AsianScientist (Jul. 18, 2018) – Researchers in Indonesia report that despite advances in healthcare, the Southeast Asian nation remains saddled with a double burden of communicable and non-communicable diseases. They published their findings in The Lancet.
Indonesia has made considerable advances in healthcare since 1990. The average life expectancy of Indonesians has increased by eight years, and the health burden from diarrheal disease and tuberculosis has been on the decline.
However, in the present study, a research group led by former Indonesian health minister Dr. Nafsiah Mboi, found that Indonesia is grappling with a growing and expensive wave of health threats from heart disease, diabetes and other non-communicable diseases. Mboi is currently a member of the board of trustees of the Center for Strategic and International Studies in Indonesia.
“Indonesia is wrestling with a ‘double burden.’ We must remain vigilant in driving down rates of communicable diseases and ailments that affect mothers and infants. At the same time, we need to prevent and treat non-communicable diseases, which is an expensive endeavor,” said Mboi. “This gets even more complicated as Indonesians live longer and wrestle with more complex combinations of diseases.”
The research group analyzed health data in Indonesia from 1990 to 2016, reviewing 333 causes of death and disability in Indonesia and seven comparison countries. It is the largest systemic effort ever to examine Indonesian health trends and their causes, and is part of the Global Burden of Disease study, a comprehensive effort to quantify health internationally.
In 1990, diarrheal diseases, lower respiratory infections and tuberculosis were the top three causes of death and disease. More than 25 years later, tuberculosis was the ranked fourth among the causes of health loss in Indonesia. Diarrheal diseases were ranked ten, and lung respiratory infections fell out of the top ten list.
However, new challenges have emerged. The health loss from non-communicable diseases has dramatically increased. Rates of cardiovascular diseases and diabetes have ballooned in the past 25-plus years. These increases have been fueled by poor diet, high blood pressure, high blood sugar and tobacco use. The researchers particularly noted the increasing impact of diabetes—death and disability from diabetes increased by 38.5 percent since 2006, promising to strain the country’s health system for years to come.
Injuries from traffic accidents and non-deadly ailments such as low back and neck pain, along with vision and hearing loss, are also taking an increasing toll on Indonesians’ health.
The study comes at a critical time for Indonesia. More than 180 million people—nearly 70 percent of the population—are enrolled in Jaminan Kesehatan Nasional, the country’s national insurance program. This program was launched in 2014 and aims to provide health coverage for all Indonesians, with the government paying premiums of people living in poverty. The government has set the ambitious goal of enrolling 95 percent of the population by 2019, effectively achieving universal health coverage.
This rapid expansion of health care will require intensified and strategic investments, according to Mboi.
“This study will help the government make more informed health investments and policies in the coming years. We need continued research efforts to increase our understanding of health trends, especially in different provinces of our very large and diverse country,” she said.
The article can be found at: Mboi et al. (2018) On the Road to Universal Health Care in Indonesia, 1990–2016: a Systematic Analysis for the Global Burden of Disease Study 2016.
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Source: Institute for Health Metrics and Evaluation; Photo: Pexels.
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