Improving Access to healthcare in Indonesia

Access to innovative treatment is a serious issue for many patients in Indonesia. Low awareness of treatment options, poor understanding on the fundamentals of completing full course of treatment, suboptimal healthcare system, and affordability are among the biggest barriers to appropriate healthcare and achieving nation’s wellbeing. We believe in comprehensive programmes to address these issues and ease the access to healthcare in general.

A. Improving Patient Access to Our Innovative Treatment

Patient Assistance Programme

Affordability is one of greatest access barriers in Indonesia. As a developing country with medium per capita income and huge socioeconomic disparity, Indonesia has been struggling to provide quality healthcare that serves everyone throughout the archipelago. The Universal Healthcare Coverage (UHC) was just launched in 2014 and is still striving to better its service. UHC does not always cover all types of medicine or full cycle of treatment; thus treatment cost becomes a major deterrent for patients in completing treatment. Diseases that causes financial catastrophe, like cancer, not only affect the haves but also the underprivileged. Therefore, there is a critical need to ease the access to our innovative treatment.

What we’re doing

Since 2009, we have been showing commitment to help patients alleviating treatment cost burden by providing patient assistance programme.   

Our impact

To date we have helped more than 9,000 patients nationwide to access 7 products and we will continue to expand access to our medicines through this programme.

B. Engage in Health Policy Discussions

We believe that excellent healthcare system is fundamental for the wellbeing of the society. Therefore we are committed to promote and foster public discussion on accelerating healthcare system improvement in Indonesia. We worked together with the government, non-governmental organisations, universities, as well as patient organisations and the media to bring prevailing and potential issues to the public sphere and make them heard, discussed, and responded.

Despite the effort of the government to improve healthcare, the health budget in Indonesia is well below other countries within the region. Together with other stakeholders, we engaged in series of dialogues on the topic to encourage policy change. Amongst other key initiatives was our partnership with Indonesian Health Economic Association (InaHEA) where we supported policy discussion on healthcare financing during their key congress,  attended by 2,000 participants. Co-organized with Center for Health Economics and Policy Studies (CHEPS) we also initiated a public discussion “When Economics and Health Meet”,

Another key policy discussion where we deeply engaged is the cancer control policy. According to the ASEAN CosT In ONcology (ACTION) study, a study on socio-economic burden of cancer in eight ASEAN member countries, 70% of patients who are diagnosed with cancer will experience financial catastrophe or died one year after diagnosis. Together with our partner, we organized series of policy discussions on the importance of cancer control policy. We also believe on the emerging role of patient organization in the policy discussions. Therefore, we initiated the first health advocacy workshop “Let’s Defeat Cancer Together” attended by 19 patient organizations, organized in partnership with Kusuma Buana Foundation and the Ministry of Health.

C. Disease Awareness Campaigns

Disease awareness is another issue that challenges Indonesia’s healthcare system. Suboptimal knowledge, inaccurate information, cultural taboo, myths, fear, and poverty often deter people from seeing physicians. Patients often come to the healthcare facilities when the disease has worsened or reached late stage, resulting in higher cost of treatment and lower chance of survival. Together with the Ministry of Health, we are committed to help raising public awareness on diseases that are our expertise areas.

Hepatitis B and C: Fight Hepatitis - Know It, Test It, and Beat It

Approximately 240 million people worldwide suffer from chronic liver disease. About 600,000 people die because of Hepatitis B, while approximately 350,000-500,000 of Hepatitis C.1 Both Hepatitis B and Hepatitis C viruses attack liver with no symptoms at early stage and may deteriorate patient's condition into liver cirrhosis or liver cancer at later stage.

What We’re Doing

We continue “Fight Hepatitis: Know It, Test It, and Beat It” campaign to encourage general public to seek for reliable information, high risk populations to get tested and start the referral system, and patients to follow the treatment process.

We are partnering with the Ministry of Health, the Indonesian Red Cross, and Indonesian Association for the Study of the Liver (PPHI) to organise Hepatitis Day commemorations and various campaign activities, including public seminars.

Our Impact

Sixteen public awareness seminars held in Indonesian Red Cross sites were attended by more than 1,500 people in 2015 and 2016. Additionally, hepatitis workshops designed to increase doctor’s counselling expertise for reactive donors were attended by more than 700 doctors.

We developed an integrated website which provides information on both Hepatitis B and Hepatitis C to the public, www.LawanHepatitis.com. Two animation videos on Hepatitis B and Hepatitis C were developed and promoted, and by the facilitation of the ministry, have been broadcasted on the giant screen in Indonesia’s major cities.

Cancer: Let's Defeat Cancer Together

Cancer has become a major health issue in Indonesia. The Ministry of Health estimates that deaths caused by cancer accounts for 13 percent of all deaths in the country. This goes along with the upsurge in non-communicable diseases which now account for almost 60 percent of the total disease burden. According to the national data, cancer prevalence in Indonesia is approximately 1.4 per 1,000 people. Around 70% of cancer patients in Indonesia see physicians at the late stage due to low awareness, cultural taboo, fear, as well as inadequate and inaccurate information on cancer and cancer treatment.

What We’re Doing

We launched a national level public education campaign “Let’s Defeat Cancer Together”. This umbrella campaign includes a series of cancer awareness campaigns on specific cancer, i.e. breast cancer, colorectal cancer, ovarian cancer, and lymphoma.

We worked with the Ministry of Health and the National Cancer Control Committee to develop Indonesia's most comprehensive online resource offering information to patients in local language, www.KalahkanKanker.com, Youtube channel “Kalahkan Kanker”, and a booklet on various types of cancer for community leaders. We also collaborate with 24 partners from various backgrounds, i.e. community organisations, patient organisations, and private sector to expand the outreach.

Under “Let’s Defeat Cancer Together”, we initiated specific cancer awareness programme which includes:

Breast Cancer: Let’s Perform BSE (Breast Self-Examination)

This is an early detection campaign that educates women on how to perform BSE (or called ‘SADARI’ in Indonesian). We aim to expand the adoption of the BSE in partnership with the Ministry of Health and various partners, thus promoting the disease awareness and acceptance in local communities.

Colorectal Cancer: Check Your Bowel Movement, Detect Colorectal Cancer

In Indonesia, colorectal cancer has in the last few decades become the third most common cancer in the country after lung and breast cancers, with a mortality of 18.958 patients (Globocan 2012), mostly thought to be influenced by several risk factors i.e. dietary changes and tobacco smoking. “Check Your Bowel Movement, Detect Colorectal Cancer” campaign is the first ever nationwide campaign in Indonesia targeting colorectal cancer, starting with the very simple step of changing people’s behaviour in the toilets.

Ovarian Cancer: OvaCheck – Getting to Know Ovarian Cancer

The International Agency for Research on Cancer estimates that ovarian cancer has the highest mortality rate of all gynaecological cancers. The symptoms of ovarian cancer are often ambiguous, so the majority of patients are only identified in the later stages of the disease; therefore ovarian cancer is often referred to as “the silent killer”.

We launched “OvaCheck – Getting to Know Ovarian Cancer” campaign that aims to raise awareness of the symptoms of ovarian cancer and encourage women who have key symptoms to see their doctor without delay.

Lymphoma: Care for Lymphoma

Lymphoma has grown in incidence by 80% since the early 1970s worldwide. According to Lymphoma Coalition, 73% of lymphoma patients worldwide are not aware of what lymphoma is when they are diagnosed.  Lack of awareness is due to the vague symptoms of lymphoma which are often overlooked by the patients.

We initiated “Care for Lymphoma” campaign to increase public awareness and encourage people to consult with a physician to receive proper information and treatment. Partnering with patient organizations, community and private sectors, we organized series of public education such as public seminars, education materials, and media relations.

Our Impact

The campaign launch was attended by around 200 participants who represented partners, healthcare professionals associations, community organisations, as well as patient organisations, showing a mutual commitment to the “Let’s Defeat Cancer Together” campaign.

Various education materials were developed, including three animation videos, which has more than 30,000 online viewers and reached more than 100,000 people nationwide. We also produced nearly 90,000 printed materials (booklet, leaflet, poster, sticker), which were distributed nationwide through the partners’ channels, reaching approximately 2 million Indonesians. Meanwhile, our one-stop cancer website garnered over 32,000 views since the launch in December 2015. Our breast cancer awareness animation video, “Brassiere Chitchat”, was produced in three versions and has been viewed by more than 30,000 online viewers. More than 14 patient organisations has been promoting and playing the video during their public events, reaching more than 70,000 people.

In 2016, we worked together with the partners to conduct four provincial-level community leader workshops with nearly 1,000 attendees. The pre-test and post-test evaluations show the community leaders’ knowledge increase. They also experience confidence improvement to share the knowledge they obtained to the community they live in.

Kidney Disease and Transplantation: Healthy Kidney for All

It is estimated that around 103,000 people in Indonesia are diagnosed with chronic kidney disease every year. The disease can be widely deterred if people at higher risk actively drink 8 glasses of water a day, consume types of food that do not contain too much salt, and have regular kidney function examination.

What We’re Doing

Through the campaign “Healthy Kidney for All”, we attempt to increase public awareness on chronic kidney disease and educate people about renal transplant. We work with Indonesian Society of Nephrology (PERNEFRI) to conduct public seminars for general public, patients, and their families.

Our Impact

We produced and disseminated 2,000 booklets and have educated more than 1,500 people through a series of educational seminars which were held in the several cities.

References

1. http://www.who.int/mediacentre/factsheets/fs164/en/

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Tags: Access to healthcare