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The Development of Health in the Development Reform Cabinet is carried out through health paradigm so as to realize the "Healthy Indonesia 2010" program.

The main objective of health development towards Healthy Indonesia 2010 is to enhance the awareness, willingness and capability of healthy life for individuals to realize the maximum of community's health standard through the achievement of healthy life for the community, nation and state, marked with the healthy citizen's behavior in their environment. Meanwhile, they should have the capability to enjoy qualified health services justly and equally, and they also have optimal healthy life standard in Indonesia as a whole.

The targets of health development towards Healthy Indonesia 2010 are :

(a) healthy behavioral life;

(b) healthy environment:

(c) healthy effort;

(d) healthy development management; and (d) healthy quality.

To achieve the objectives and targets of health development towards the realization of Healthy Indonesia 2010, there are some general policies of healthy development such as:

(a) the Enhancement of the Public Self Reliance and Partnership;

(b) the Enhancement of Health Effort;

(c) the Enhancement the Environment Health;

(d) the Enhancement of Human Resources;

(e) the Enhancement of the Policy and management of Health Development: and

(f) the Enhancement of Research and Development.

Reform steps in the health sector consists of 12 (twelve) programs, such as: Introducing Health Paradigm: Health Development Program oriented to the Autonomy; Reform in the Hospital Services Sectors; Eradicating Graft and Collusion Practice; Drug Reform Sector: Health Officers Utility Reform: Health Services for the Poor; Health Insurance and Community Medical Services Insurance (JPKM): Social Safety Net in the field of health (JPS-BK) Program Managed with JPKM Principle: Monitoring and Management of and Workers Nutrition: Health Sector Effort in Overcoming Disasters; and Decentralization.

Since the middle of 1998, a new Health Paradigm has been introduced, stressing in preventive and curative effort without ignoring curative and rehabilitative services in health development. With the introduction of this paradigm, health services will be more cost effective.

Logical consequent from this new paradigm is the need to carry out the adjustment of health development programs and relocation of human resources having more priority in the promotive and preventive efforts.

The health-oriented development with regional basis is always encouraged, such as free smoking area, and healthy village, healthy island, and or the development healthy district. Free Smoking Area has been gradually introduced to all parts of the districts.

To develop Hospital to be a "Health Institute" as a role model for the public at large as regard to healthy environment, safety and security of work, as well as healthy behavior, the Ministry of Health has made a few changes perspectively, among others, formerly a hospital functioned as a "Curative Oriented" should be changed into "Health Care Oriented" for all members of the families. Because its function is to take care, so hospital does not only become "the house for patients" but it changes into a "the existing place to take care of health".

Meanwhile, the position of Nursery and Children Hospital (RSAB) "Harapan Kita, RS Jantung Harapan Kita, RS Kanker Dharmais" should be returned as a technical implementator/ executor unit of the Ministry of Health and benefit it as optimally for the interest of health development.

To implement reform in the field of medicines, the Ministry of Health makes it compulsory for pharmacies to provide generic medicines and gradually the Government will reduce the prices of generic medicines to make them affordable to the people. The medicines are directly distributed to pharmacies, hospitals and doctors from pharmaceutical factories to short cut the bureaucracy and drug distribution.

In addition, the Government undertakes cooperation with various institutions to develop economic raw material for pharmaceutical industry by utilizing domestic resources and potentials especially material taken from medicinal plants.

Under cooperation with PT Perkebunan, FT Kirnia Farma and BPPT, the Ministry of Health encourages the establishment of medical plants plantation by involving the people residing around the plantation; boosts partnership between traditional medicine industry and farmers, religious boarding schools and cooperatives around factory sites; establishment of extract factory as well as provide information on how to establish and to utilize Family Medicine Garden (TOGA).

Reform in the placement/utilization of new doctors and dentists is carried  out through  the establishment of Reform Team on the Placement of Doctors and Dentists, in which professional organization (IDI and PDGI) are involved. This team is to review the placement policy of new doctors and dentists in such a way that the placement could evenly provide medical services but at the same time would not impede the career of those new doctors in the future.

Destitute people should be able to enjoy better medical services as the Government increases subsidy of medical services for those peopie and provide them with free medical services in Public Health Centers (Puskesmas) and government-owned hospital by using Health Card (Kartu Sehat).

In anticipation of the impact of economic crisis, the Government launched Social Safety Net in the field of health (JPS-BK) in August 1998. This program has been given special attention and carefully implemented. JPS-BK program is divided into two groups of efforts, namely: a. Intervention effort in the form of financial assistance for the operation of Puskesmas, midwife services and provision for extra food, recovery: and b. Supporting effort in the form of revitalization of Food and Nutrition Warning System (SKPG), Community Medical Services Insurance and financial assistance for provincial (Dati 1) and District Government (Dati II).

In Health Insurance, Indonesia has implemented medical services through the Community Medical Services Insurance (JPKM) as stipulated in Law No. 23/1992. JPKM is designed to benefit all concerned parties so that the people are protected and are guaranteed to get post medical services that are affordable, which in turn will increase the health condition of the people.

For the sake of integration, the ongoing implementation of JPS-BK is carried out based on the principal of JPKM. Meaning, the fund provided by the Government to finance medical services for destitute people is not directly given to Puskesmas and/or midwife in rural areas but is channeled through organizing body (Bapel) of JPKM established in every district area (Dati II).

Successful implementation of JPKM will increase its role in accelerating the decentralization as not all-medical services are managed by the central Government or even provincial Government but are managed by each provider of medical services involved in JPKM protlrarn. The central Government concerns only with the legislation, provision of facility and supervision beside provision of certain medical services for the people such as immunization, eradication of conlagious diseases, health education, environment sanitation and medical services for high risk elderly people as well as destitute people through subsidy and/or direct management of various institutions.

In the framework of monitoring and handling of malnutrition, the Government provided assistance through the implementation of SKPG in all provinces in November through December 1998. The main objective of this activity was among other things to increase the sense of crisis among decision-makers in regional areas, to introduce the basic concept of SKPG (indicators, work mechanism etc.) and to increase the involvement food and nutrition institutions in regional areas The problem of malnutrition needs to be handled in a professional way. For that reason the Ministry of Health has developed a program called Tracing of Malnutrition Cases and Management of Protein Deficiency on Children in Puskemas and hospitals. Until now malnutrition cases in medical institutions (Puskesmas and hospitals) have been managed professionally in accordance with WHO standard.

In JPS-BK program, efforts to maintain nutrition of the children are undertaken by providing extra food to children aged 6 to 23 months from destitute families. Fund allocated for this program in 1998/1999 was Rp750 per child for 3 months. In 1998/99, it has been undertaken the providing extra food to 103.3 thousand of pregnant women who suffered from chronicle energy crisis (KEK) and 945.4 thousand children and children under 6-23 months of age. Beside, effort to improve  community/people's nutrition especially for women and under five years old children is continually carried out through providing high dosage A vitamin for 11.6 million under five years old children and yodium capsule for 12.1 million people, and iron tablet (Fe) for 5.7 million pregnant women, in the effort to overcome nutrition anemia. Effort to improve the students has been implemented through providing extra food for 8.1 million student of PMT-AS and 52,482 student of SD/MI. Meanwhile, the improvement of the community's role is from integrated post (posyandu) revitalization so as to support the activities of providing extra food for pregnant women, pre-delivery women, baby and children under one year old.

The Ministry of Health does not establish special medical services efforts in coping with disasters. It only intensifies the utilization of the already available facilities and infrastructure. Should there happen a disaster, medical personnel can make use of the medical supply available at Puskemas, pharmaceutical warehouses and hospitals. If it is felt that there are shortages of medical supply, they can ask the nearest Kimia Farma Pharmacy to loan them the supply while the medical assistance is provided free of charge. In this case, an integrated coordination is established with the National Coordinating Agency for Disaster Relief (Bakornas PB), Ministry of Social Welfare, regional governments, medical units of the Armed Forces, police force and National SAR (Search and Rescue) Agency.

In the framework of decentralization, hospitals that are directly managed by the Ministry of Health will be handed over to provincial governments. Thus, the provincial government has the authority to appoint the members of management board of the hospital and independently manage the financial matters. This policy is expected to reduce subsidy given bv the central Government.


The social welfare development is part of the general welfare, and makes up an endeavor of national movement. It is aimed at creating social welfare by and for the whole people of Indonesia in the frame of creating social justice, which is mentioned in the Preamble as well as in Articles 33 and 34 of the 1945 Constitution. Therefore, every citizen has equal right to obtain social welfare and at the same time each has an obligation to create the social welfare.

The mission of social welfare development is to implement the role in creating a social justice by giving attention to destitute families and the less fortune. In general, it is also to prevent, control and overcome the social problems, including various unexpected social impacts caused by the industrialization process, reform flow, globalization and the rapid information flow.

Furthermore, the other aim is to maintain and to strengthen social stability and social integrity by increasing the spirit of social solidarity and partnership among the community.

The development of social welfare is aimed at placing the basics of social life to create a civil society. Also, it is aimed at empowering destitute families to improve their resilience and capabilities against the critical situation. Besides, it is to revitalize the economic life the community as well as to prevent the spread and worsening of social problems.

The main target of social welfare development is how the destitute families as well as children under five (balita) can be saved and rehabilitated from the collapse situation, which is caused by crisis and disasters.

The further target is to create and to implement the social resilience network effectively and efficiently as well as transparently. Also it is aimed at obtaining support and commitment from all parties. Finally, it creates the Reform Agenda of Development for Social Welfare in general.

Based on People's Consultative Assembly Decree No X of 1998, there are two aspects of policy and strategy of social welfare development: the sector aspect (Kessos) and cross-sector aspect as well as the community role involvement.

The sector aspect is designed to sharpen target priorities and the activities which are relates to social welfare service (safety rescuing, recovery, rehabilitation as well as empowerment toward the clients/PMKS). Also it is to improve the quality and quantity of concern and involvement of sources/PSKS, besides to enhance professionalism and the optimal service of the social workers by measuring the speed, accuracy, transparency, accountability and the community participation involvement.

The cross-sector aspect and the community role involvement are designed to increase coordination, starting from data collecting, planning, implementing and evaluating coordinated in the centers (KOKESRA and TASKIN) and local/provincial level which is focused on bottom-up principle and decentralization as well as efficiency.


The steps of reform on social welfare development consist of three points, which are:

First, it is to reorient the vision and mission of social welfare development from the residual charity approach to universal one, not only in the form of full and total comprehension, recovery and empowerment, but also protection in its role to cope with the social impact of monetary crisis.

Secondly, it is to carry out rescue program and empowerment toward the groups of destitute families such as children, elderly people and poor people families who are directly affected by the crisis through the social resilience networking as well as the victims of social riots.

Thirdly, it is to grow and to enhance the spirit of social solidarity among the communities who work together with the government level to care about and take role in overcoming the crisis impact. Then, they make coordination with related government agencies so that the impact of crisis can be handled by more integratedly and directly.

Outstanding achievements have been noted in the field of protection towards children and youths; empowerment of communities; attention to the elderly people welfare; overcoming of disaster; making efficient use of foreign aids; encouraging the soul and the spirit of KSN (National Social Solidarity); improving ofPKS (Social Welfare Development) management; and development central.

In the effort of protecting the children and youths from the critical situation to be capable in implementing their social functions, in 1998/1999 assistance has been provided to 128,870 neglected children who live in private or government orphanages, as well as handling 26,000 of street children in 12 cities. These are not only implemented by local government, but also by non-governmental organizations (LSM) and many religious organizations (Pondok Pesantren).

Meanwhile, development effort has been implemented to improve the quality of social service for caring children and their environment To support these programs (Law No. of 1979 on Children's Welfare), there is currently issued a Government Regulation on Children Protection.

In implementing community empowerment, it is directed to those with less income, such as the socially underdeveloped tribes, the very poor families, the victims of natural disasters as well as marginal community groups who are affected by the monetary crisis. In 1998/1999, development efforts have been provided to cover 5,131 families of the socially underdeveloped tribes in 18 provinces, to 114,924 very poor families , as well as to 16,450 destitute families in 25 provinces.

In 1998/99 social assistance was extended in the form of social guidance, vocational guidance and provision of work capital to 124,924 very poor families over 2,891 villages. The amount of work capital is according to their skill. Efforts for empowerment of the very poor family is carried out by way of group approach that has succeeded to increase social relation among members, to encourage mutual cooperation and solidarity in facing crisis. The increase in cooperation, and access to the various social service resource, guidance for members to benefit from the production economic yield to meet the basic need of the family members, as well as together solving the problem of a member, are among the activities of a "Kube" group. This activity is an effort to prevent the rise of social problems such as neglected children (sheet children), the elderly people, and the handicapped.

In line with Law No. 13 of 1998 on the elderly welfare, programs have been improved in order to create the social welfare toward the elderly people. Further agreement is still processed into a Government Regulation. During one year of The Development Reform Cabinet, services have been given directly to 35,296 elderly people, covering the institutional services and family services as well as facilities in transportation. Besides, upgrading efforts have been implemented to encourage the role of community in developing social welfare of the elderly people.

Assistance is also given to disaster victims, including improving the alert system toward people living in regions that are continuously threatened by natural disasters by giving social assistance and empowerment efforts in providing food such as rice, a variety of side dishes as well as construction materials.

In 1998/1999 rice has been distributed in the amount of 11,490.7 tons, providing a variety of side dishes food to 508,702 people, as well as construction materials to 12,684 families. In addition, in supporting of disaster handling, there have been, provided 27 units of kitchen cars spread over 27 province.

The sources of aid are contributed either from the State Budget (APBN) and foreign funding institutions such as WFP as well as private local companies. Assistance is also given to the victims of social riots over some provinces, such as social aid and empowerment. In the frame of social welfare development, effort has been implemented to seek the sources of foreign aids, such as loans and grants, in order to overcome the limitation of local budget expenditures. These assistance are designed to develop and rehabilitate the social institutions in the form of physical facilities as well as operational instruments.

In 1998/1999, the assistance has been given through SPL. IX and X 36 social rehabilitation institutions for the handicapped and 217 Loka Bina Karya (LBK) for handling post rehabilitation outside institutions. In the same year, vocational training of Pusat Rehabilitasi Bina Daksa (PRVBD) has been officially operated. This is funded by a grant from the Japan International Cooperation Agency (JICA). Assistance has been also received from several international institutions or non-governmental institutions, such as WFP, CCF, WVI, ADRA and CWS. Besides, rice assistance has been received during three to six months to 1,319,940 people in 10 provinces in the frame of empowerment program.

The enhancement of the soul and spirit of the National Social Solidarity (KSN) has been implemented, involving all the communities and the business world toward the social concern of to the communities who affected by crisis. For examples, the participation of APKINDO, SINAR MAS GROUP, JAYANTI GROUP and many others, has proved that the big support comes from the communities to handle the social welfare problems. For instance, SINARMAS GROUP provided assistance in the form of counseling and guidance, seed assistance, production facilities and capital stock; furthermore, JAYANTI GROUP gave financial assistance to handle social problems in three provinces, namely Irian Jaya, Nusa Tenggara Timur and Nusa Tenggara Barat.

In the same way, many movements of KSN have been implemented, such as cheap Food Cafe (Warung Nasi lklas), movement to replace parcels with Donation Pack (Gerakan Mengganti Parsel dengan Paket Peduli), as well as sharing for gathering (Berbagai Rasa Untuk Sesama). These programs reflected the concern of high class people towards the lower class who suffer from social welfare problems.

The establishment of the Warung Nasi lklas program will give a benefit such as security belt between the rich and the poor. In the same way, the model of GAPPAI distributes community support in the form of giving parcels to college and integrated institutions. Meanwhile, the model of Berbagi Rasa Untuk Sesama arranges the meeting through the particular events between two classes.

In the field of arrangement and management stabilization, social welfare development (PKS) covers data stabilization of social welfare; promoting efficiency of human resources; and national legislation program.

In data stabilization of social welfare, cooperation has been worked out with BPS (Central Bureau of Statistics), LIPI (Indonesian Council of Sciences) and BPPT (The Agency for the Study and Assessment of Technology) to stabilize data collection system. As a result, data of PMKS can be obtained, such as children under five (balita), neglected children, elderly people, the handicapped as well as the homeless. The process of data collecting is connected with Survey of the National Social Economy (SUSENAS) implementation.

To improve the human resources empowerment, job transfers have been carried out among the officials in the I, II and III echelons in the central as well as in the local level. This is intended to promote organization performance of social welfare development.

Apart from this, the structuring and developing of Higher Learning Institute of Social Welfare in Bandung as education institution service in the field of social welfare development, has been implemented.

In the range of national legislation program in 1998/1999, some products of law have been resulted, such as Law No. 13/1998 on the elderly people welfare, and three other products which are related with the implementation of Law No. 48/1998 on improvement of social effort for the handicapped, various presidential decrees, minister of social affairs' decree and related ministers' decrees.

Finally, in the frame of controlling development, verification has been implemented to 118 objects. In that case, there are 1,194 findings, which successfully save the state wealth at the amount of Rp.240,049,988.30. From those findings, 368 cases have been completed with the value of Rp.37,091,654.10 and the rest is 826 findings with the value of Rp-202,958,334.20.

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