World Health Day, observed every April 7, serves as a global moment to reassess the direction of health development across countries. The commemoration also invites collective reflection on how far health systems can respond to increasingly complex challenges, ranging from the rise of non-communicable diseases (NCDs) such as diabetes and cancer to mental health issues and the impacts of climate change. On the other hand, unequal access to health services and limited funding in several countries, including Indonesia, remain important concerns in efforts to realize a more equitable health system.
In reflecting on World Health Day, Professor Fatwa Sari Tetra Dewi from the Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada (FK-KMK UGM), emphasized the importance of building a health system that is not only responsive but also capable of controlling various types of diseases in line with current health challenges. In addition, the system must be community-oriented, designed based on real community needs, and supported by public participation. She noted that strengthening the health system cannot rely on a single sector alone.
“The health system needs to be integrated with strong multisector collaboration, because health problems are not solely the responsibility of the health sector but also involve other sectors such as the economy and industry,” she said in an interview on Thursday (Apr. 9).
On the other hand, the health system must also be grounded in scientific evidence, including academic data and digital technology. Although Indonesia’s health system is considered quite responsive to global challenges, its resilience remains uneven across sectors and disease types. She also highlighted the high burden of health financing, particularly for NCD treatment, which continues to strain the National Health Insurance (JKN) scheme.
“Even though the national health insurance, or JKN, covers nearly 80 percent of the population, which is relatively high according to WHO, many people still have to pay out of pocket,” Professor Dewi explained.
Currently, Indonesia’s health system is shifting from a curative approach toward strengthening preventive measures. However, the data still show that most JKN expenditures are absorbed by NCD treatment. This situation underscores the importance of reinforcing preventive efforts to reduce future health and financial burdens.
“Budget limitations remain a challenge, making it difficult for the government to optimally balance curative needs and the strengthening of preventive programs,” she said.
According to Professor Dewi, many health issues are interconnected. Physical and mental health conditions are closely linked, while climate change also contributes to increasing disease risks, including NCDs. Therefore, health policy approaches cannot be implemented in part but must consider the interconnections among issues comprehensively.
She further emphasized that efforts to control climate change must begin early as a long-term investment. Without adequate intervention, the impacts of climate change are expected to worsen public health conditions and the country’s economic burden in the future.
“Climate change must be addressed now because its impacts will be felt in the long term. If not controlled, health problems and climate change will further worsen the country’s financial condition,” she said.
Professor Dewi also pointed to persistent disparities in access to health services as a major challenge in Indonesia, including the uneven distribution of health workers. Data show that only about half of community health centers (puskesmas) have a full complement of health personnel, with most medical workers concentrated in large cities. This condition makes it difficult for people in certain areas to access quality health services.
“This ultimately results in uneven health burdens, with higher burdens in areas where access to proper health services is limited,” she explained.
In the coming years, efforts need to focus on strengthening preventive and promotive measures. She reaffirmed that prevention must become the primary strategy without neglecting the importance of curative services. Early detection through health screening and raising public awareness are essential. However, low public participation remains a challenge, particularly due to the fear of knowing one’s health condition early.
“This condition shows the need for a shift in public mindset to become more proactive in maintaining health and undergoing routine checkups,” she said.
The professor stressed that promotive efforts through encouraging healthy lifestyles must be strengthened, including controlling risk factors such as smoking habits, unhealthy diets, and lack of physical activity that trigger NCDs. She emphasized the need for supportive policies accompanied by cross-sector synergy to ensure these efforts are effective.
“There needs to be an entity capable of synergizing various sectors so that development is not only oriented toward the economy but also toward welfare, including health,” she concluded.
Author: Cyntia Noviana
Editor: Gusti Grehenson
Post-editor: Rajendra Arya
Photo: Freepik