indonesia is the world’s fourth most popu-
lous nation, with an estimated population of 248,818,100 in
2013.2 Straddling the equator in Southeast Asia, Indonesia
stretches 5,200 km from east to west. The population is het-
erogeneous and scattered unevenly across the nation’s
18,000 islands, 6,000 of which are populated. The World
Bank classifies Indonesia as lower–middle income.3 There
has been steady economic growth in recent years; nonethe-
less, 28 million people, or 11% of the population, are classi-
fied as poor.4
All of these factors influence health status and health serv-
ices in Indonesia. The country is going through an
Aspect of Service
Ratio of hospital beds/1,000 population
Ratio of general practitioners/100,000 population
Ratio of public health centers per village/urban neighborhood
Number of general practitioners per public health center
TABLE 1. Variation in Coverage of Health Services in Indonesia (2013)9
epidemiological transition with a double burden of acute and
chronic diseases, the latter increasing steadily and expected
to reach 60% of total disease burden. The public health sys-
tem faces a full spectrum of challenges from the high-mortal-
ity infectious diseases of poverty to the more complex and
chronic problems of noncommunicable diseases.5,6
Competition for budget among ministries has always been
difficult for the health sector, but there has been progress in
recent years as central government expenditure on health
rose from Rp 10.5 trillion in 2005 (1.08 billion USD) or
2.06% of the national budget to Rp 47.4 trillion in 2014 (4.86
billion USD constant) or 2.50% of the budget.b These figures
do not include provincial and district-level health budgets,
which vary from a high of 15.79% of the provincial budget
in one case to a low of 1.95%.7
With national development, Indonesia has witnessed
growing inequities related to access and quality of health
care (see Table 1). These inequities became an increasing
concern after decentralization started in 1999 (Law 22/
1999),8 when certain sectoral responsibilities including
health care were moved from the national level to the district
level. As a result, health finance and services became a patch-
work of uncoordinated, inadequately standardized and super-
vised public and private enterprises. Standards, entitlements,
services, and financial support for public health varied signif-
icantly across the country. For example, provincial data from
2013 in Table 1 show considerable variation in achievement
for four important, regularly reported indicators related to
health services: the ratio of hospital beds per 1,000 popula-
tion, the ratio of general practitioners per 100,000 popula-
tion, the ratio of public health centers per village/urban
neighborhood,c and the number of general practitioners per
public health center.
JKN PRINCIPLES AND EARLY OPERATIONS
JKN is intended to address these growing disparities in health
care in Indonesia. Its main objective is to create a well-inte-
grated, sustainable, accessible, and equitable health system
that provides comprehensive, high-quality care to all Indone-
sians. During the years between passage of Law 40 in 2004
Highest Provincial
Ratio (Best Coverage) Lowest Provincial Ratio Indonesian Average
2.9 0.6 1.1
155.5 8.8 38.1
8.3 0.6 3.4
4.6 0.4 1.8

and the launch of the consolidated National Health Insurance
Scheme on 1 January 2014, many steps were taken toward
fulfillment of the national commitment to have a health care
system for all Indonesians. When the law was adopted in
2004, only civil servants, the military, and the police were
covered by health insurance, each in a separate program.
Attention was first directed to develop new coverage for the
health needs of the poor. In 2005, a new Social Health Insur-
ance for the Poor program was launched for that purpose
(called Asuransi Kesehatan untuk Yang Miskin or Askeskin).
In 2008, Askeskin evolved into a broader program of health
insurance (known as Jamkesmas)10 with wider coverage and
incorporating lessons learned from Askeskin. In 2010, a new
program was added to reduce maternal and child mortality,
providing coverage for all pregnant women (Jaminan Persa-
linan or Jampersal). The final years of preparation for the
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launch of JKN focused on designing how to consolidate the
multiple programs under one national administrative, man-
agement, and service system while at the same time identify-
ing and moving to ”fill gaps” in coverage (improving equity)
and raising the quality of services. This period included the
development of a “road map” for continuing expansion of
the system from its launch in 2014 to the achievement of
UHC by 2019.
The development of JKN was based on five core
principles:
 The spirit and practice of gotong royong, meaning
mutual support.
 Mandatory membership for all Indonesians by 2019.
 “Portability” of the right to service: members of JKN are
entitled to service anywhere in Indonesia.
 Principles and best practice of social health insurance to
guide the management of JKN.
 Medical service is equal for all JKN members; however,
members paying all or a portion of their own member-
ship can choose to pay for a higher level of in-patient
service.
An early challenge in the implementation of JNK was
integrating into one system the separate insurance programs
that had covered the poor and near poor (PBId), civil serv-
ants, the military, the police, pensioners, and some staff of
state enterprises (BUMNe). Except for PBI, these insurance
programs all involved financial contributions by both the
employer and the employee. Under JKN all of these systems
became part of the unified National Social Health Insurance
Scheme with a single management system as well as a single
system of rights and benefits for members. On 1 January
2014, membership in JKN was opened to others, defined as
Mboi: Indonesia: On the Way to UHC 93
independent members, who would pay their own premiums.
Some provincial and district governments also chose to
enroll the near poor from their local programs in JKN,
thereby bringing the total number of poor and near-poor sub-
sidized by government to 93.9 million by 31 August 2014.f
Under JKN, the Ministry of Health is responsible for setting
clinical guidelines and technical norms. On the other hand,
health care delivery depends on a mix of public and private
providers. The financial affairs of JKN are run by an indepen-
dent management agency for the health wing of the Social
Security System, called BPJS Health.g This agency manages
the new health insurance system, including recruitment of
members, payment to service providers, and collection of fees.
Another major goal of JKN, which was important to pol-
icy makers, was improving the quality of care. In order to
move forward on this objective, and based on the principle
that what could be measured would be well managed, we did
a full assessment of our system’s quality of care both from
the providers’ technical perspective as well as from the
patients’ satisfaction standpoint. We then sought to
strengthen our medical education system, to assure the avail-
ability of qualified staff at primary health centers (PHCs) and
hospitals through the rotation and field assignments of doc-
tors and specialists and to encourage service by qualified
doctors in the most challenging island, border, and isolated
posts through the introduction of incentives (financial and
educational opportunities).
Key Challenges of Building JKN
The Ministry of Health established six working groups to
address key challenges in implementing the JKN:
1. Regulatory infrastructure for both service delivery and
management
2. Finance, transformation, and integration of programs
and institutions (from former programs)
3. Health facilities, referral, and infrastructure
4. Human resources and capacity building
5. Pharmaceutical and medical devices
6. Socialization and advocacy
The working groups were widely inclusive and in all cases
included people from the health sector as well as domestic
and international experts and institutional and organizational
representatives. For example, the working group on health
facilities included representatives of hospitals and the Indo-
nesian Medical Association, as well as health economists,
people from the Ministry of Finance, the national planning
 94 Health Systems & Reform, Vol. 1 (2015), No. 2
board, and other organizations. The working groups reported
to me, as Minister, and I reported to the President on the
development of JKN, through the Coordinating Minister of
People’s Welfare and the Vice President, personally charged
by the President with overall responsibility for assuring
smooth and timely development and launch of JKN. Among
the many topics addressed by these working groups, I fol-
lowed four with particular interest because of their potential
long-term impact on the acceptability and sustainability of
JKN.
1. Improving the skills and placement of health care pro-
viders would have a profound impact on quality of care
at all levels in the health system, which, in turn, would
influence the utilization of facilities. For JKN to work
effectively we needed the public to embrace and utilize
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primary care and not go directly to hospitals. In some
parts of Indonesia, skepticism about the quality of ser-
vice had left primary care underutilized and hospitals
clogged with patients not needing that level of service.
Multiple efforts were launched to begin the processes
of improving both quality and distribution of health
care providers.Depending on the location and the
nature of local need, there were improvements made in
quality and distribution of staff. For example, there was
widespread capacity building for doctors, nurses, labo-
ratory staff, and others. Increasing numbers of health
care workers were assigned and reassigned to help
more facilities reach national minimum service stand-
ards. Beyond these actions directly related to staff,
other actions contributed to increased effectiveness.
Support for infrastructure improvement was provided
where needed, and a national formulary and e-catalog
were established to improve access to medication.
There were also revisions in regulations and guidelines
clarifying treatments and standards and expanding the
role of primary health centers with an emphasis on pre-
vention and health promotion, early diagnosis and treat-
ment, as well as management of chronic care.
The primary time frame for this article (six months
after the start of JKN implementation) is too short for a
serious evaluation of the effectiveness of these inter-
ventions, and the road map for achievement of UHC is
five years. Nonetheless, extensive field travel during
much of 2014 saw evidence of improvements in service
provided by primary health centers as well as expanded
community utilization. Information collected during
the first and second quarters of 2014 showed increases
in utilization of primary health centers and declines in
referral upward through the system in many areas,
because staff and programs at the primary level were
better able to respond to patients. More extensive
information would be provided in the 2014 year-end
report and annual reports thereafter.
2. Clarification of the different components in the contin-
uum of care and the linkages between them was an
essential part of the preparation for scaling up JKN.
This called for extensive efforts by the working groups
on forms, procedures, and standards. It was also a topic
of advocacy by me, as Minister, and other members of
the JKN development team during national field travel.
3. Creation of an effective national management informa-
tion system was a crucial goal to serve the needs of
patients, health care providers, facilities, and BPJS
Health. This information system would be critical to
the capacity of JKN to fulfill the principle of
“portability” of coverage and the goal of providing
quality care to JKN members. Membership, health
records, and accounts needed to be current and accessi-
ble when and where a patient requested service. Build-
ing the management information system called for the
integration of multiple existing systems and the crea-
tion of a new umbrella system to hold the data and pro-
vide information as needed.
The management information system was the back-
bone of the JKN, and its initial performance worked
well (most of the time) as patients moved through the
system and health care providers billed BPJS Health
for services and were paid. Like other aspects of the
system, the management information system will
undergo periodic evaluation and improvements as
needed. Furthermore, in addition to formal evaluation
systems, print media, TV, social media, and even text
messages to me as Minister have all been active since
the day of launch, and these informal feedback mecha-
nisms have helped identify challenges to be met. In this
way we are making progress.
4. The development of standard and appropriate fees and
tariffs will be critical to survival of the entire health
insurance system. Sufficient income is needed for JKN
to be financially viable, but the needs of three main
actors also have to be met: JKN members, health care
providers, and institutions providing primary and refer-
ral care. Without a “reasonable” arrangement for each
actor (with a fee and service package for members and
compensation for providers), the system will not sur-
vive. In searching for the right balance, we worked
with key stakeholders: the Ministry of Finance, various
academic teams, the Indonesian Medical Association,
the Association of Hospitals, and existing insurance
schemes; we also sought good communication with the
Indonesian Parliament. We received good input from
different parties, and we developed careful modeling of
different options. In the end, as Minister, balancing the
concerns and inputs from multiple groups, I set the

starting point for our tariffs and fees. Only time and
careful monitoring and evaluation will tell how close or
far we were from finding “the right balance.”
With JKN, Indonesia is seeking to develop a comprehen-
sive health care system that can provide service from preven-
tion to the highest level of specialist care for all of its
citizens. Primary care service at the community level focuses
on the prevention of ill health, early diagnosis and treatment
of disease, management of chronic conditions, and referral
for more complicated services.
Historically, funding for PHCs was channeled through the
office of the district government with any income earned by
a PHC also returning to the district government. To
strengthen the position of PHCs in managing their own
affairs, a new financial system was designed with payment
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on a capitation basis. The capitation system was developed
with participation from different parts of the country and
with extensive reference to historic utilization rates in earlier
programs. (Per capita payments are made to the health center
according to the number of JKN members designating that
center as their primary health care center.) People who are
not yet JKN members may use the center by paying on a fee-
for-service basis for visits (as was true before the start of
JKN) and they are encouraged to become regular members.
Under the new system, which was discussed and negotiated
with Ministries of Finance, Home Affairs, and Health,
BPKP,h and BPKi and then codified in Presidential Decree
12/2013,11 the JKN capitation fee is paid directly to the PHC
by BPJS Health. (There is some variation in calculation of
the fee from one PHC to another, based on the service pro-
vided and the PHC’s personnel.) Furthermore, a minimum of
60% of capitation income is to be used as a staff incentive
for health workers,12 to “top up” the small compensation
they receive as civil servants.
At the hospital level, the JKN teams developed a payment
system based on the Indonesia Case Based Groups, a prospec-
tive payment system with rates set according to the diagnosed
condition to be treated. Indonesia Case Based Groups payment
scales were developed with the participation of organizations
of health professionals and the Association of Hospitals, as
well as extensive review of treatment standards and payments
in diverse situations. Prior to the launch and for some time
thereafter, sporadic protests continued from some hospitals
and various health care providers, particularly specialists
accustomed to fee-for-service payment. As hospitals came to
understand the new system, many found that it worked to their
advantage and institutional complaints subsided.
Another major area of reform focused on systems of pro-
curement and management of medicines and medical
Mboi: Indonesia: On the Way to UHC 95
equipment. Our pre-JKN assessment made it clear that for
efficiency, effectiveness, and transparency we needed to
rethink these material aspects of our health system. With the
new unified system, JKN became the largest provider in
Indonesian public health, and negotiations were undertaken
by the Government Agency for Goods and Services Procure-
ment Policyj to develop a new and more efficient system that
is easy to monitor and easy for JKN service providers to use.
The result was establishment of a national on-line formulary,
an e-catalog, and a system of e-procurement accessible to all
with appropriate authority.
As with other aspects of JKN development, the work to
reform procurement and management of medicines included
representatives of multiple levels of government, health care
providers, and the pharmaceutical industry. Discussion took
place to reach agreement on acceptable standards and to
assure that no unreasonable profit would be associated with
the launch of JKN. By the time negotiations were concluded,
the prices agreed for JKN medicines averaged 30%–40%
less than before.k
Early Experience with JKN
Having successfully integrated the membership rolls of the
existing government insurance schemes,l on 1 January 2014
BPJS Health had 112,208,564 members in its database enti-
tled to be served by JKN (according to BPJS Health). The
year-end membership target for 2014 was set at 121,600,000.
That target was surpassed by 1 May, and as of 31 August the
total membership was 127,251,791. Though the integration
process involved many details, the greatest challenges were
consolidating the membership lists, agreeing on entitlements
of members, managing relations with service providers (both
governmental and nongovernmental) including compensa-
tion, and operationalizing these multiple agreements in a
smooth “rollover” for the launch of JKN on 1 January 2014.
Addressing all of these challenges called for a flexible mind-
set and a combination of human and technical skills, particu-
larly among the political and operational leaders of the
various separate systems, as they worked out how to come
together under one umbrella.
Minimum health services standards set before the launch
of JKN apply without exception to all government health
facilities. Provincial and national health offices have respon-
sibility for monitoring compliance with those standards and
assisting where improvements are needed. Nongovernmental
facilities working with BPJS must meet those standards to be
accredited as JKN service providers.
As of 31 August 2014, 17,285 primary-level providers
were working with BPJS Health, and 1,583 referral hospitals
 96 Health Systems & Reform, Vol. 1 (2015), No. 2
were registered. Of these providers, about 36% of primary-
level facilities and 42% of referral-level facilities were pri-
vate. In addition, 1,245 pharmacies and 798 opticians were
private. Private health care in Indonesia runs the full spectrum
from simple not-for-profit facilities to the most expensive spe-
cialist hospitals. For health facilities that were stretched finan-
cially, becoming a JKN provider was viewed as advantageous
because it could produce more regular and adequate income.
At the same time, the Ministry of Health was pleased to have
high-end private health providers continue to work with JKN
in compliance with existing regulations, reflecting the varied
market for health care in Indonesia.
Lessons Learned
In early 2014, there were both Indonesians and international
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partners who were dubious about how the launch of JKN
would go—because of the country’s size in terms of popula-
tion and the geographic challenges of a widely spread archi-
pelago, the limitations of central control in highly
decentralized Indonesia, the historic professional indepen-
dence of many health care providers and groups of providers,
and examples of “bumpy starts” to the start of national health
insurance in other countries. In fact, JKN got off to a
smoother start than many people expected.
In reviewing what Indonesia has accomplished, I would
highlight four lessons for countries seeking to develop com-
prehensive national social health insurance:
1. Strong political commitment. The birth of JKN had
strong political commitment from top national leaders,
starting with Law 40 of 2004 coming into force under
President Megawati and reinforced when President
Susilo Bambang Yudhoyono designated the launch of
JKN as a priority for his second term (2010–2014) to
be supervised directly by the Vice President. Agree-
ment on a multisectoral road map for JKN secured the
“buy-in” of sectoral partners outside of health to play
their respective roles and work together for successful
implementation of JKN. Key partners outside of health
included, among others, the National Planning Board,
the Ministries of Finance and Home Affairs, the Indo-
nesian Parliament, BPKP (Board of Development and
Finance Supervision), and BPK (the National Audit
Board). My long-standing concern with the field of
national health insurance systems led me, as Minister,
to call for acceleration of the final steps to assure a
timely launch. Furthermore, I was available when
needed to negotiate with and cajole partners who were
slower to get on board than others and to choose
between competing views when debate threatened to
slow progress.
2. Comprehensive examination of our health care system.
We approached the creation and launch of JKN not as
an exercise in health financing alone but as an opportu-
nity for a comprehensive review of our health system,
including attention to both coverage and quality, in the
best interests of our people and on a sustainable basis.
For Indonesia, the development, launch, and continuing
evolution of the national health insurance scheme was
an issue of both health finance and health service.
“Getting it right” on health finance is the only way to
assure continuity and sustainability in provision of qual-
ity health service for the people of Indonesia. Strength-
ening the quantity and quality of service with particular
emphasis at the primary level for prevention of ill
health, promotion of good health, early diagnosis and
treatment, referral, and management of chronic care is
necessary to attract and hold good levels of utilization.
3. Multiparty participation in development. The creation
of the overall JKN system and its many subsystems
was carried out as multisectoral, multipartner, multi-
level exercises. This was not (and could not have been)
a health-sector exercise alone. Diverse national and
local-level authorities were involved, public and private
entities took part, and important input came from asso-
ciations of health care providers, the Association of
Hospitals, and academics. Likewise, to minimize mis-
use of funds and corruption, a range of government
bodies with national responsibility for governance and
accountability was built into the system.
4. On-going monitoring and assessment. The use of various
feedback systems has helped us during the development
and testing of JKN components as well as since the
launch. We have practiced continuous monitoring, eval-
uation, fine-tuning, and more major adjustments. We
tried hard to create the best system possible for the
launch on 1 January 2014, but we also knew that we
would need to make adjustments as we implemented.
This “information loop,” combined with adequate
authority and flexibility to allow for change, has played
a critical role in the fine-tuning needed to get our large
system up and running. For example, the Indonesia Case
Based Groups fee scale was developed to cover 1,077
diagnoses and procedures. Analysis of claims over the
first five months from more than 1,000 hospitals indi-
cated that established fees for 39 groups were either too
high or too low. Though the regularly scheduled review
of tariffs and fees will occur only every two years, with
this evidence of problems from the field, I used my
authority as Minister to make immediate corrections,
thereby reducing frustration and inefficiency.
What is the long-term future of JKN as the “people’s door
to equitable health care” in Indonesia? This commentary lays
out the primary steps taken and issues considered as we

worked to get the system off to a good start. The review con-
siders the first few months of operation (after the launch on 1
January 2014), with most information focused on the first six
months. Only a longer period of implementation will tell us
how successful we have been in creating an equitable and
sustainable health insurance scheme for Indonesia with atten-
tion to both quality of service and health finance.
DISCLOSURE OF POTENTIAL CONFLICTS OF
INTEREST
No potential conflicts of interest were disclosed.
ACKNOWLEDGMENTS
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Special thanks are extended to Donald Pardede, Karen Hous-
ton Smith, and Dr. Jack Lagenbrunner, as well as the co-
Editors-in-Chief of Health Systems and Reform, in particular
Dr. Michael R. Reich, for providing data and other important
assistance during preparation of this article.
NOTES
[a] Because translation of the names of Indonesia institu-
tions and titles of laws are not always translated into
English in the same way, we have noted the Indonesian
title of any laws, decrees, and regulations mentioned in
the text as well as the official Indonesian name of insti-
tutions that have statutory involvement with the work
of the National Social Health Insurance Scheme (JKN).
[b] Data on budget from Ministry of Health. Conversion
to US dollars from World Bank in response to request
for conversion of Rupiah budget figures to US dollars.
[c] The terms village and urban neighborhood are carefully
defined terms referring to both setting and facilities.
[d] Penerima Bantuan Iuran (PBI) or “Recipients of Gov-
ernment Fee Support” for membership in the National
Social Health Insurance Scheme (JKN).
[e] Badan Usaha Milik Negara (BUMN). Enterprises
owned by government.
[f] The poor in Indonesia total 28 million people, as defined
in Reference 4. The phrase “poor and near poor”
encompasses 86.4 million, including 28 million poor
and 58.4 million classified by the Ministry of Social
Affairs as “near poor” and unable to pay the JKN
premium.
[g] Badan Penyelenggara Jaminan Sosial (BPJS). Man-
agement Agency for Social Security, regulated by
Law 24/ 2011. BPJS Health is the name of the
Mboi: Indonesia: On the Way to UHC 97
management agency specifically responsible for man-
agement of the health component, JKN, in the
national society security system.
[h] Badan Pengawasan Keuangan dan Pembangunan
(BPKP). Board of Finance and Development Supervision.
[i] Badan Pemeriksaan Keuangan (BPK). Audit Board of
the Republic of Indonesia.
[j] Lembaga Kebijakan Pengadaan Barang/Jasa Pemerin-
tah. Government Agency for Goods and Services Pro-
curement Policy.
[k] Ministry of Health, Director General for Pharmaceuti-
cals and Medical Equipment.
[l] Civil servants from Askes, the poor and near poor from
Jamkesmas, the military and police from their own
insurance system, and laborers covered by Jamsostek.
REFERENCES
[1] UU 40/2004 tentang Sistem Jaminan Social Nasional (SJSN).
Law 40/2004 on the National Social Security System.
[2] Indonesian Central Bureau of Statistics. Proyeksi Penduduk
Indonesia 2010–2035. Jakarta: Badan Pusat Statistik; 2013;
Table 1.3, p. 55.
[3] World Bank web page. n.d. Available at http://www.World
bank.org/about/country&lendinggroups (accessed 2 January
2015).
[4] Statistics Indonesia. Number of poor people, percentage of
poor people and the poverty line, 1970–2013. March 2013.
Available at http://www.bps.go.id/linkTabelStatis/view/id/
1494 (accessed 16 April 2015)
[5] Health sector review: consolidated report. Jakarta: Kementer-
ian PPN/BAPPENAS; October 2014; xiv-xvi, 36–47.
[6] GBD 2013 Mortality and Causes of Death Collaborators.
Global, regional, and national age–sex specific all-cause and
cause-specific mortality for 240 causes of death, 1990–2013: a
systematic analysis for the Global Burden of Disease Study.
Lancet 2013; 385(9963): 117–171.
[7] Indonesia Ministry of Health. Profil Kesehatan Indonesia
Tahun 2013. Jakarta: Ministry of Health; 2014; p. 64.
[8] UU 22/1999 tentang Pemerintah Daerah. Law 22/1999 on
local government.
[9] Indonesia Ministry of Health. Profil Kesehatan Indonesia
Tahun 2013. Jakarta: Ministry of Health; 2014 (hospital beds,
p. 38; general practitioners per 100,000 population, p. 52; pub-
lic health centers, p. 45; general practitioners per public health
center, p. 55).
[10] Harimurti P, Pambudi E, Pigazzini A, Tandon A. The nuts &
bolts of Jamkesmas: Indonesia’s government-financed health
coverage program. UNICO Studies Series 8. Washington, DC:
World Bank; 2013.
[11] Peraturan Presiden Republik Indonesia nomor 12 tahun 2013
tentang Jaminan Kesehatan. Presidential Decree 12 of 2013
on Health Insurance.
[12] Ministerial Decree 19/2014. Guidelines on Management of
PHC Funds.