Assessment Question Approach/Background Key Informants Illustrative Questions for KeyInformants4) How can financial o Assess ability of districts to manage o Franz von Roenneo What types of contractingincentives (such asand enforce contracts with providers o David Dunlopexperiences have you had? Whatperformance-basedthat include performanceo Pak Laksonowere the challenges andpayments, paymentspecificationso DEPKES officials administeringoutcomes?mechanisms) be used to o Assess ability of insurers to manage Jamkesmaso How are you reimbursed forimprove access to services and enforce contracts with providers o Officials at Askesservices under Jamkesmas?or quality of services atthat include performanceo District health officialso Do private providers acceptprivate providers (ie,specificationso District hospitals and private hospitals Jamkesmas payments?midwives, GPs, Asyiyah, o Assess the reimbursement process o IBI, and member representatives o Are capitation payments underetc)?for Jamkesmas, Askes to seeidentify potential obstacles foro Indonesia Medical Assn, and memberrepresentativesJamkesmas tied to performancemeasures?private providerso NGOs – Asyiyah, Muhammadiyaho Assess prior related experiences orbest practiceso AusAID sponsored survey ofsubnational insurance schemes5) What role cano Assess the current role of each o Claudia Rokxo Are there regular meetings atprofessional associations professional association ino IBIdistrict level?play in monitoring andaccreditation and monitoring o Indonesia Medical Assno Are there up-to-date membershipimproving quality of care o Assess the organizational structure o Pharmacists Associationrecords?among private providers? of the professional associations,particularly subnational capacityoo Are there standard norms ofpractice recognized by theassociation?56
ANNEX B: FIELD ASSESSMENTREPORTS1. YOGYAKARTAThe purpose of this assessment was to provide field data as a supplement to the desk top review whichwas completed in early March 2009. The team of four people, Dr. Firman Lubis, Lucy Mize, DamaryantiSuryaningsih, and Dr. Hasbullah Thabrany were in the field for four days (May 13 to May 16, 2009).Information was gathered from the professional organizations present in Yogyakarta, counterparts at theDistrict and Provincial <strong>Health</strong> office, private providers and consumers.1.1 Provincial InformationYogyakarta Province is called a Daerah Istimewa or Special Area and is the second smallest provinceafter Jakarta. It consists of five districts: Yogyakarta City, Sleman, Bantul, Kulonprogo and Gunungkidul.The 2000 census indicates that there is an approximate 3,120,500 population. Sleman is the largest districtwith a little over 900,000 inhabitants. 19.4 percent of the province population lives below the nationalpoverty line, and the provincial health office reports that 942,129 people are enrolled in Jamkesmas(Kompas, September 2, 2008). There were 39 cases of maternal death in the province in 2008 and ofthose, 18 were in Bantul. There are 583 specialist physicians in the province out of a total of 2093doctors, 73 are obstetricians and 77 are pediatricians.1.2 District InformationThe Dinas Kesehatan office in Yogyakarta is computerized and has reliable records on health informationand statistics. From their records, the following is noted:Indicator Number Data Source and NotesPopulation 392,000 2000 Census, district recordsDelivery by <strong>Health</strong> Worker 95.8% (province)90.83% (district)2007 DHS,Kepala Dinas Yogyakarta Kota, Dr. ChoirulDTP3 Coverage 97% (province) 2007 DHSDPT 3 and HepatitisCombination as used inYogyakarta City92.4% Kepala Dinas Yogyakarta Kota, Dr. ChoirulNumber of Physicians 154 DI Kota Yogyakarta Web Page. In conversation, Dinasestimated there were at least 500 doctors practicing inYogyakarta, although they live in neighboring districts.Number of Midwives 410-432 There is a data discrepancy between IBI Pusat and IBICabangNumber of Puskesmas(Community <strong>Health</strong> Centers)18 DIY Government WebsiteNumber of Apotek 115 DI Kota Yogyakarta DataBalai Pengobatan 28 Small treatment centers, usually headed by nurse or midwife57
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PRIVATE SECTOR HEALTHCARE IN INDONE
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PRIVATE SECTOR HEALTH CAREIN INDONE
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7. Rationalizing Use of Medications
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ABBREVIATIONSANCAskesAskeskinAusAID
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THEUSAIDVATWHOTotal health expendit
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EXECUTIVE SUMMARYAs documented in I
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By using their power to select whic
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higher reimbursement for complex de
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2. BACKGROUND2.1 GENERAL BACKGROUND
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- Page 71 and 72: ANNEX A: ASSESSMENT GUIDEIndonesia
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- Page 82 and 83: 1.3.4 DinKes Experience with Privat
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- Page 94 and 95: Dinas Yogyakarta31. Mardiningsih, S
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- Page 106 and 107: As per IMA Propinsi, they meet with
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members who pay membership fees. Th
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emainder paying out of pocket. Reve
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3.20 Indonesian Pharmacists Associa
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OtherApotek Gitamara, Jl. Kemanggis
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13. Government of Indonesia, World
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41. Thrabany, Hasbullah, et al. 200