Indonesian Journal of Health Administration
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REWRITING GLOBAL HEALTH MAPS: INDONESIA’S STRATEGIC REALIGNMENT AND WHO REGIONALISM'S FUTURE
Full text linkThis commentary discusses Indonesia's strategic decision to move from the WHO Southeast Asia region (SEARO) to the Western Pacific region (WPRO), which was formally approved at the 78th World Health Assembly in May 2025. This move shows that Indonesia wants to be more active in determining the direction of its global health cooperation, while also revealing power imbalances and limitations in the WHO regional system. The article also compares Indonesia's experience with other countries, such as Mongolia and Israel, that have made similar moves. It concludes that the WHO's regional system needs to be adjusted to be more equitable and flexible, and give all member states an equal voice.
Keywords: Global health, Indonesia, multilateralism, regionalism, power asymmetry
WHEN DONORS SET THE DIRECTION: LIMITS OF PROJECT-BASED HEALTH INTERVENTIONS IN LMICS – LESSONS FROM INDONESIA
Full text linkHealth development in many low- and middle-income countries (LMICs) tends to be driven by donor-driven pilot projects frequently framed as innovative and scalable solutions. However, these programs typically disappear once external funding ends, resulting in the failure to achieve sustainability and long-term impact. This commentary explores the limitations of project-based development in LMICs, highlighting how shifts in the global aid architecture create complex pressures on recipient countries. Indonesia serves as a case study to illustrate how the proliferation of non-governmental organizations (NGOs) and competition for donor funding have led to fragmented implementation, donor-dependent strategies, and low levels of community ownership.
Keywords: Donor-driven development, health program sovereignty, Indonesia, NGO
DETERMINE THE POLICY TARGET TO INCREASE INSTITUTIONAL DELIVERY AMONG INDONESIAN FEMALE WORKERS
Full text linkIntroduction: Indonesia continues to face a significant challenge in terms of maternal and infant mortality. The government is working to promote the use of health facilities for childbirth to mitigate maternal mortality.
Aim: The study aims to determine the policy target to increase the rate of institutional delivery among female workers in Indonesia.
Methods: The study analyzed secondary data from the 2023 Indonesian Health Survey. It conducted cross-sectional research on 30,173 female workers. In addition to institutional delivery as the dependent variable, we examined eight independent variables: residence, age, education, marital status, wealth, insurance, antenatal care (ANC), and parity. The analysis involved bivariate method followed by binary logistic regression in the last stage.
Results: Approximately 70.6% of female workers had institutional delivery. Female workers in urban areas were 1.157 times more likely than rural workers to perform institutional delivery (95%CI 1.153-1.161). Three worker characteristics (age, education, and marital status) were related to institutional delivery. Wealthier workers had a greater the possibility of executing institutional delivery. Insured workers were more likely than the uninsured ones to deliver in health facilities. Female workers with adequate ANC were 1.210 times more likely than those with inadequate ANC to execute institutional delivery (95%CI 1.166-1.256). Additionally, women with fewer childbirths had a higher probability of performing an institutional delivery.
Conclusion: The policy target to increase institutional delivery was women workers in rural areas who were older, had poor education, were divorced/widowed, were the poorest, had inadequate ANC, were uninsured, and were grand multiparous.
Keywords: institutional delivery, institutional birth, maternal health, female worker, public health
THE IMPLEMENTATION OF PATIENT SAFETY GOALS FOR PATIENTS' SATISFACTION IN THE HEMODIALYSIS UNIT
Full text linkBackground: Surveys on patient safety in dialysis units uncover a range of significant patient safety issues. Hemodialysis centers are particularly vulnerable to adverse events due to a number of risk factors, such as machine malfunctions, excessive blood loss, patient falls, prescription errors, and inadequate infection control procedures.
Aim: Analyze the problem of implementing patient safety goals and describe the patients' satisfaction with the implementation of patient safety goals.
Methods: This study employs a concurrent embedded methodology with a mixed-methods design, utilizing quantitative data to complement the qualitative data. Applying the focus group discussion (FGD) technique, questionnaires and observations of hemodialysis patients' satisfaction with implementing patient safety goals were utilized to complete the data collection.
Results: According to the patient satisfaction survey, two patients were worried that their dialyzer tubes had been mixed up, earning a negative score of 5.13%. 23.07% of patients had negative results on the infection prevention risk questionnaire; 3 patients (7.69%) only seldom cleaned their hands before starting dialysis, and 6 patients (15.38%) did not.
Conclusion: The implementation of patients' identification and the reduction of infection risk through hand hygiene have not been carried out consistently, concerning patient safety goals in the hemodialysis unit.
Keywords: hand hygiene, hemodialysis, patient safety goals, patients' satisfaction, patients' identificatio
EDUCATION'S ROLE IN PRIMARY HEALTHCARE UTILIZATION AMONG OLDER PEOPLE IN INDONESIA
Full text linkIntroduction: The current situation shows that life expectancy is increasing, so the population of older people is also growing. As a vulnerable group, more senior people desperately need primary health care, and barriers to accessing services will increase vulnerability.
Aim: The study aimed to investigate the impact of education on primary healthcare utilization among older people.
Methods: This cross-sectional study examined 52,893 older people. It employed primary healthcare utilization as an outcome variable and education level as an exposure variable. Furthermore, the study used eight control variables: residence type, age group, gender, marital status, wealth, time travel to primary healthcare, and health insurance. We employed binary logistic regression to examine the data.
Results: The study showed that older adults with primary education were 1.050 times more likely than those without to utilize primary healthcare (95% CI 1.046-1.054). Older people with secondary education were 0.643 times less likely to use primary healthcare than those without (95% CI 0.638-0.649). Older adults with secondary education were 0.378 times less likely than those without to use primary healthcare (95% CI 0.372-0.383). Furthermore, the study indicated that all control variables were significantly related to direct healthcare utilization.
Conclusion: The study concluded that education level influences primary healthcare utilization among older people in Indonesia.
Keywords: elderly people, education, primary healthcare, healthcare evaluation, healthcare access, public healt
POLICY IMPLEMENTATION TO ACCELERATE STUNTING REDUCTION: A QUALITATIVE STUDY
Full text linkBackground: The prevalence of stunting in Kepahyang Regency in Bengkulu Province is high (24.9%). Despite the policy of Accelerating Stunting Reduction or Percepatan Penurunan Stunting (PPS) outlined in Presidential Decree Number 72 of 2021, results have been suboptimal.
Aims: This study aims to analyze and evaluate the implementation of PPS policies and identify supporting and inhibiting factors.
Methods: Research using a qualitative approach, focusing on the evaluation of achievements of 11 specific nutrition intervention indicators with policy implementation analysis using the strengthening of Edward III policy analysis. Data collection used in-depth interview guidelines with six stakeholders, focus group discussions (FGD) in two groups, and document observation. Informants are selected by purposive sampling. Data analysis uses content analysis.
Results: The implementation of PPS in Kepahyang Regency faces communication problems, limited resources, complex bureaucratic structures, and inadequate supervision, which shows the need for increased coordination and support. Village government support and good social conditions are supporting factors, while lack of communication between the village government and the community and minimal budget support are the main obstacles.
Conclusion: Communication issues, resource limitations, bureaucratic complexity, and inadequate supervision are the inhibiting factors. Strong support from local government and health workers is the supporting factor.
Keywords: implementation, policy, specific nutrition interventions, stuntin
A SCOPING REVIEW OF MHEALTH TECHNOLOGIES FOR PATIENTS UNDERGOING HAEMODIALYSIS
Full text linkBackground: The prevalence of patients requiring haemodialysis increases annually, highlighting the need for improved quality of care. Haemodialysis care involves several key aspects, including monitoring, education, and patient connectivity. The availability of mobile health (mHealth) technology enhances the effectiveness and efficiency of patient monitoring compared to conventional methods, ultimately improving patients’ quality of life.
Aims: To map the development, types, and impact of mHealth technologies on patients undergoing haemodialysis.
Methods: We conducted a scoping review following the Arksey and O’Malley methodological framework. We searched PubMed, Scopus, ScienceDirect, Google Scholar, CINAHL, and Sage Journals to identify relevant studies describing integrated mobile health applications for monitoring patients with CKD undergoing haemodialysis. Two independent reviewers screened and categorised findings based on predefined synthesis questions. Eleven studies representing various mHealth technologies were included. The PRISMA-ScR guidelines for scoping reviews were followed to ensure comprehensive reporting of results.
Results: Out of 1,200 papers, 11 studies representing mHealth technologies were included. Most respondents were patients, though several articles also involved healthcare providers. We map our findings into three themes: the functionality of the applications, the types and features of mHealth technologies, and their impact.
Conclusion: mHealth can be implemented as web-based or application-based platforms, offering innovative solutions for monitoring, education, and enhanced connectivity between patients and healthcare providers.
Keywords: mHealth, haemodialysis, quality of life, monitoring, CK
