Instilling Trust and Mobilizing Resources: COVID-19 Challenges in Indonesia

04 June 2020

“The coronavirus spreads like wildfire, and thanks to us, it’s spreading now to other regions [of Indonesia]. Social distancing acts like the fire extinguisher, but it must be readily implemented in affected areas. It is the responsibility of regional government to provide the fire extinguisher for places in need. Question is: is government financially ready to provide it?” asked Hasbullah Thabrany, Chief of Party for USAID Health Financing Activity (HFA) led by ThinkWell.

Indonesia is currently battling high numbers of confirmed COVID-19 cases. As of June 1, there are 26,940 confirmed cases, with 1,641 deaths. Numbers are expected to continue increasing. Worldwide, experts agree that social distancing could help to stem the tide, but there have been barriers to adoption of these strategies in Indonesia.

Major challenges in Indonesia, including mobilizing resources and communicating about the outbreak, are rooted in decentralization of the health system, and much of the execution of preparedness efforts is being done at the regional and local level. Messages delivered to local communities about the pandemic and effectiveness of social distancing are disorganized and unclear, posing risks to gaining public trust.

“To avoid the spread of wildfire, it is imperative that local government take measures needed to allocate fund. This needs advocacy especially, even at the district level, if needed – to educate and raise awareness of local leaders of the urgency of the matter, and to act quickly,” Dr. Thabrany added.

In every part of the world, this is a litmus test for health systems capacity. There is a lack of capacity to prevent and detect COVID-19 cases early enough for intervention in Indonesia, while providers are bearing the impact of supply-side limitations. It is an unmerciful exposure of long-standing neglect to the health systems backbone of the country.

ThinkWell is committed to providing support for reliable measures for health financing in relation to COVID-19, especially financing care for patients. USAID HFA, with ThinkWell, is seeking ways to illuminate the cost associated with of COVID-19, by looking at costs associated with the infection beyond clinical care. We also plan to collect additional data from National COVID-19 Task Force officials to provide COVID-19 case estimation and projections in country. The study aims to provide better evidence for claim reimbursement of COVID-19 cases, as well as provide input to the budget scheme related to the pandemic. The study is in partnership with the Center of Health Financing and Insurance of the MOH (CHFI/PPJK MOH GOI) and the National Institute for Health Research and Development (NIHRD MOH GOI).

Dr. Thabrany presented during a webinar in April 2020, a collaboration between the Indonesian Association of District Indonesian Association of District Health Office and USAID HFA. Speakers included Dr Edhie Rahmat, MSc, USAID Office for Health; Dr. Bayu Teja Mulyawan, Apt., M. Pharm, MM, The Head of the Bureau of Planning of the Ministry of Health; Purwanto, SE, MSc, Director, the Budget of the Human Development and and Culture, Ministry of Finance; Hasbullah Thabrany, MPH, DrPH, ThinkWell. Participants included directors of primary health care services and district health official staff all over the region.