The 67th World Health Assembly, Geneva, May 2014

Summary

Indonesia’s ageing population and unhealthy lifestyles suggests the health and economic impact of non-communicable diseases (NCDs) will increase. An evaluation of policy options for the WHO package of essential NCDs (PEN) finds that the current option is cost-saving compared to not screening for diseases. However, a different approach could be more cost-effective with minimal loss in health benefit but the willingness of Indonesia decision-makers to make this switch needs to be explicitly identified.

This policy brief summarises a collaborative study that assessed value for money and budget impact of screening and treatment for diabetes and hypertension on primary health care in Indonesia, which aims to assist the government in making resource allocations.

Key findings from the study, documented in the policy brief, include:

  • Screening for diabetes and hypertension in Indonesia is cost-saving compared to no screening, but current coverage is low and needs improvement
  • Community-based selective screening for those aged over 40 (organised by village health care volunteers and known as PEN-PBD) is cost-ineffective compared to the current PEN policy of community-based screening people aged 15 years.
  • Selective screening at primary healthcare facilities (PEN-PKM) is cost-saving with only a small loss in health benefit relative to the current PEN policy
  • The budget amount currently used to cover only 28% of the population under the current policy could be used to increase coverage to 63% of the targeted population without significantly compromising health outcomes if a switch is made to the PEN-PKM.

The study recommends that the current PEN policy should be continued as it is cost-saving and that the primary prevention strategy should be implemented at the same time. It also suggests extending coverage–especially for those who are under-represented, poor and vulnerable.

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