PRIVATE SECTOR HEALTH CARE IN INDONESIA - Health Systems ...

Indicator DKI West Jakarta Data Source and NotesAPBD budget for health Rp 1.74 trillion Est Rp 253 billion www.berita8.com websiteAPBN budget for health(Note: No DAK, DAU allocation forDKI Jakarta)Rp16.9 trillion (2008)Rp 20.27 trillion (2009)— Speech of President RI on08/15/08, andNK APBN 2009, Pg-97How can services provided at private facilities be better integrated into thehealth system to ensure better delivery and monitoring of priority healthservices (ie, TB, ANC)?3.3 Reliability of Records on Providers at suDinKes (Suku Dinas, for city level IN JAKARTA)The Sudinkes maintains records on health providers in the district, as they are responsible forlicensing them. However, some of the figures are distorted because of the way practices are registered.For example, there are 2,010 registered GP practices, and 1,454 specialist doctors, but they may includedoctors that have several registered practice sites. District records also show 408 registered apotek and158 toko obat. The district has no capacity to ensure that everyone is licensed, or that licenses are up todate, as the first private midwife the team visited was a midwife whose license had expired.3.4 Role of SuDinKes in supervision and monitoring OF private providers and ensuring theiroverall qualityThe Sudinkes believes that it is their role to license and supervise all doctors and midwives, includingones in private practice. While they do issue the licenses, given the limited manpower however, theSudinkes claims that it is not possible for them to visit or monitor these practices to ensure quality. Butthey do make sure that other required licenses are in place and the number of doctors and other staff meetthe requirements, but they do not have time to monitor clinical quality.IBI, and midwives, were the one group of informants that felt there was sufficient coordination withSudinkes. Private hospitals seem to have little interaction with Sudinkes, although they are occasionallyasked to participate in district health programs, or invited to selected discussions.The situation on licensing of pharmacists and pharmacy outlets is confused. Sudinkes accepts that it istheir role to license pharmacists, and issues licenses for a period of five years. The local branch of ISFI(Pharmacists Association) provides a recommendation letter which in West Jakarta is considered anecessary requirement. The licenses for pharmacy shops/outlets are issued at Province level, but with thebulk of the application being received and processed at Sudinkes level and a final recommendation madeto Province level. The Sudinkes states that with manpower restrictions it is not possible for them tomonitor pharmacy operations once licensed.3.5 Reporting practices of private providersThe information on reporting practices was inconsistent. Sudinkes officials reported that they do notreceive reports from private individual providers, but do get information from hospitals and clinics.However, private practice midwives assured us that they report to the Puskesmas every month. Staff at aPuskesmas also reported that they distribute TB drugs to eight private practice doctors and they providereports to the Puskesmas. One hospital visited also reported that it provided monthly reports of TB100