Health Finance and Governance Project (HFG) Final Report: Strengthening Indonesia’s Capacity to Accelerate Progress Toward Universal Health Coverage

Led by Abt Associates, the project team worked with partner countries to increase their domestic resources for health, manage those resources more effectively, and make wise purchasing decisions. The project collaborated with health stakeholders to protect families from catastrophic healthcare costs, expand access to priority services, and ensure equitable population coverage. Key activities included improving financing by mobilizing domestic resources, reducing financial barriers, expanding health insurance, and implementing provider payment systems. The project also enhanced governance for better health system management and greater accountability and transparency. Additionally, it improved management and operations systems to advance the delivery and effectiveness of healthcare, and advanced techniques to measure progress in health systems performance. The HFG project focused on three priority areas: strategic health purchasing, JKN implementation research, and Health Accounts. In each of these areas, the project built the government's capacity to implement its JKN reform agenda and strengthen financing and planning for health. Evidence from the project's activities informed the Presidential Decree on JKN, a measure set for release in 2018 that will usher in strategic health purchasing reforms to improve the efficiency, effectiveness, and quality of JKN services. The project's work in strategic health purchasing aimed to strengthen government capacity and consensus to implement reforms. This involved establishing a GOI-led process for making feasible, step-by-step improvements in strategic health purchasing and provider payment mechanisms. The project also built GOI capacity for strategic health purchasing and built GOI consensus on potential reforms through trainings, working group deliberations, and study tours to other countries. The project's activities in Indonesia were part of a larger effort to accelerate the country's progress toward universal health coverage (UHC). The project's work in Health Accounts with the University of Indonesia improved the Ministry of Health's capacity to analyze and interpret Health Accounts findings to make informed recommendations on health financing to government counterparts. The project's efforts in implementation research with the Center for Health Policy and Management at the University of Gadjah Mada built local expertise on implementation research that the Ministry of Health can enlist to rapidly identify issues affecting the rollout of policy reforms. The project's work in Indonesia has contributed to strengthened government stewardship, particularly financial stewardship of the health system, and provided evidence to improve the implementation of JKN and other major health reforms. The project's activities have informed the Presidential Decree on JKN and have helped to build the government's capacity to implement its JKN reform agenda and strengthen financing and planning for health.