A Health indicator is a distinctive character of a population, an individual or environment which is subjected to measure either directly or indirectly and can be used to describe the quantity and quantity of health of a population or individual. Health indicators define the health problems in a particular population in a given point of time. It defines the differences in health population and the extent to which the population can assess objective programs to combat the health problems. Health indicators include measurements of diseases or illness which is used to measure the total health outcome of a given population.
It also measures the positive aspects of a given population’s health and behavior for example quality of life, health expectancy or life skills. Indicators can also measure economic and social conditions related to health and a population’s physical environment, healthy public policy and health literacy (Evans & Stoddart 372). Health indicators can also measure both health promotion outcomes and intermediate health outcomes.
Generally, Health indicators capture the key dimension of health in a given population such as the number of people suffering from heart attack or chronic diseases or how often patients assess hospitals for medical care and treatment. The following illustrates health indicators in Indonesia providing a good description of health situation in the country and how the health indicators relate to Millennium Development Goals (MDGs).
Indonesia is a Southeast Asia and Oceania county comprising of approximately 17, 508 islands (Ricklefs 11). Indonesia is ranked number four in the world in terms of population. The country has 238 million people with 300 ethnic groups in 33 provinces speaking 350 different languages spread all over the islands (Ricklefs110). Indonesia being a republic has got an elected president and legislature. The country shares borders with Malaysia, East Timor and Papua New Guinea.
Indonesia has a politically dominant population with distinct ethnic, religious and linguistic groups with the largest being Javanese. Indonesia became a united country after developing a national language which defines it and a national motto Bhinneka Tunggal Ika meaning many, yet one (Schwarz 98). Majority of the population consists mainly of Muslims. However, despite being densely populated region, the country is one of the few regions where one can still see broad territories of wild nature which are considered to be the second highest biodiversity in the world (Schwarz 100). Poverty is widespread in Indonesia despite having richly natural resources.
Health strategies and policies in Indonesia
The Ministry of Health and Social Welfare in Indonesia created Healthy Indonesia 2010 which allows the country to collaborate with others since health is a responsibility which is shared. Indonesia’s Government agencies and department, community and private sectors have taken the mandate to take care of health concerns of the population (Taylor 168). Some of the basic goals that Healthy Indonesia 2010 wants to achieve are: promote self-reliance within the public as a way to achieve government health, enhance and maintain quality, affordable and accessible health care services, initiate and lead health directions of national development and finally enhance and maintain family, individual and public health by improving the environment (Clevan 145).
Indonesian Ministry of Health and Social Welfare enacted two new fundamental Acts namely Act No. 25/1999 on Financial Balance between Central Government and Local Governments and Local Governance which is Act No. 22/1999. These two Acts are used to legalize the implementation of a decentralization policy which gives Indonesia’s districts and provinces large sovereignty to take control over their homes except foreign affairs, monetary and fiscal, defence, religion and justice (World Health Organization 111). With the new set National health Development Vision and Mission statements, as well as on the basis of the policy of decentralization, four main issues were agreed upon in order to serve as a basis for Strategy for National Health Development formulation.
These include: professionalism, decentralization, Community Managed Healthcare Programme and initiation of health-oriented national development. However other programmes in the nation are also supported despite identification of the four major elements which act as pillars of Strategy for National Health Development.
Health Indicators in Indonesia
Indonesia is ranked the fourth country with the highest population in the whole world with the total population of 234.2 million with a Gross national income per capita of 3600. The life expectancy at birth m/f yearly is 66/77 while the probability of dying of children under the age of five per 1000 live births is 39. The probability of dying between the age of 15 and 60 m/f is 234/143 per 1000 population in Indonesia. The total health expenditure per capita is 99 while the total health expenditure as % of GDP is 2. 4.
According to Clevan, “Indonesia is regarded to have relatively adequate level of provision of health care services with 30 000 people having one public health care centre” (67). This covers large variations in accessing the geographic position of the health centre. Those who live in the small islands or remote interior have poor access to health care services hence you find that there is high death rate in such regions. The leading factors are the shortage in the number of human resources in the health services, as well as there is poor distribution of the health workforce (Clevan 65). The Ministry of Health RI and its partners in Indonesia are striving to make sure that there are sufficient emergency systems that are ready to respond in case of emergency in the nation (Klementiev 68). They are also aiming at reducing the regional health crisis in the health care centre.
According to the World Health Organization, communicable diseases are considered to be the prime causes of morbidity in Indonesia; nearly 250 people in Indonesia die of tuberculosis (TB) daily while they estimate that over half a million death cases is recorded every year the cause being tuberculosis (WHO 112). Malaria has affected large parts of the country, as well as there are often cases of dengue hemorrhagic which are also reported yearly in Indonesia. Indonesia is the third country that has the burden of leprosy among its population.
In 2008, high rate of fatality for avian influenza averagely 81% was recorded in Indonesia. The Ministry of Health and Social Welfare take all the necessary measures to control and prevent avian influenza among other infectious diseases that are spreading across Indonesia. The government of Indonesia has invested greatly on this project to promote good health among the large population. In 2005, the country experienced high spread of poliomyelitis in several provinces.
During the same year, there were reports of outbreak of diphtheria and measles which was mainly as a result of weakness in routine expanded immunization program in Indonesia. Many deaths reports was recorded mainly children under the age of 5 years were affected mostly. In 2006, approximately 293,200 Indonesians were reported to have HIV-AIDS. This was a report recorded by National AIDs Commission in 2009.
Indonesia is still having a challenge on how to deal with epidemiological alteration towards non-communicable diseases (NCDs). Indonesia has also had a burden dealing with chronic conditions such as cancer, metabolic disorders, tobacco dependence and cardiovascular diseases. This is because these chronic conditions are costly and cause a lot of suffering in human lives. Indonesia experienced a decline in productive days estimated to be about 12.3% as a result of neurological and mental disorders (Fahimi, Schwartz & Mokdad 102). This situation was exacerbate by tsunami which occurred in 2004; it had greatly influenced mental health of the affected population.
The Millennium Development Goals (MDGs) were created to help eradicate health problems experienced by many nations all over the world. MDGs are international development goals which are eight in number; they are visions that 193 United Nation member states and 23 international organizations want to achieve by 2015 (Andy & Andrew 395). Eradication of extreme hunger and poverty is one of the goals of MDGs. Others are achieve universal primary education, combat malaria, HIV/AIDs and other diseases, develop global partnership to facilitate development, improve maternal health, reduce child mortality rates, ensure environmental sustainability and promote woman empowering and gender equality (Amir 319).
Relevant development indicators in Indonesia
Indonesia is doing its best to improve maternal health, child and new born health through health policy and financing. This is part of one of the major goals of Millennium Development Goals of improving maternal health. The main sources of funding of health care centers are the government and community. Those living in the remote islands in Indonesia are being focused more on. Maternal health services such as postnatal and childbirth care for babies and mothers are offered, basic obstetric care is also offered in health care centers in remote areas (Noeleen 10). Children between the ages of 6-23 months are put on complementary feeding together with their mothers with chronic energy deficiency (Halfon 132).
Social Safety Net Program targeting poor families was invented by Indonesian government as an effort to overcome impact economic crisis meant to improve the health status of children coming from poor families. About 12.985.128 poor families now own health card while as many as 48.7% estimated to be 6.815.501 poor families now have access to health facilities (Vickers 204).
The government of Indonesia is encouraging the population to use protection and family planning methods. Condoms are distributed in colleges and health care centers as a way of combating HIV/AIDs. The government also offer public teaching and free testing of HIV/AIDs to make people aware of the disease and also become aware of their status to avoid spreading the disease. Free treatment is also offered to those suffering from tuberculosis. Children are being vaccinated after a given period of time to combat measles and polio.
Indonesian government is offering free primary education and promoting girl child education as a way of achieving universal education. Women are also included in wage employment in nonagricultural regions to empower women and also to promote gender equality within the Indonesian population (Grown 85). The government has also improved sanitation in the urban population as a way of ensuring environmental sustainability. Having a clean environment will also keep the population healthy from diseases such as malaria, typhoid and diarrhea.
In conclusion, health indictor is important in many ways for example it plays a major role of capturing the key dimension of health in a given population measuring the positive aspects of a given population’s health and behavior Through the health of health indictor, I have been able to address the health status of Indonesia and the challenges the country if facing.
Amir, Attaran. “An Immeasurable Crisis: A Criticism of the Millennium Development Goals and Why They Cannot Be Measured”. Journal of Medicine, 10.2 (2005): 318-319. Print.
Andy, Haines & Andrew Cassels. “Can The Millennium Development Goals Be Attained?” BMJ: British Medical Journal, 7462.329 (2004): 394-39. Print.
Clevan, David. Ministry of Health: Indonesia health profile, Indonesia: Public Health Publishers, 2001. Print.
Evans, Ray & Glen Stoddart. “Original determinants of health model accessed in Am J Public Health.” Journal of health Am J Public Health 93.8 (2003): 371–379. Print.
Fahimi, Makir, Levy Schwartz and Mokdad Armid. “Tracking chronic disease and risk behavior prevalence as survey participation declines: statistics from the Behavioral Risk Factor Surveillance System and other national surveys”. Journal of National Health Survey, 5.3 (2008): 96- 104. Print.
Grown, Caren. “Answering the Skeptics: Achieving Gender Equality and the Millennium Development Goals”. Journal of Health Care Development, 48.3 (2005): 82–86. Print.
Halfon, Newton. Measuring the Health and Well-Being of Children and Youth: New Models. Presented at the Children’s Health, The Nation’s Wealth Meeting. Los Angeles: Los Angeles Press, 2005. Print.
Klementiev, Andrew. “An alternative measure of years of healthy life: Advancing Quality of Life in a Turbulent World”. Journal of Social Indicators Research Series, 29.4 (2006): 67-84. Print.
Noeleen, Heyzer. “Making the Links: Women’s Rights and Empowerment Are Key to Achieving the Millennium Development Goals”. Journal of Millennium Development Goals, 13.6 (2005): 19-12. Print.
Ricklefs, Mike. A History of Modern Indonesia since c.1300, Second Edition. MacMillan: MacMillan Publishers, 1991. Print.
Schwarz, Arnold. A Nation in Waiting: Indonesia in the 1990s. Westview: Westview Press, 1994. Print.
Taylor, Gelman. Indonesia: Peoples and Histories. London: Yale University Press, 2003. Print.
Vickers, Adrian. A History of Modern Indonesia. Cambridge: Cambridge University Press, 2005. Print.
World Health Organization (WHO). “Indonesia: country Corporation Strategy”. Journal of World Health Organization, 10.5 (2010): 110-120. Print.