Indonesia had a three-tiered system of community health centers in the late 1990s, with 0.66 hospital beds per 1,000 population, the lowest rate among members of the Association of Southeast Asian Nations (ASEAN).[1] In the mid-1990s, according to the World Health Organization (WHO), there were 16 physicians per 100,000 population in Indonesia, 50 nurses per 100,000, and 26 midwives per 100,000.[1] Both traditional and modern health practices are employed. Government health expenditures are about 3.7 percent of the gross domestic product (GDP).[1] There is about a 75:25 percent ratio of public to private health-care expenditures.[1]
Unsafe drinking water is a major cause of diarrhea, which is a major killer of young children in Indonesia.[1]
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HIV/AIDS has posed a major public health threat since the early 1990s.[1] In 2003 Indonesia ranked third among ASEAN nations in Southeast Asia, after Myanmar and Thailand, with a 0.1 percent adult prevalence rate, 130,000 HIV/AIDS cases, and 2,400 deaths.[1] In Jakarta it is estimated that 17 percent of prostitutes have contracted HIV/AIDS; in some parts of Papua, it is thought that the rate of infection among village women who are not prostitutes may be as high as 26 percent.[1]
Three other health hazards facing Indonesia in 2004 were dengue fever, dengue haemorrhagic fever (DHF) and avian influenza.[1] All 30 provincial-level units were affected by dengue fever and DHF, according to the WHO. The outbreak of highly pathogenic avian influenza (A/H5N1) in chickens and ducks in Indonesia was said to pose a significant threat to human health.[1]
By 2010, there are three malaria regions in Indonesia: Nusa Tenggara Barat with 20 cases per 1,000 citizens, Nusa Tenggara Timur with 20-50, and Maluku and Papua with more than 50 cases per thousand. The medium endemicity in Sumatra, Kalimantan and Sulawesi, whereas low endemicity is in Java and Bali which almost 100 percent of malaria cases have been confirmed clear.[2] At 1990 malaria average incidence was 4.96 per 1,000 and declined to 1.96 per 1000 at 2010. The government is targeting to rid the country of malaria by 2030 and elimination means to achieve less than 1 incidence per 1,000 people.[3]
Indonesia has routine vaccination to children below age 5 years as World Health Organization (WHO) recommendations including vaccination of Hepatitis B which has high prevalency in Indonesia. Almost all of the vaccines provided by PT Bio Farma which one of the 29 companies with a prequalification certificate from the WHO among 200 vaccine company in the world. It also has been exported to 110 countries in the world.[4] Indonesian vaccines are prefer among countries with high Moslem population due to they are halal vaccines.
PT Bio Farma as a global vaccine producer will produce pentavalent vaccine (diphteria, pertussis, tetanus, hepatitis B and haemophilus influanzae type B or HiB). In 2012 the GAVI (Global Alliance for Vaccine and Immunization) will donate 80 percent of the needs of pentavalent vaccine and in the third year government should self fulfilment.[5]
June 2011: The third phase test of dengue vaccine involving 800 humans with ages of 2 and 14 years old have been held in 5 community health center around Jakarta and will be conducted also in Bandung, West Java and Denpasar, Bali with 800 and 400 participants, respectively. The first test was performed on a limited number of soldiers and the second phase was conducted on a small number of children and if within the next 5 years the vaccine is found to be safe for humans, government will apply the dengue vaccine to public.[6]
In June 2011, the United Nations Population Fund released a report on The State of the World's Midwifery. It contained new data on the midwifery workforce and policies relating to newborn and maternal mortality for 58 countries. The 2010 maternal mortality rate per 100,000 births for Indonesia is 240. This is compared with 228.6 in 2008 and 252.9 in 1990. The under 5 mortality rate, per 1,000 births is 41 and the neonatal mortality as a percentage of under 5's mortality is 49. The aim of this report is to highlight ways in which the Millennium Development Goals can be achieved, particularly Goal 4 – Reduce child mortality and Goal 5 – improve maternal death. In Indonesia the number of midwives per 1,000 live births is unavailable and 1 in 190 shows us the lifetime risk of death for pregnant women. [7]
On 2010, an estimated 56 percent of Indonesian mainly state employees, low-income earners and those with private coverage have some from health insurance. It will boost to 100 percent with a system of universal social health insurance coverage in place by 2014. The aim is that everybody doesn't have to pay when they are hospitalized in basic/class-3 hospital beds.[8]
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