Government Support

One of the most notable features of Indonesia's health care system, in comparison with other Southeast Asian nations, was the low level of government support. The modern health care system continued the Dutch colonial pattern of low investment in health care. The Dutch did relatively little in the field of public health prior to 1910, with the exception of giving smallpox vaccinations. In the 1930s, however, the government devoted increased attention to health education and disease prevention, particularly in rural areas. An elaborate public health infrastructure had developed by 1939, including a particularly sophisticated model program in Purwokerto in Jawa Tengah Province. But this public health system collapsed after the Japanese invasion in 1942. During World War II, mortality rose dramatically and the general health situation of the country deteriorated.

In the postwar period, a network of maternal and child health centers was established, but resources were extremely limited, with one physician for every 100,000 people. The first dramatic improvements resulted from the establishment of the network of community health centers. Although there was considerable resistance by the general population toward using these facilities at first, by the 1980 census, 40 percent of people reporting illness in the prior week had sought treatment at one of the community health centers.

Unfortunately, direct central government spending on health (apart from intergovernmental transfers) fell by 45 percent in real terms between FY 1982 and FY 1987 because of the declining revenues from the oil industry. The Outer Islands continued to suffer a severe shortage of physicians and hospitals, but this deficit was partially offset by a higher percentage of community health centers, staffed by health care workers.

Source: U.S. Library of Congress