Apart from the general health situation, there is an urgent need for a reform in the health infrastructure. In the first place, new hospitals have to be built. According to the Indonesian Ministry of Health, there were just 2,269 hospitals in 2018. On average, that means that a clinic has to supply for almost 100,000 inhabitants. The number of hospital beds was also disproportionately low amounting to 281,082.
Indonesia's healthcare is currently based mainly on the so-called Puskesmas (Pusat kesehatan masyarakat: Public healthcare center). These are contact points where trained nurses provide the most necessary services, such as vaccinations, providing pregnant women with vitamin supplements or bandaging wounds. Doctors are only present at certain times. In 2018, there were 9,993 such facilities. They are particularly found in poorer and more remote regions and provinces where there are no hospitals available.
In order to reduce the huge pent-up demand at least a little, the Indonesian government introduced a general health insurance in early 2015. In 2018, the general health insurance with the Kartu Indonesia Sehat (Health card) only covered approximately 92.4 million people. Additionally, the new health insurance system only provides a basic coverage, especially since the contribution rates are only a few euros per month. Unfortunately, anyone suffering from malaria, dengue or even tuberculosis can therefore not expect an optimal state-of-the-art treatment, although the increased number of dengue cases in the recent years proves the necessity of a proper health system. Nevertheless, a general health insurance is only valuable if there are enough clinics and doctors available. In 2018, there were about 134,459 general practitioners working in Indonesia, far too few considering the size of the population.
The government is aware of this matter and seeks to improve the situation by promoting insurance, investing in the health infrastructure and opening the market to foreign doctors. However, it can be doubted that the situation is able to improve greatly in the near future.