Challenges and Overlooked Aspects in Indonesia’s Free Health Screening

Supporting universal healthcare coverage is essential to enhance quality of life. However, many still struggle to access basic healthcare services like health check-ups, especially those in remote areas and low-income groups. To address this issue, the Indonesian government has introduced a free health screening program for all citizens on their birthdays starting in 2025. While this is a positive step forward, there are several challenges and overlooked aspects in the program’s design that need to be addressed.

Free Health Screening as a Birthday Gift

The free health screening program is a separate program from the health screening program of the National Health Insurance of Indonesia, which focuses on examining 14 types of diseases, including diabetes, hypertension, stroke, heart disease, cervical cancer, breast cancer, tuberculosis (TB), and anemia.

The free birthday health screening program focuses on early detection of various diseases based on age groups, aiming to minimize the risk of death and disability. The age groups are: toddler screening, adolescent screening (under 18), adult screening, and elderly screening.

Toddler screening focuses on early detection of congenital diseases, such as congenital hypothyroidism, which can be treated if identified early. Adolescent screening checks for common health issues such as obesity, diabetes, and dental health problems. For adult screening, the focus is on early detection of cancer, including breast and cervical cancer, which are the leading causes of death among women in Indonesia, as well as prostate cancer in men. Furthermore, elderly screening includes checks for Alzheimer’s, osteoporosis, and general health issues related to aging.

The birthday health screening will be held at community health centers and schools according to the relevant age category. To support data collection, the Indonesian Ministry of Health is collaborating with the Indonesian Directorate General of Population and Civil Registration. Citizens celebrating their birthdays can access this service at the nearest community health centers by bringing their ID card.

“The screening program is a birthday gift from the state to the people, conducted every birthday to ensure that health problems can be monitored early,” said Minister of Health Budi Gunadi Sadikin.

The Urgency of Raising Awareness

The free health screening program is good news for Indonesia’s healthcare system and aligns with the Sustainable Development Goals. However, ensuring the program’s effectiveness is crucial, especially considering the low public awareness of the importance of health check-ups. According to the 2022 Health Statistics data, only 17.44% of Indonesians undergo regular health check-ups.

Another issue that deserves attention is the quality of healthcare services, facilities, and medical equipment that are often inadequate. This is particularly common in primary healthcare facilities such as community health centers and integrated maternal and child health healthcare posts. At the same time, the uneven distribution of healthcare workers, particularly doctors and specialists, remains a serious ongoing issue.

Therefore, raising awareness and understanding about the importance of regular health check-ups, along with efforts to improve the quality and equitable distribution of healthcare services and healthcare workers, is a crucial first step in supporting the effectiveness of this program.

Anticipating Challenges

The Indonesian Medical Association (IDI) has warned about potential issues that may arise from the free health screening program, including the lack of standards for health check-up results. This refers to a case study in Japan, which has implemented a similar program. Based on this case study, this program needs to also anticipate the need for an integrated platform to store and share information, manage data for infants and students in a unified way, and manage health information and education from infancy to working age and the elderly.

To ensure the free health screening program runs effectively and optimally, the Indonesian Medical Association recommends the following:

Guaranteeing the availability of competent medical personnel and adequate equipment at every healthcare facility.
Providing ongoing training for healthcare workers to enhance their skills in early disease detection.
Ensuring the availability of necessary medications.
Expanding the program’s coverage to remote areas and marginalized communities.
Adding more types of screenings tailored to the needs of the community.
Improving coordination between the central and local governments in the program’s implementation.
Conducting regular evaluations to assess the program’s effectiveness and make improvements if necessary.
Collecting relevant data and information to support decision-making.
Maximizing the function and benefits of the mobile-based health app from the Ministry of Health as a platform for managing integrated lifetime health check-up data to monitor maintenance and health promotion efforts.
Educating the public on how to use personal health records, which contain individual health information.

Mental Health: Crucial Yet Overlooked

Creating a healthy, prosperous society requires a comprehensive, coherent, and inclusive approach. This free health screening program must be accompanied by other interventions, from shifting to better dietary habits to supporting policies to improve public health. These efforts should include, but not be limited to, promoting increased physical activity, health education, and better access to quality healthcare services. Health check-ups within this program must also consider and adjust to the specific needs of vulnerable groups, especially individuals with diverse disabilities, to ensure that the program is truly fair and inclusive.

All in all, health is not just about physical wellbeing but also involves mental or psychological health. In many cases, mental health significantly affects and even determines a person’s physical health condition. Unfortunately, despite being proven to affect people from all walks of life, including children and the elderly, mental health issues are still overlooked in the design of the free health screening program for birthdays. Therefore, the Indonesian government needs to recognize this and incorporate mental health into the agenda of the upcoming program in 2025.

Translator: Dinda Rahmania

Editor: Kresentia Madina & Nazalea Kusuma

The original version of this article is published in Indonesian at Green Network Asia – Indonesia.

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