Health in Indonesia

Poverty and poor health are clearly linked, with poor health both a consequence and an underlying cause of poverty. Poor women and children are particularly vulnerable, with 16,000 women dying every day from complications of pregnancy, delivery and anaemia, and 2.2 million diarrhoea deaths annually from poor water quality and sanitation. Decentralization has bought both challenges and opportunities. Local governments have become the focal point for health care provision and health care spending has increased by 40 per cent in a matter of a few years, according to World Bank statistics. However, Indonesia’s expenditure for health, less than $1 per person per day, remains well under the World Health Organization’s recommended $5.

CARE's programming

In the 1970s, CARE supported medical training for aspiring Indonesian doctors and nurses. By the 1980s, CARE integrated a number of health components into environmental and water and sanitation programs. By 2002, CARE’s health program had rapidly expanded to address the economic and political crisis of the late 1990s, which had a significant impact on health services throughout the country. Today, CARE’s health program focuses on four main areas:

• Communicable diseases and surveillance, particularly malaria and tuberculosis;
• Nutrition, using Essential Nutrition Action approach;
• Maternal and newborn health, through low-tech community-based Centres of Mothers Education;
• Air Rahmat and hygiene improvement: simple, low-cost water treatment solution with safe water storage and behaviour change techniques.

Through its programming, CARE Indonesia is committed to helping achieve the UN Millennium Development Goals in health: reducing child mortality; improving maternal health; and combatting HIV/AIDS, malaria and other diseases.

Current approaches

In its health program, CARE uses four main approaches:

1. Empower individuals and communities
   Using a grassroots, community-based approach, CARE empowers people to realize their rights to health and health services.  With the correct knowledge, skills and social support, people can adopt behaviours that reduce health risks. CARE uses education, mass media techniques and community mobilization to accomplish this.
2. Strengthen local health services
   Working at the community level, CARE develops the capacity of health service providers through formal in-service training, experiential learning and mentoring. To complement this, local health clinics have been revitalized through the provision of equipment and, in some cases, the construction of facilities. Community feedback on provision of health services is promoted.
3. Influence government policies
   From the local and provincial up to the national level, CARE works closely with the government to build capacity in health planning and management. Strong health policies reduce rates of illness and promote equity; therefore, CARE seeks to link government services to the people. This approach enables the community to influence local level policies related to access and quality of health services, and supports the implementation of national-level public health policies and campaigns.
4. Build partnerships and alliances
   CARE has fostered a number of relationships with Indonesian and international academic institutes, centres of excellence and international agencies. This has enabled CARE to develop and implement sustainable health models and form networks that disseminate and build upon national and international best practices in the health sector. For instance, CARE has collaborated closely with the U.S. Centers for Disease Control to develop a sustainable, market-driven model to provide safe drinking water to the Indonesian public.