PROJECT

In response to the request from Indonesia’s Ministry of Health (MOH), World Health Organization, South East Asia Regional Office (WHO SEARO) commissioned the HITAP International Unit (HIU) to provide support for the Package of Essential Non-communicable (PEN) disease intervention evaluation. The evaluation is predicted to include qualitative analysis on technical competency of staff, public acceptance, and current barriers of introducing PEN program and reporting of the healthcare profile (patient statistics, etc.) as well as a qualitative analysis, which will be a health and economic assessment of the current PEN compared to ‘no screening’ in order to inform local stakeholders of the health and economic impact of introducing PEN in Indonesia. The evaluation will also explore the outcomes of modifying the current PEN program by changing the target population and method for diabetes screening. For this project, local data collected from 4 provinces will be used. The results of the qualitative and quantitative study are expected to inform future development of the non-communicable disease (NCD) prevention and control program in Indonesia as well as to provide a case example of applying health technology assessment in public health programs in low- and middle-income countries (LMICs).

There is a considerable demand for evidence-based policy development on prevention and control of NCDs in Indonesia. The increasingly aging population and unhealthy lifestyles, coupled with an increased investment in healthcare by the government of Indonesia’s new commitment to the UHC, have stimulated this demand. As the PEN disease interventions has been recognized as a cost-effective set of interventions for LMICs to deal with the high prevalence as well as high morbidity and mortality of NCDs, Indonesia’s MOH promptly incorporated the PEN interventions into its public health service at primary care level since 2011.

The PEN interventions were incorporated in the MOH comprehensive NCD program. With the emphasis on community engagement, Posbindu, which is the community-based awareness, monitoring, and screening activity for diabetes and hypertension, has been introduced and implemented by trained village health volunteers called kader. For those with positive screening, they are referred to the primary health care centre or Puskesmas for diagnosis and proper treatment. This arrangement allows the PEN intervention to be implemented throughout the country where there are large variations of available human resource.

 

After three years of policy implementation, there are some concerns regarding the effectiveness and impact of the program implementation. The MOH, with the support of the WHO, is planning to evaluate this effort and invited HITAP to be involved to ensure that the evaluation provides a comprehensive result that will improve technical efficiencies and raise political and public awareness of the NCD prevention and control program in Indonesia.