INDONESIAN PREVENTION

POLICY AND STRATEGY TO

TACKLE HYPERTENSION
I N D O N E S I A N M I N I S T RY O F H E A LT H
D I R E C T O R AT E O F N C D S P R E V E N T I O N A N D C O N T R O L

Scientific Meeting of Indonesian Society of Hypertension 2020

 Changing Behaviour
“It’s one small step for man, one
giant leap for mankind.”

- NEIL ARMSTRONG
 OUTLINE

Current situation

Government Policy and Strategy

Challenges

Way Forward

3
Indonesian Cause Of Death
Based On Risk Factors, 2017

Total Deaths: 1,768,080 deaths

The most risk factors for death

High Blood Pressure (Hypertension): 23.7%
High Blood sugar level (DM): 18.4%
Smoking: 12.7%
Obesity: 7.7%
Lack fruit consumption: 5.6%
Lack vegetable consumption: 4.7%
Source: IHME Global Burden of Disease, 2017
Indonesian Cardiovascular Cause Of Death
Based On Risk Factors, per Province 2017
Indonesian causes DALYs
in 2007 and 2017

* All ages
Source: IHME Global Burden of Disease, 2017
 Catastrophic Spending in JKN
• Catastrophic diseases take 20% from
Others
7% Total Spending of JKN services.
CKD
12%
1.Cardiovascular disease: 52% (10.5 trillion)
2. Cancer: 17% (3,4 trillion)
Stroke
13%
CVD
51%
3. Stroke: 13% (2.6 trillion)
4. Chronic Kidney Failure: 12% (2.4 trillion)
5. Thalassemia: 2% (490 billion)
6. Haemophilia: 2% (358 billion)
Cancer 7. Hepatic cirrhosis: 2% (334 billion)
17%
8. Leukemia: 2% (333 billion)
 Economic Loss from NCD
Scaling EPIC model Output Contribution of each disease to overall loss of
Economic Burden Of NCD for 2012-2030 GDP output Indonesia 2012-2030
Type of NCD Disease Total Output Loss
(USD trillion)
Diabetes 0.2
Cardivaskular Disease 1.77
( Ischemic heart disease and
Cerebrovascular disease)
Respiratory Disease (COPD) 0.82
Cancer ( Breast Cancer) 0.7
Mental Illness 0.98
Overall Total 4.47

Expected economic output loss for Indonesia: $4.47 trillion lost due to NCDs ($17,863 per capita) 1 from 2012
through 2030
Source: World Economic Forum, 2015
Current Situation

Source : BHR 2018

 Hypertension Prevalence in Indonesia
34.1%
31.7%

25.8%

9.5% 8.8%
7.2%
4.7%

0.4% 0.7%

RKD 2007 RKD 2013 RKD 2018

BP Measurement
Pengukuran Tekanan Darah Diagnosis Dokter
Doctor Diagnosis Taking
Minum Medication
Obat
*) BP Measurement for ≥ 18 yr old
**) Based on interview for ≥ 15 yr old for Diagnosed hypertension and taking medication
 Indonesian Hypertension
Characteristic
By Age By Gender By Residential

69.5 34.4

63.2 36.8
28.8

55.2 31.3
22.8

45.3

33.7
31.6

20.1

13.2

15-24 25-34 35-44 45-54 55-64 65-74 75+ Male

Laki-laki Female
Perempuan Urban
Perkotaan Rural
Perdesaan

Source : BHR 2018

 Hypertension Adherence
in Indonesia
Routine medication; 4.7%

59.8% Taking no medication; 1.3%

Not Routine medication; 2.8%

31.3% Diagnosed Hypertension

8,8%

14.5%
12.5% 11.5%
8.1%
4.5%
2.0%

hy ity bs er e n ct bl
e
Undiagnosed Hypertension; 91.2%
alt cil er th icn tio ffe ila
h e fa l h O ed ica e e a
ng h na em ed d av
alt tio m Si t
eeli he di tak y no
F o tra tt
o bu tio
n
tt to
v isi ki
ng rgo r d ci a
e Ta F o
ffo ed
in a M
ut n't
-ro Ca
on
N

Source : BHR 2018

 Hypertension Cases in Indonesia

• Estimated Hypetension case

63.309.620
• Hypertension by diagnosed
5.571.246
BP Measurement
Undetected Hypertension
8,8
57.738.374
Diagnosed
Hypertension

13
 Hypertension Risk Factor
in Indonesia
120
60
100 93.5 95.5

80
50
60
40 29.3 28.8
21.8 40
20 15.4
6.9 8.5
0
y s g n 30
e sit b ete k in
pt
io
b ia o m
O D Sm n su
Co 20
le
te ab
e g
V 10
d
s an
t
ui
f Fr
o 0
ess 1
L
Sugar Consumption > 50gr/day Salt Consumpton >2000mg/day
2013 2018 Fatty Food Consumption

Source : National Health Research Source :

 Government Policy
HEALTH
Education and Information of
PROMOTION:
Hypertension for the community

EARLY
• Integrated and Risk factor and Prognosis Factor early
DETECTION
Detection by Health Professional and
Comprehensive trained people
Prompt Treatment
Approaches
• Inclusive SPECIFIC
• Based on Family Salt Sugar and Fatty food
PROTECTION
Consumption control, Free Smoke are
Support and Policy

Community
Participation
 Goverment Strategy
Community Movement for Healthy Indonesia Program Minimum Standard
Healthy Life with Family Approach for Health Services
 Goverment Strategy

Smoke Free Policy Community Empowerment

 Health Facility Strengthening
Integrated Health Services for NCDs
Surveilance
Challenges
 Inter goverment sincronization action plan to tackle Hypertension (Budget, action plan and monev)

 Increasing Community Awareness to tackle Hypertension and it’s risk factor

 Developing Sustainable Surveilance system

 Increasing Research for Effective Hypertension Intervention and how to implement it as a

Hypertension prevention and control Health System
 Strengthening Health Facility to mantain continuum care for Hypertension

 Increasing Multisector and interdisiplinary networking and collaboration to tackle Hypertension and
it’s risk factor
Way Forward
• NCDs program Advocacy and Socialization to local goverment

• Developing Evidence Based Public Policy for Hypertension

• Capacity building for community and health provider to tackle Hypertension risk factor

• Public Private Partnership to Reduce Hypertension Risk Factor

Thank You