challenges and opportunities for future public spending
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Challenges and Opportunities for Future Public Spending. Investing in Indonesia’s Health. Health Public Expenditure Review 2008. Indonesia’s Health System and Financing Challenges. Indonesians are living longer and child mortality has fallen dramatically. - PowerPoint PPT PresentationTRANSCRIPT
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Challenges and Opportunities for Future Challenges and Opportunities for Future Public SpendingPublic Spending
Investing in Indonesia’s Investing in Indonesia’s HealthHealth
Health Public Expenditure Review 2008
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Indonesia’s Health Indonesia’s Health System and Financing System and Financing
ChallengesChallenges
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Indonesians are living longer and Indonesians are living longer and child mortality has fallen child mortality has fallen dramaticallydramatically
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Indonesia’s Health System Health System ChallengesChallenges Stagnating Health OutcomesStagnating Health Outcomes Geographic InequalitiesGeographic Inequalities Under-funding Under-funding Inefficiencies (low utilization)Inefficiencies (low utilization) Financially UnsustainableFinancially Unsustainable Limited Health Insurance CoverageLimited Health Insurance Coverage Weak StewardshipWeak Stewardship
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Particular challenges remain in Particular challenges remain in MDG related areasMDG related areas Maternal mortalityMaternal mortality Child malnutritionChild malnutrition Female literacy and access to clean Female literacy and access to clean
waterwater Geographical disparitiesGeographical disparities
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Demographic transformation will Demographic transformation will demand a different, more expensive, demand a different, more expensive, health care systemhealth care system
Indonesia 1970 Indonesia 2025
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Indonesia’s Health Financing Challenges
Ensuring Adequate Fiscal SpaceEnsuring Adequate Fiscal Space Ensuring Adequate & Equitable Ensuring Adequate & Equitable
FinancingFinancing Improving Efficiency in Provider Improving Efficiency in Provider
Payment SystemsPayment Systems Enrolling Informal Sector WorkersEnrolling Informal Sector Workers Defining Basic Benefit PackageDefining Basic Benefit Package Developing Data for Decision Making Developing Data for Decision Making
(DDM)(DDM)
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9 Ideas for Better Health Outcomes 9 Ideas for Better Health Outcomes in Indonesiain Indonesia
Policy Policy OptionsOptions::
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1. Make better use of existing resources, while 1. Make better use of existing resources, while also making more resources available in the also making more resources available in the medium termmedium term
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2. Increase spending on maternal 2. Increase spending on maternal healthhealth
Allocate more resources for referral and Allocate more resources for referral and institutional deliveriesinstitutional deliveries
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3. Improve resource allocation for 3. Improve resource allocation for preventive care & allow sufficient preventive care & allow sufficient resources for O&Mresources for O&M
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4. Devote additional resources and 4. Devote additional resources and attention to all major public goods that attention to all major public goods that determine health outcomesdetermine health outcomesMillennium Development Goals Households/Communities Health Sector and
Related SectorGovernment Policies and
Actions
Health
- Underweight- Under-five
mortality ratio - Maternal
mortality ratio- Communicable
diseases
Household actions and risk
factors
- Use of Health service
- Dietary, sanitary and sexual practices- Lifestyle
Household Assets
- Human - Physical- Financial
Community Factors- Cultural norms
- Community institutions- Social capital- Enviroment
Other MDG outcomes
- Poverty
Health providers- Private: for-profit nonprofit- Public hospitals, primary care, informal
Finance and Inputs
- Public and private insurance; financing and coverage- Drugs
- Health sector policies at macro, health system and micro levels
- Government spending
Other policies - Infrastructure- Transport- Energy- Agriculture- Water and sanitation
Supplies in related sectors
- Food - Energy- Roads- Water and Sanitation
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5. Adjust DAU to provide incentives for 5. Adjust DAU to provide incentives for local civil service reform and amend PP local civil service reform and amend PP No. 55 to allow operational use of the No. 55 to allow operational use of the DAKDAK
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6. Increase coverage of the Askeskin 6. Increase coverage of the Askeskin ProgramProgram
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7. Ensure financial sustainability of 7. Ensure financial sustainability of Askeskin by introducing cost-Askeskin by introducing cost-containment optionscontainment options
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8. Increase efficiency by including 8. Increase efficiency by including private providers in insurance private providers in insurance schemesschemes
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9. Improve reporting and budgeting 9. Improve reporting and budgeting systems as well as data availability systems as well as data availability and transparencyand transparency
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Thank You