Search

Objective. The aim of the present study was to examine non-communicable disease (NCD) policy formation and implementation in Indonesia. Methods. Interviews were conducted with 13 Indonesian health policy workers. The processes and issues relating to NCD policy formation were mapped, exploring the interactions between policy makers, technical/implementation bodies, alliances across various levels and the mobilisation of non-policy actors. Results. Problems in NCD policy formation include insufficient political interest in NCD control, disconnected policies and difficulty in multisectoral coordination. These problems are well illustrated in relation to tobacco control, but also apply to other control efforts. Nevertheless, participants were optimistic that there are plentiful opportunities for improving NCD control policies given growing global attention to NCD, increases in the national health budget and the growing body of Indonesia-relevant NCD-related research. Conclusion. Indonesia's success in the creation and implementation of NCD policy will be dependent on high-level governmental leadership, including support from the President, the Health Minister and coordinating ministries. [ABSTRACT FROM AUTHOR]

We examined women's access to health insurance in Indonesia. We analyzed IFLS-4 data of 1,400 adult women residing in four major cities. Among this population, the health insurance coverage was 24%. Women who were older, involved in paid work, and with higher education had greater access to health insurance (p < .05). We also found there were disparities in the probability of having health insurance across community levels (Median Odds Ratios = 3.40). Given the importance of health insurance for women's health, strategies should be developed to expand health insurance coverage among women in Indonesia, including the disparities across community levels. Such problems might also be encountered in other developing countries with low health insurance coverage. [ABSTRACT FROM AUTHOR]

Aim To explore the implementation of poslansia, a community-based integrated health service implemented across Indonesia to improve the health status of older people through health promotion and disease prevention. Methods Data analysis of 307 poslansia surveyed in the 4th wave of Indonesia Family Life Survey ( IFLS-4). We examined the services provided in the programme, resources and perceived problems. Results The services provided by poslansia focused mostly on risk factor screening and treatment for minor illness, and less on health promotion activities. Lack of support from community health centres, no permanent place for holding poslansia and lack of participant interest in joining the programme were associated with fewer services provided in the programme ( P < 0.05). Conclusion The findings indicate existing support from the community, community health centres and related institutions for poslansia is not adequate for optimal service function. Health awareness among the older population should also be increased for programme sustainability. [ABSTRACT FROM AUTHOR]

Inhabitants of rural areas can be tempted to migrate to urban areas for the type and range of facilities available. Although urban inhabitants may benefit from greater access to human and social services, living in a big city can also bring disadvantages to some residents due to changes in social and physical environments. We analysed data from 4,208 women aged >15 years old participating in the fourth wave of the Indonesia Family Life Survey. Chronic condition risk factors – systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), and tobacco use – among women in four major cities in Indonesia (Jakarta, Surabaya, Medan, and Bandung) were compared against other cities. Fractional polynomial regression models were applied to examine the association between living in the major cities and SBP, DBP, BMI, and tobacco use. The models were also adjusted for age, education, employment status, migration status, ethnic groups, and religion. The patterns of SBP, DBP, and BMI were plotted and contrasted between groups of cities. Chronic condition prevalence was higher for women in major cities than in contrasting cities (p<0.005). Living in major cities increased the risk of having higher SBP, DBP, BMI and being a current smoker. Chronic disease risk factors in major cities were evident from younger ages. Women residing in Indonesia's major cities have a higher risk of developing chronic conditions, starting at younger ages. The findings highlight the challenges inherent in providing long-term healthcare with its associated cost within major Indonesian cities and the importance of chronic disease prevention programmes targeting women at an early age. [ABSTRACT FROM AUTHOR]

Purpose Difficult living conditions in urban areas could result in an increased risk of developing depression, particularly among women. One of the strong predictors of depression is poverty, which could lead to inequality in risk of depression. However, previous studies found conflicting results between poverty and depression. This study examines whether depression was unequally distributed among young and middle-adult women in Indonesia׳s major cities and investigate the factors contributed to the inequality. Methods Data from 1117 young and middle-adult women in Indonesia׳s major cities (Jakarta, Surabaya, Medan, and Bandung) were analysed. Concentration Index (CI) was calculated to measure the degree of the inequality. The CI was decomposed to investigate the factor contributing most to the inequality. Results The prevalence of depression was 15% and more concentrated among lower economic group (CI=−0.0545). Compared to the middle-adult group, the prevalence of depression among women in the young-adult group was significantly higher (18% vs 11%, p <0.05) and more equally distributed (CI=−0.0343 vs CI=−0.1001). Household consumption expenditure was the factor that contributed most to inequality in both group. Other factors contributing to inequality were smoking in young-adult group and marital status in middle-adult group. Contribution of education to inequality varied for different age groups. Conclusion Depression is more concentrated among the lower economic groups, with household expenditure being the major factor contributing to the inequality. This finding emphasises the importance of primary care level mental health services, particularly in poorer urban communities. Limitation This study is based on a cross-sectional data, and only assesses social determinants of depression. These determinants are important to address in addition to biological determinants and other factors. [ABSTRACT FROM AUTHOR]