HMN - Indonesia Health Info System 2007

Health Metrics Network
Indonesia Health Information System

Review and Assessment
Co-ordinated by
Centre for Data and Information

Ministry of Health of Indonesia
Contributors
National Family Planning Board
National Statistics Board
Ministry of Internal Affairs
National Family Planning Board
Jakarta, Indonesia, August, 2007
ACKNOWLEDGEMENTS
First of all on behalf of the Ministry of Health of Indonesia, we would like to extend our
gratitude to Health Metrics Network (HMN) Geneva through World Health Organisation
(WHO) Indonesia for their direction and financial support. Without this support, the
assessment could not have been undertaken.
We would also like to thank all the respondents who have participated in the assessment and
contributed their view to further the development of Health Information System in Indonesia.
The same appreciation also goes to members of Technical Team who have been mentioned in
the cover, for giving their valuable time to assist the assessment and finalisation of the report.
Gratitude is also expressed to all stakeholders, for their participation in internal socialisation
and assessment. Without their contribution, the assessment would not be completed.
As we are all aware, reports are far from perfect, therefore, any suggested corrections or
criticism are welcome.
Jakarta, Indonesia, 27 September 2007
Director of Centre for Data and Information,

Ministry of Health of Indonesia
DR. Bambang Hartono, SKM; MPH
Contact authors
DR. Bambang Hartono, SKM;M.Sc (hartonoba@yahoo.com)
DR. Suartini Bambang, MPH;M.Sc (hmn_ina2@dnet.net.id)
Drs. Djoko Tjahjono, MPH (hmn_ina1@dnet.net.id)
Hary Purwanto, SKM; MKes (harypurwanto2001@yahoo.com)
Yudianto, SKM, MSi and his staffs (yudianto@excite.com)
Dr. Doti Indrasanto (hmn_ina1@dnet.net.id)
Prof. Budi Utomo (butomo49@yahoo.co.id)
Iskandar Zulkarnain, SKM; Mkes (iskandarz@depkes.go.id)
Drs. Johan Arief (johan@centrin.net.id)
Email correspondence : hmn_ina2@dnet.net.id
TABLE OF CONTENTS
page
Acknowledgement
Table of contents
ii
List of acronyms
iv
1.
Background of Health Information Systems in Indonesia
2.
Objectives of the HIS assessment
2.1
General objective
2.2
Specific objectives
3.
Methodology
4.
HIS components and standards
5.
Result of HIS Assessment using HMN Tools
5.1
Resources
5.2
Indicators
10
5.3
Data Sources
11
6.
Data management
15
7.
Information products
16
7.1
Health Status Indicators
16
7.2
Health Systems Indicators
16
7.3
Risk factors
17
8.
Dissemination and use of information
18
8.1
Analysis and use of information
18
8.2
Policy and advocacy
19
8.3
Priority and planning
19
8.4
Resources allocation
19
8.5
Implementation/action
19
9.
Summary of the HIS assessment and policy implication
20
10.
Recommendation
23
References
ANNEXES
1.
Organisation of HIS Assessment
2.
Summary of result of HIS Assessment of all Sub-categories
3.
Chart of summary results
4.
Diagram of Ministry of Health Organisation Structure
5.
Net-work co-ordination between CHDI, other MOH units, and Regional level
6.
Diagram of the relation between all stakeholders committed to HIS
7.
Indonesia Essential Indicators
LIST OF ACRONYMS
BKKBN
National Family Planning Coordination Board
BPS
National Bureau of Statistics
CDI
Centre for Data and Information
CHDI
Centre for Health Data and Information
CHIS
Country Health Information Systems
Depdagri
Ministry of Home Affairs
Depkominfo
Ministry of Communication and Information
DRS
Demographic Surveillance System
GIS
Geographic Information System
HIS
Health Information System
HIV/AIDS
Human Immunodeficiency Virus / Acquired Immune Deficiency

Syndrome
HMN
Health Metrics Network
ICT
Information, Communication, and Technology
MDGs
Millennium Development Goals
MOH
Ministry of Health
NGO
Non-Government Organisation
NHIS
National Health Information System
SPM
Minimum Health Services Standard
SRS
Sample Registration System
SWOT
Strength, Weaknesses, Opportunity, and Threat
WHO
World Health Organisation
1.
BACKGROUND OF HEALTH INFORMATION SYSTEMS IN INDONESIA.
In 1985 the Centre for Health Data and Information (CHDI) was established as a new unit
within the Ministry of Health (MOH). One of its responsibilities is the operation of the
Health Information System (HIS) in the country. Prior to the establishment of CHDI, the HIS
had been implemented by program managers within the MOH, although they were for the
purpose of specific programmes and operated in a fragmented and sporadic/ specific fashion.
Currently, the implementation of HIS in Indonesia consists of two parts, routine and nonroutine. The routine HIS consists of health and diseases record (includes diseases
surveillance), specific programmes e.g. Malaria, Tuberculosis, and Tobacco control, health
services record or facility-based information system includes health centre and hospital
records, specific health services. Administrative record is also part of routine HIS. The nonroutine HIS includes related surveys and studies, and assessments.
Although many international donors have been working on the development of HIS with
program management units at MOH, provincial or district health offices, usually they often
developed their own specific HIS. This is however, without any co-ordination with the CDI
or MOH. This has resulted in the National Health Information System (NHIS) becoming
even less integrated.
In the past, through the support of the World Bank, Asian Development Bank, and other
donors, several assessments focusing on specific HIS components had been conducted, and
their results have been used to improve the HIS specific components. These include the
following:
In 1996, an evaluation of the health centre information system was conducted by MOH,
with one of its suggestions being the need to simplify disease included in recording
forms, from the previous list of 150 down to 22 diseases items.
In 2000, with the funding support from the World Bank, the CDI (MOH) had streamlined
the health centre information recording and reporting system by reducing the number of
recording forms, streamlining the data to be recorded and reported, and also the data
coding system. The streamlining system has been piloted in several areas. This has
resulted in more timely and complete reporting of data, however, so far it has yet to be
followed up.
In 2002, using the government budget, the CDI (MOH) has conducted the evaluation of
HIS resources, in which the results were used to justify the HIS personnel capacity
building and the procurement of equipment.
Apart from the above assessment and evaluation, a comprehensive HIS assessment and
strategic plan development has not yet been undertaken.
With the recent funding support from Health Metrics Network (HMN) Geneva through
WHO, the Government of Indonesia with the co-ordinating unit of CDI, MOH, has
conducted a comprehensive HIS assessment. The assessment also has been completed with
internal HIS socialisation and conducted by HIS stakeholders i.e. National Bureau of
Statistics (BPS), Ministry of Home Affairs (Depdagri), and National Family Planning Board
(BKKBN). The activities will be followed up by Development of HIS Strategic HIS Plan.
The HMN HIS Assessment Tool has been applied for the HIS assessment. The tool has been
translated into Bahasa Indonesia and reviewed through technical meetings participated in by
all stakeholders.
Due to several limitations, HIS assessments have been delayed until March to April 2007.
HIS assessment report therefore, could not be submitted on time. One of the limitations for
example, data collection schedule could not be decided upon alone by the interviewer, but
should also adjusted to the time availability of targeted respondents.
One of the stakeholders, i.e. the Ministry of Communication and Information (Depkominfo),
was not able to participate in the HIS Assessment. The reason for this, is that the ministry is
newly established and still in a very early stage of development. However, Depkominfo will
take part actively as a team member in the development of the HIS Strategic Plan.
2.
OBJECTIVES OF THE HIS ASSESSMENT
2.1
General Objective
To ascertain a Country Health Information Systems (CHIS) in support of evidencebased decision making.
2.2
Specific objectives
To establish baseline information of currently applied HIS.
To obtain stakeholders awareness and understanding their role in HIS.
To implement the HIS assessment result in building up stakeholder commitment and

participation in HIS strategic planning development
To provide baseline data in mobilising all HIS resources.
To use performance result of HIS in terms of integration, provide quality information

which includes data collection, processing, analysis, and the culture of using
information.
Although framework of HMN is considered as guidelines for the assessment, the questioners
included in the tools are not reflecting the information obtained from interview which should
be included in the report. Therefore, to complete the report, the team has considered to insert
more information from different sources.
3.
METHODOLOGY
Data collection was done over a two month period (March to April 2007) in all stakeholders
i.e. MOH, BPS, Depdagri, and BKKBN. In addition, sub-national assessments were also
conducted in 7 provinces, namely Lampung, Bengkulu, Bali, East and Central Jawa, South
Sulawesi, and East Kalimantan. These provinces were considered as representative of West,
Central, and East Indonesia.
The data collection team comprised of members from CDI, MOH (as leading unit), BPS,
Depdagri, and BKKBN.
The HMN tool in Bahasa Indonesia version was applied and used for data collection, through
interviews conducted with various potential respondents. The key respondents include
programme managers, planning and policy makers, researchers, finance officers, HIS
personnel, and administrative officers. The respondents were also selected by applying
criteria of Group Builders as has been outlined in the tool.
In-depth interviews using snow balling questions were also applied to several respondents
to obtain important qualitative information and empirical data.
Data generated from interviews was inserted into HMN tool and analysed by the Technical
Team. The preliminary of HIS assessment results were then presented in stakeholders
meetings to obtain their review and input for the finalisation of the report.
4.
HIS COMPONENTS AND STANDARDS
The six components and standards as have been outlined in HMN HIS Assessment Tools
were being assessed. These are : Resources; Essential Indicators; Data Sources; Data
Management; Information Products; and Dissemination and use of Information.
The assessment result were classified using the following criteria :
Result classification
Percentage range
Not functional
0 20 %
Not adequate at all
21 40 %
Present but not adequate
41 60 %
Adequate
61 80 %
Highly
81 100 %
Using the aforementioned criteria, the summary of these six component results is illustrated
in the next table.
SUMMARY OF HIS SIX COMPONENTS RESULT

IN INDONESIA
SUMMARY
RESULT
SCORE
Resources
47 %
Indicators
61 %
Data sources
51 %
Not adequate at all
35 %
55 %
Dissemination and use
57 %
OVERALL RESULT
51 %
Data management
The above summary of HIS Assessment results indicates that all components are either
Present but not adequate or Not adequate at all. There are some areas that need to be
developed to obtain more quality information to support evidence-based decision making.
Result of all sub-categories in detail as can be seen in the ANNEX 2 of the report.
5.
RESULT OF HIS ASSESSMENT USING HMN TOOLS
5.1
RESOURCES
5.1.1
Policy and Planning
National policy on HIS, only been established in 2002, with the Minister of Health Decree
No. 511/MenKes/SK/V/2002. This document represents as a legal document concerning
Policy and Strategy on HIS Development. The document also includes all components as
members of HIS Networks. The link among components can be seen in the diagram of HIS
institution. However, the strategic planning and operational guidance as essential parts of the
document, has not been developed yet.
Private health sectors have less participation in the existing HIS. As a result, very little
data/information are generated from these sources.
This year (2007), NHIS online has been introduced as one of operational targets of MOH
new Vision and Mission. However, this initiative is in an early stage of implementation.
The HIS assessment result revealed that although there is legislation on HIS, it is not yet
strongly enforced. HIS strategic planning is still being developed.
Integration of information was inadequate. Overlap in the flow of information, poor analysis,
and duplication of reports, has caused reduced quality of information.
Co-ordination between National Bureau of Statistics and MOH has been in existence,
however, it was being done mostly in an ad hoc basis when issues of immediate intervention
were needed.
It was also noted that there is no regular meeting or assessment to monitor the achievement
of HIS and its sub-systems. At regional level, although instruments to monitor performance
of HIS including Health Systems performance are available, they have not been implemented
on regular basis.
Table below illustrates the summary of policy and planning result.

SUMMARY
Policy and Planning
5.1.2
RESULT
SCORE
48 %
HIS institution, human resources, and financing
5.1.2.1 HIS institution
Diagram of Ministry of Health Organisation Structures with the Centre for Data and
Information as responsible unit to run the HIS, can be seen in the Annex 4
Diagram concerning the relation between all stakeholders committed in HIS, can be seen in
the ANNEX 6
HIS institution in the MOH by health administrative level.
National level
At National level, there is one specific unit responsible for HIS i.e. The Centre for Data and
Information. This unit is under the MOH Secretary General. Please refer to the Diagram of
Ministry of Health in the annex.
The unit has responsibility to develop HIS, information management, bank data development
and management, and monitoring and evaluation of HIS.
Apart from the above unit, every unit in MOH also has its own division dealing with data and
information.
Province level
At Province level, the attachment of HIS unit varies from one province to another. It
depends on the local view of the importance of HIS. For example, some of them attached at
the Planning unit, while others are attached to Health promotion unit. This condition is due to
lack of technical guidance on how the unit should be integrated, therefore, resulting in
varying attachment of HIS unit.
District/ City level

The variation in HIS unit attachment is also found in the District/City level. The
implementation of Decentralisation in 2001, has also affected the information flow or
reporting system from District/City to Province level. The reporting system from
District/City to Province level is considered as voluntary, therefore it is not continuous.
Health services level
Although HIS is implemented at the health centres, there is no specific unit or personnel
responsible for the HIS. In the hospitals, HIS is implemented, but mainly for the purpose of
medical records and billing system.
5.1.2.2 Human Resources

Human resources in HIS have not been of optimal quality. This is due to low appreciation of
the importance of information and therefore, human resources assigned to the unit were also
those of lower quality compared to those in other units. Less fulltime HIS personnel and
rapid turnover rate have also added to the existing problems.
In terms of quantity, there is a lack of the number of HIS personnel and some of them are
also representing as personnel of other health programmes.
5.1.2.3 Financing
Previously, funding for HIS at all health management levels was very limited.
In response to the need for information for evidence-based decision making, HIS budget has
been increased significantly, both at national or regional level.
According to Government budget sources, the increasing HIS budget at national level in
2005, 2006, and 2007 are Rp 16,700,000.00 , Rp 27,800,000.00 , and
Rp 66,172,000.00 respectively.
At regional level, the increasing HIS budget started from 2006 to 2007 i.e. Rp 10 billion to
Rp 12,5 billion.
Numerous agencies such as the World Bank and Asian Development Bank have been
continuing to allocate the budgets for HIS development in the MOH. However, a lack of coordination between them and the CDI, MOH has frequently lead to inefficient use of funds
such as duplication of programmes, activities, and procurements.
The next table presents summary results of HIS institution, human resources, and financing.
SUMMARY
HIS institution, Human

resources, and financing
5.1.3
RESULT
SCORE
41 %
HIS infrastructures
Indonesia is a large country consisting of many islands, in which the capacity of local
government varies from one region to another. This has been a cause of variation in both
quantity and quality of HIS infrastructures, which includes the availability ICT facilities i.e.
computers, telephone/fax, internet etc.
Below is the HIS assessment result categorised by administrative level.
National level
ICT facilities were adequate at the national level, and key managers and HIS personnel have
access to ICT facilities. However, software for certain application and data ware-houses are
still inadequate. Lists of HIS infrastructures at government sectors, are only covered 50 89
% of facilities, although it is annually up-dating. At private sectors it was found to be out of
date and only covered 50 % of facilities.
Regional level
There was variation of ICT facilities available at province and district/city level. In the island
of Jawa for example, ICT facilities are more available compared to islands outside Jawa.
Some districts outside Jawa had only limited ICT facilities. Although telephone lines are
available almost in all districts, some of them have no access to internet services. Budget
allocated for ICT maintenance at province and district/city level was inadequate, which
sometime affected the continuation of reporting.
Health services level
ICT facilities are not equally distributed at all health centres. Some health centres have no
access to ICT facilities or telephone lines.
The condition of ICT facilities at hospitals are better compared to health centres. ICT
facilities are always available, although they are typically only being used for billing and
medical record purposes.
Table below presents summary of HIS assessment result on infrastructures.
SUMMARY RESULT OF HIS INFRASTRUCTURES
SUMMARY
HIS infrastructures
RESULT
Overall summary result of resources are presented in the next table.
SCORE
55 %
SUMMARY RESULT OF RESOURCES
SUMMARY
RESULT
SCORE
Policy and Planning
48 %
HIS institution, Human

resources, and financing
41 %
HIS infrastructures
55 %
OVERALL
47 %
5.2
INDICATORS
Indonesia has two essential indicators for the purpose of monitoring health system
performance. These are :
Healthy Indonesia 2010 indicators, was developed for the purpose of monitoring health
system performance at national level, and;
Minimum Health Service Standard (Standar Pelayanan Minimal = SPM in bahasa

Indonesia), was created for monitoring health system performance at District/City level.
Although the aforementioned indicators are developed for monitoring health systems
performance, the number of indicators are still too numerous.
Healthy Indonesia 2010, for example, consists of 50 indicators, which are grouped into 4
components. These are: health status, healthy behaviour, healthy environment, and access to
quality health services. The multitude of indicators is due to every programme manager
demanding its own specific indicator to be presented in the national indicator.
The SPM, which was developed to monitor health system performance at District/City level,
consists of too many indicators i.e. 47 indicators. Currently, MOH is streamlining the
indicators from 47 to only 18 indicators, although it has not been implemented yet. These
indicators are obligatory for health services at the District/City level.
Implementation of Decentralisation on health starting from 2001, has lead to proliferation of
SPM, with every district/city including their own local specific indicators. However, data
collected from these indicators are not yet included in the current reporting system.
The monitoring of health related Millennium Development Goals (MDGs) indicators is still
in an early stage of development i.e. building co-ordination between health and health related
units as how to monitor and present the MDG indicators efficiently.
The next table is summary result of HIS assessment concerning indicators
SUMMARY RESULT OF INDICATORS
SUMMARY
Indicators
5.3
RESULT
SCORE
Adequate
61 %
DATA SOURCES
Indonesia has different sources of health data/information. They are grouped into two
different categories i.e. Routine and Non-routine sources.
Data from routine sources includes health and diseases record (includes disease surveillance),
specific programmes i.e. Immunisation, Malaria, TB, HIV/AIDS, Tobacco control, health
services records (health centre, hospital, and specific health services), and administrative
record.
Vital statistics also form a routine data source which is compiled by the Ministry of Home
Affairs. However, it is in early stage of development, and therefore data originating from this
source was not available or incomplete.
Non-routine sources include all surveys i.e. population-based surveys, rapid assessment etc.
Although routine data sources are considered to be the main sources of HIS data, they were
of low quality.
Details of assessment result in each category are as follows:

5.3.1
Census
Although assessment result revealed that census only being present but not adequate, it is
being conducted routinely every 10 years with frequent publication. To complement the
result from census, Household Health Survey (SKRT) and Demographic Health Survey
(SDKI) are also being conducted in every 5 years. SDKI, in particular, is being conducted to
capture health related problems and trends.
There is still a large time gap between data collection and publication, which frequently
results in the information becoming obsolete before it can be used.
Population projections by age and sex are available at National and Province level, but not at
district/city level. Disaggregation data are also available on specific request. Results from
population projections, have been used to estimate target coverage of health services and
planning for National and Province level.
5.3.2
Vital statistics
The vital registration system is one of Ministry of Home Affairs responsibilities, under the
Population Administration Directorate General. Results from HIS assessment showed that
vital statistics was not adequate at all.
HIS assessment found that only 11 19 % the cause of mortality was recorded in the
registration form. Verbal autopsy was never been validated. In-depth interview result showed
that Indonesia is being inadequate in terms of data collection, management, and analysis
concerning vital registration or SRS/DSS
ICD X has been implemented in almost all of hospital records, while there is variation of
implementation at the Health Centres.
Result of the assessment has also revealed that vital registration publication was categorised
into sex, age, and geographical area, however these are obtained only from vital registration
sample which was considered as less representative for Indonesia. There has been a 5 years
gap between data collection and publication regarding vital registration sample. The same
situation is found in Population Surveillance system.
Although evaluation regarding the completeness of Vital registration has been done in every
5 years, the result is still incomplete or in doubt.
5.3.3
Population-based surveys
Result of assessment revealed that Population based survey are the only data sources found to
be adequate. Good co-ordination between BPS and MOH also was adequate. It was found
that surveys at national level i.e. SKRT and SDKI have been conducted every 5 years
capturing maternal and child health services coverage, and estimation of infant and underfive mortality rate.
Prevalence of the five major non-communicable diseases also has been estimated. These
include disability, psychiatric, hypertension, diabetic, accident etc. Risk factors were also
estimated, which include smoking, drug use, diet, and physical disability.
Data management and analysis of SDKI was adequate. Moreover, result of assessment
revealed that :
5.3.4
All surveys have implemented international standard for consent, confidentiality,

and access to personal data. Some analysis has eliminated personal identification.
Data collected have been dis-aggregated by sex, age and geographical area and can
be retrieved upon request.
Population-based health indicators survey has also been conducted, although it

could only be generated for 75 % of the population.
Health and diseases record (include diseases surveillance)
Health and diseases records, including diseases surveillance systems were found to be not
adequate at all. Some of the findings revealed that different forms of report were being used
in different units, which resulted in difficulties in matching data.
Health and diseases records are collected in health services point using specific form. Data is
then compiled monthly and quarterly. Although all cases have been recorded in the form,
case definition is available only for Epidemiology important diseases and diseases should be
eradicated/eliminated. Only 25 to 75 % health personnel capacity are able to diagnose
diseases accurately. The laboratory confirmed regarding diagnoses and fluctuation of
diseases is very low i.e. less than 25 %. Percentage of weekly and monthly Epidemiology
reporting are ranging from 25 to 75 %
Surveillance data are being published, however, not on a routine basis and not cover all of
regional level. Decision makers are having difficulty in completing surveillance reports and
other public health programmes.
ICD X tabulation is done mostly by hospitals, whereas at the health centre level it varies.
5.3.5
Health Service Record
It was found that health service records were present but not adequate. Although in Indonesia
there was health service based information system, however data generated were very limited
and did not covered private facilities. There was no systematic approach to monitor and
evaluate the quality of private health services, although survey related to quality of services
had been conducted in the last 5 years.
There were inadequate numbers i.e. 1 to 9 % availability of HIS personnel at district/city

level. Training and technical meetings on HIS were frequently provided at national or
international courses, but were sometimes not participated in by HIS personnel from District/
City level. The assessment result revealed that only 5 to 24 % of health personnel trained in
HIS.
Feedback mechanism on health service report was also inadequate. The same condition was
found in terms of data validation, verification, and consistencies.
Health services achievement coverage was estimated through population projection. This had
been undertaken in 50 to 89% districts/cities.
5.3.6
Administrative record
The result of HIS assessment showed that administrative record is being present but not
adequate.
Apart from HIS routine data collection, administrative records are complimentary data
sources. These can be presented as follows :
5.3.6.1 Mapping of infrastructures and health services

Indonesia has been mapping infrastructures and health services, but it is still in the
development phase to obtain 90 % of mapping. Mapping the location of infrastructures and
health services is present but not adequate. The National database has only been updated in
the previous 3 years.
However, there is an effort of health managers at national and regional level to use this
information to evaluate physical access of population to health services and to the
distribution of population, and equitable of services according to acceptable standard.
5.3.6.2 Human Resources Information Systems

Human resources information system exists in the MOH, although it is not frequently
updated. The system was previously designed for health personnel data by profession as
compare to population served for the purpose of equal distribution of health personnel The
system is available at the Bureau of Personnel, MOH. Since the system is newly established,
currently it is only used for rewarding purposes i.e. increasing rank and pension and only
available in the last 3 years.
Further, data from training institution were available, but it has not been integrated into the
human resources information systems or HIS. It is not possible to obtain this data in the
MOH database. Result of HIS assessment indicated that human resources information system
was being present but not adequate. Data concerning human resources was available only in
the last 3 years.
5.3.6.3 Financial Data Sources

Health Services financing data concerning budget allocation is available and recorded at the
Planning and Financing Bureau at the MOH. Budget information from all sources and detail
budget allocation are available at this unit, however, expenditures are only being recorded at
the unit concerned. Data dis-aggregated by national and sub-national level is also available
on demand.
Although capacity of personnel in National Health Accounts (NHA) is adequate, they are
however only contracted on a part time basis and for short-term assignments.
5.3.6.4 Equipment and supplies

Data on inventory and equipment status are available. There is an obligation that every health
facility has to submit the report once a year. Yearly report on logistics and equipment i.e.
drug, vaccine, contraception, and other logistics, is generated from quarterly report.
Human resources are present but not adequate to undertake reporting of logistics and health
supplies/equipment. Reports are prepared at least once a year, reporting from different
sources of logistics is not integrated.
The next table is summary result of data sources obtained from HIS assessment.
SUMMARY RESULT OF DATA SOURCES
SUMMARY
RESULT
SCORE
Census
53%
Vital statistics
Not adequate at all
37%
Population-based survey
Adequate
71%
Health and diseases record (include

diseases surveillance)
Health services record
Not adequate at all
40%
53%
Administrative record
51%
OVERALL
51 %
6.
DATA MANAGEMENT
Overall data management practice in the country were found to be not adequate at all.
Detail result of HIS assessment on data management are :
Written procedures for data management i.e. Reporting and Recording system
applied to health centres and hospitals were available, however these were being
implemented partially.
Fragmented data have been found in every health programme, although efforts to
integrate them has been initiated.
Integrated data warehouse to accommodate data from all sources is not available at
national level, both facility-based and population-based.
There is a data dictionary at national level especially provided for Population based
surveys. However, this dictionary is not available at regional level. Further, user
friendly reporting system that can be assessed at any level is also not available
Identification codes are available within similar data based and health facility,
although merging data is still difficult.
Table below illustrates the summary result of data management.

SUMMARY RESULT OF DATA MANAGEMENT
7.
SUMMARY
RESULT
SCORE
Data management
Not Adequate at all
35 %
INFORMATION PRODUCT
Result of HIS assessment revealed that all information products were being present but not
adequate.
Data collection method i.e. timeliness, periodicity, consistency, representative, dis-aggregate,
and estimation method/transparency were all present but not adequate
Details of the assessment result are explained below :
7.1
Health Status Indicators
Health status indicators in Indonesia are collected through surveys such as Household Health
Survey (SKRT) and Demographic and Health Survey (SDKI). Both surveys are conducting
by the BPS in co-ordination with MOH. Quality of these indicators showed that they are
being present but not adequate.
a.
Mortality
Result of assessment showed that mortality indicator was present but not adequate. Indirect
method of data collection was done through SKRT and SDKI. Timeliness of data collection
was adequate, and being collected once in every 5 years. All data have been dis-aggregated
by demographic characteristics (age and sex), socio-economic status (work, privilege, and
parental educational background), or geographical area (urban versus rural).
Questionnaires to capture mortality data have been introduced by asking whether a family
member has died recently or questionnaires which reflect an indirect estimation of child and
adult mortality.
b.
Morbidity
Morbidity data was also present but not adequate. Although data collection was adequate, it
is only done at 5 to 10 years intervals, thus rendering much of it out of date.
Estimation has been dis-aggregated by demographic characteristics, socio-economic status,
and area distribution.
7.2
Health Systems Indicators
The quality of health system indicators was also present but not adequate. Methods to collect
data on health systems indicators were adequate, i.e. through routinely HIS. Health systems
indicators covered human resources, drug supplies, and burden of diseases.
Finance indicators, which are part of the health systems indicators, are covered in NHA. Data
validation is conducted twice a year in technical meetings participated by national, province,
and district/city health management level. The objectives of technical meeting is to obtain
verification, completeness, and consistency of current data available to be presented in health
profile.
7.3
Risk Factors
Result of risk factors was present but not adequate. Only a few assessments covering small
areas have been conducted by MOH and universities. These are assessments of total number
of poor families, housing characteristics, access to health facilities, nutrition problem, and
HIV/AIDS
Assessments on housing characteristics, access to health facilities were collected through
SKRT and SDKI using sampling area. Smoking characteristics as important risk factors is
only collected through SKRT which also use estimate questionnaires. Information on other
risk factors such as drug abuse, contraceptive use among the sex workers, and alcohol
consumption have not been collected.
The next table illustrates the result of HIS assessment on information product.
SUMMARY RESULT OF INFORMATION PRODUCTS
SUMMARY
RESULT
SCORE
54 %
Health status ;
Mortality
52 %
Morbidity
55 %
Health Systems
60 %
Risk factors
51 %
OVERALL
55 %
8.
DISSEMINATION AND USE OF INFORMATION
Summary result of HIS assessment on dissemination and use of information were present but
not adequate.
Details of the assessment result are as follows :
8.1
Analysis and use of information
Analysis and use of information was found to be adequate. Currently, the demand on good
quality and timely information is strong and evidence-based decision making is high.
Result of HIS analysis is presented in the form of graphs and narrative at province and
district/city level. At national level there is more effort to display information in the form of
Geographical Information Systems (GIS) version.
HIS is use at the point of health services for immediate intervention. Results from subnational assessment showed that HIS information was rarely used to support decision making
at province and district/city level, due to quality information not being available.
HIS information at all levels are available as public domain and displayed on the website for
public accessed.
8.2
Policy and advocacy
Result of assessment on policy and advocacy was present but not adequate. There was some
advocacy in the use of information, but it was very limited. HIS summary reports, census,
and surveys are analysed and reports have also been produced and disseminated, however it
was not used for policy formulation.
Infant and under-five mortality, for example, are only available on estimation basis, which
has been considered less accurate. These data are among those data demanded by policy
makers.
8.3
Priority and planning were present but not adequate, and the overall score was 55 %,
however, information on diseases burden, risk factors, health systems, and health status was
less frequently used to in planning development. Only 40 to 80 % risk indicators data are
used to define short, medium, and long-term targets at national level.
8.4
Overall result of resources allocation was present but not adequate. HIS information is being
used for national resources allocation. Allocation of medical professional, for example, is
done using ratio i.e. the availability of medical professional over population served. These
data is available in HIS.
Budget allocation, however, was made using data from other sources other than HIS i.e.
Finance Bureau, MOH. The same condition also was found at province and district/city level.
CDI in co-ordination with Directorate of Pharmaceutical Services, MOH, provide
information for allocation of drug/supplies and health equipment to the district/city level.
In the last 5 years, HIS information has been used for yearly budget and resources allocation.
To some extent, HIS information was used for national resources allocation and equal
distribution of drug and health equipment.
8.5
Overall, the use of information for implementation/action was present but not adequate. This
reflects that the use of information by health care providers for implementation/action is
inadequate. The use of health risk factors to target the vulnerable group of population was
also inadequate.
Summary result of dissemination and use of information is illustrated in the table below.
SUMMARY RESULT OF DISSEMINATION AND USE OF INFORMATION
9.
SUMMARY
RESULT
SCORE
Analysis and use of

information
Adequate
67 %
Policy and advocacy
56 %
55 %
47 %
52 %
OVERALL
Summary of the HIS assessment and policy implications
Summary of HIS assessment had been conducted through several technical meetings which
included all HIS stakeholders to enable the technical team obtaining more review and
feedback. The result of the assessment was presented to obtain immediate feedback. Further,
stakeholders were asked to provide feedback on result analysis.
The Strength, Weaknesses, Opportunity, and Threat (SWOT) analysis of assessment result is
described below :
Strengths
Health infrastructures are adequate at national and regional level. Health infrastructures
and human resources are available down through to sub-district and village level.
HIS has been developed although for specific purposes. There is a specific functional unit
at national level i.e. CHDI, MOH that co-ordinates HIS activities. There are also
functional units available at province, district/city, and health services level, although
their capacity needs to be developed more.
HIS has been previously developed by many units within the MOH, although only for
specific purposes. Therefore, decision makers are already aware of the use of information
to support their decisions.
There is a relatively good usage (although not optimal) of HIS for the purpose of
planning, finance and resources allocation at all health management levels.
Good usage of HIS was also found for the purpose of Development of Health Profile,
Integrated surveillance system, Nutrition Early Warning system, Report on the use of
drug and narcotics, prevention of certain diseases, and unusual health events.
There is ICT infrastructure available at all district/city level, although it is being less
adequate at the health centre level. Education facilities in ICT are also adequate.
Moreover, details of strengths include :
There has been a high demand for HIS to support evidence-based decision by health
managers, policy makers, donors, and NGOs.
A well defined document on development and strategy of NHIS and regional HIS is
in place.
A national health indicators namely Healthy Indonesia 2010 indicators exist, as well
as a Minimum Standard of Health Services Indicators (SPM) applied at district/city
level.
There are functional HIS units at all health management levels to conduct HIS
activities.
There is a well defined of system standardisation, networking, and other ICT

facilities, which enable easier management of data.
Weaknesses
Fragmentation of HIS was found within MOH units.
A well defined strategic plan on HIS is not available
Lack of well trained HIS personnel particularly at province, district/city, and health
services level.
Although at national level well trained HIS personnel are adequate, turnover rate is high,
due to information units being unpromising in terms of career opportunities compared to
other units.
Data warehouses at national level are not yet well developed and are not available at
district/city level.
Although ICT equipment are available down to district/city level, maintenance budget is
very limited.
Poor coverage and use of information from vital registration system
Very limited use of health information by the community.
Other weaknesses include :
Changing government policy from centralise to decentralise has affected flow of

information.
Code standardisation is not yet well developed and this has caused the difficulty in
integrating HIS.
Sharing of information between health and health related sectors is very limited.
Development of HIS is often hindered by difference views of HIS by different levels of

management.
Opportunities
Evidence-based decision making is in high demand, either by executive or legislative

sectors.
HIS is always being evaluated to improve HIS performance and to allow integration of
information among different health programmes, as well as management systems.
Policy on centralisation of networking in CHDI, MOH, has increased the role of CHDI
significantly.
Web-site are available and can be accessed at province and some district/city level.
Capacity building of HIS personnel in the field of Epidemiology, Statistics, and Health
Information Systems through degree and short term programmes.
Inclusion of functional HIS personnel is considered at the moment. They will receive
compensation in addition to their existing remuneration as functional statisticians or
computer programmer.
Improvement of ICT equipment and its maintenance at national and district/city level
Vital registration is in high demand from decision makers. Pilots in certain areas have
been undertaken.
Government budget allocated for HIS and donors fund contributions are increasing.
Threats
ICT facilities can be damaged by computer virus or hacker attacks, which can erase
information in databank.
The frequent changes in government policy has affected HIS policy and implementation.
Data collection systems at regional level are frequently uncoordinated, therefore

integration is difficult.
Turnover rate of HIS personnel is high. .
Certain donor driven health programmes have their specific information needs and
develop their own HIS.
10.
RECOMMENDATIONS
Recommendations that could improve performance of HIS in Indonesia are presented below :
Stakeholders support is important in development and implementation of comprehensive

strategic plan.
HIS master plan has to be developed immediately, which includes HIS plan of action.
The importance of vital registration system has to be advocated at different levels of

decision making.
Assessment of vital registration implementation should be conducted as base line data to

improve the systems.
Vital registration should be implemented and enforced at province and district/city level.
Training modules in HIS related subjects for HIS personnel and decision makers should
be developed.
On the job training for HIS personnel should be conducted regularly to update their skills
and knowledge in information systems.
Web-site information and data warehouse should be developed.
Feedback mechanism should be strengthened to improve HIS performance.
Electronic reporting system should be introduced to speed the flow of information.
Adequate ICT facilities and maintenance as well as supplies, should be to improve data
management which is currently in poor condition.
Dissemination and publication of HIS information using ICT should be improved.
Opportunities for donor co-ordination

Areas which need more funding include :
Development of HIS Strategic Plan, which involve all HIS stakeholders.
Capacity building either on the job training (short term) or long term study.
Development of training curricula and modules.
Increase opportunity of HIS personnel to attend national or international workshops as a

medium of sharing information and experience.
Critical next steps
Development of HIS Strategic Plan, which involve all stakeholders, followed by Plan of
Action
REFERENCES
1.
Departemen Kesehatan (2003), Indikator Indonesia Sehat 2010 dan Pedoman Penetapan Indikator
Propinsi Sehat dan Kabupaten/Kota Sehat, Jakarta.
2.
Departemen Kesehatan (2002), Kebijakan dan Strategi Pengembangan Sistem Informasi Kesehatan
Nasional (SIKNAS), Jakarta.
3.
Departemen Kesehatan (2002), Petunjuk Pelaksanaan Pengembangan Sistem Informasi Kesehatan

Daerah Kabupaten/Kota, Jakarta.
4.
Departemen Kesehatan (2004), Petunjuk Teknis Standar Pelayanan Minimal Bidang Kesehatan di
Kabupaten/Kota, Jakarta.
5.
Departemen Keuangan (2005), Rancangan Anggaran dan Pendapatan Belanja Negara Tahun Anggaran
2005, Jakarta.
6.
2006, Jakarta.
7.
2007, Jakarta.
8.
De Geyndt W (1994), Managing the Quality of Health Care in Developing Countries, Washington, DC,
World Bank (World Bank Technical Paper, No.258).
9.
Hartshorne JE, Carsten IL (1990), Role of Information Systems in Public Health Services. Journal of the
Dental Association of South Africa, 45: 313 - 317.
10.
Health Metrics Network (2006), Framework and standards for the development of country health
information Systems, First edition, 1.97, Geneva, WHO.
11.
Health Metrics Network (2006), Health Information System Assessment Tool, Version 1.97, Geneva,
WHO.
12.
Health Metrics Network (2006), Letter of Agreement, Geneva, WHO.
13.
Helfenbein S et al. (1987), Technologies for Management Information System in Primary Health Care.
Geneva. World Federation of Public Health Associations (Issue Paper, Information for action series)
14.
Klenau E (2000). Management of Health Information System. Design and Implementation of Health
Information Systems. Geneva, WHO.
15.
lippeveld TJ, (2000). The Context of Health Information Systems Reform. Design and Implementation of
Health Information Systems. Geneva, WHO.
16.
Murnaghan JH (1981). Health Indicators and Information Systems for the Year 2000. Annual Review of
Public Health, 2: 299 361.
17.
Result from Group Discussion, Yogyakarta Special Province (Facilitating Health Information Design),
2001.
18.
Result of Group Discussion from Bantul District (Facilitating Health Information Design), Yogyakarta
Special Province, 2001.
19.
Sapirie S (2000). Assessing Health Information Systems. Design and Implementation of Health
Information Systems. Geneva, WHO.
20.
Sapirie S, Orzeszyna S (1995). Selecting and Defining National Health Indicators. Geneva. World
Health Organization.
21.
Sauerborn R (2000). Non-routine Data Collection Method: An Overview, Design and Implementation of
Health Information Systems. Geneva, WHO.
22.
Sauerborn R (2000). Using Information to Make Decision. WHO Geneva, Design and Implementation of
Health Information Systems: 33 70.
ANNEXES
1. Organization of HIS Assessment

2. Summary Report of HIS Assessment of All Sub-Categories
3. Chart of Summary Report
4. Diagram of MOH Organization Structure
5. Network Co-ordination Between CHDI, Other MOH Units, and Regional Level
6. Diagram The Relationship Between All Stakeholders Committed in HIS
7. Indonesia Essential Health Indicators
Annex 1 : Organisation of HIS assessment
1.
Name of country: Indonesia
2.
List of organisations participated in HIS assessment are :
3.
Ministry of Health (Centre for Data and Information)
BPS
Depdagri
BKKBN
Sub National
Unit that took the lead in organising the assessment is the Centre for Data and
Information, Ministry of Health
4.
Overall there have been 15 meetings, 9 prior to the conduction of HIS assessment, 6
post HIS assessments, 8 of them were participated by all stakeholders involved in the
assessment. Small technical team had been created with frequent meetings to
undertake Final HIS Assessment Report. Small technical team has discussed the
report in a total of 9 meetings.
5.
A national consensus conference involving highest leaders will be conducted to

present and conclude HIS assessment findings. The list of organisations and the
number of participants have not been decided yet.
6.
HMN tools was not modified, only adjustment of technical terms and explanation of
ambiguous meaning It has been translated into Bahasa Indonesia prior to its
implementation.
7.
Finalisation of HIS assessment result has been slightly delayed due to awaiting
feedback from stakeholders and language barrier difficulties.
8. Finally the final report has been completed at the end of September 2007
9. Time required to complete assessment from the first planning meeting until finalisation of
HIS assessment result was 1 year.
10. Recommendations to improve assessment tools are :
The number of questions should be minimised to prevent respondents becoming bored

during interview which would lead to inaccurate answering of questions.
The tool should be piloted prior to its implementation
Annex 2 : Summary of result of HIS assessment of all sub-categories
Main Categories
Score
Inputs
Resources
47%
Process
Indicators
61%
Process
Data sources
51%
Process
Data management
35%
Outputs
55%
Impacts
Dissemination & use
57%
Resources
47%
Policy and Planning
Institutions,
human
48%
resources
&
financing
41%
Infrastructure
55%
Indicators
61%
Data sources
51%
Data management
Census
53%
Vital statistics
35%
71%
Health & diseases records
40%
Health service records
53%
Administrative records
51%
35%
55%
Health Status
53%
- Mortality
52%
- Morbidity
55%
Health system
60%
Risk factors
51%
Data collection method
50%
Timeliness
59%
Periodicity
59%
Consistency
49%
Representativeness
58%
Disaggregation
53%
Estimation
method
transparency
Dissemination & use
/
59%
57%
Analysis and Use of Information
67%
Policy and Advocacy
56%
Planning & Priority Setting
55%
Resource allocation
47%
Implementation / action
52%
Annex 3 : Chart of Summary Result

3a
: Ministry of Health Result
CHART RESULT OF HIS SITUATION

ASSESSED BY MINISTRY OF HEALTH
Return to Menu
Resources
Indicators
Data sources
Data management
Dissemination & use
Not functional
0%
10%
Not adequate at all

20%
30%
40%
50%
Adequate
60%
70%
Highly adequate
80%
90%
100%
CHART RESULT OF DATA SOURCES

Return to Menu
Census
Vital statistics
Not functional
0%
10%
Not adequate at all

20%
30%
40%

50%
60%
Adequate
70%
Highly adequate
80%
90%
100%
CHART RESULT OF HEALTH INFORMATION PRODUCTS
Return to Menu
Selected Indicators & Results
Health status - mortality
Health status - morbidity
Health system
Risk factors
Overall health indicators quality

Not functional
0%
10%
Not adequate at all
20%
30%
40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%
CHART RESULT OF HEALTH INFORMATION QUALITY

Return to Menu
Timeliness
Periodicity
Consistency / completeness
Representativeness / appropriateness
Disaggregation
Estimation method / transparency
Not functional
0%
10%
Not adequate at all

20%
30%

40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%
3b
: National Board of Statistics Result

ASSESSED BY NATIONAL BOARD OF STATISTICS (BPS)
Return to Menu
Resources
Indicators
Data sources
Data management
Dissemination & use
Not functional
0%
10%
Not adequate at all

20%
30%
40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%
CHART RESULT OF DATA

SOURCES
Return to Menu
Census
Vital statistics
Not functional
0%
10%
Not adequate at all

20%
30%

40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%

Return to Menu
Health system
Risk factors

Not functional
0%
10%
20%
Not adequate at all Present but not adequate

30%
40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%

Return to Menu
Timeliness
Periodicity
Disaggregation
Not functional
0%
3c
10%
Not adequate at all

20%
30%

40%
50%
60%
Adequate
70%
: Ministry of Home Affair Result

ASSESSED BY MINISTRY OF HOME AFFAIR
Highly adequate
80%
90%
100%
Return to Menu
Resources
Indicators
Data sources
Data management
Dissemination & use
Not functional
0%
10%
Not adequate at all

20%
30%
40%
50%
Adequate
60%
70%
Highly adequate
80%
90%
100%

Return to Menu
Census
Vital statistics
Not functional
0%
10%
Not adequate at all

20%
30%

40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%
Return to Menu
Health system
Risk factors

Not functional
0%
10%
Not adequate at all
20%
30%
40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%
Return to Menu
Timeliness
Periodicity
Disaggregation
Not functional
0%
3d
10%
Not adequate at all

20%
30%

40%
: National Family Planning Board Result
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%

ASSESSED BY NATIONAL BOARD OF FAMILY PLANNING
Return to Menu
Resources
Indicators
Data sources
Data management
Dissemination & use
Not functional
0%
10%
Not adequate at all

20%
30%
40%
50%
Adequate
60%
70%
Highly adequate
80%
90%
100%

Return to Menu
Census
Vital statistics
Not functional
0%
10%
Not adequate at all

20%
30%
40%

50%
60%
Adequate
70%
Highly adequate
80%
90%
100%
Return to Menu
Health system
Risk factors

Not functional
0%
10%
20%
30%
40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%

Return to Menu
Timeliness
Periodicity
Disaggregation
Not functional
0%
3e
10%
: Selected Provinces Result
Not adequate at
20%
30%

40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%

ASSESSED BY SELECTED PROVINCES
(Lampung, Bengkulu, Bali, East and West Jawa,
South Sulawesi, and East Kalimantan)
Return to Menu
Resources
Indicators
Data sources
Data management
Dissemination & use
Not functional
0%
10%
Not adequate at all

20%
30%
40%
50%
Adequate
60%
70%
Highly adequate
80%
90%
100%

Return to Menu
Census
Vital statistics
Not functional
0%
10%
Not adequate at all

20%
30%

40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%
Return to Menu
Health system
Risk factors

Not functional
0%
10%
20%
30%
40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%

Return to Menu
Timeliness
Periodicity
Disaggregation
Not functional
0%
10%
Not adequate at all

20%
30%

40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%
3f
Indonesia result
OVERALL CHART RESULT OF HIS SITUATION
ASSESSED IN INDONESIA
Return to Menu
Resources
Indicators
Data sources
Data management
Dissemination & use
Not functional
0%
10%
Not adequate at all

20%
30%
40%
50%
Adequate
60%
70%
Highly adequate
80%
90%
100%

Return to Menu
Census
Vital statistics
Not functional
0%
10%
Not adequate at all

20%
30%

40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%
Return to Menu
Health system
Risk factors

Not functional
0%
10%
Not adequate at all
20%
30%
40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%

Return to Menu
Timeliness
Periodicity
Disaggregation
Not functional
0%
10%
Not adequate at all

20%
30%

40%
50%
60%
Adequate
70%
Highly adequate
80%
90%
100%
Annex. 4 Ministry of Health Organization Structure
MINISTRY OF HEALTH ORGANIZATION STRUCTURE

MINISTER OF HEALTH
INSPECTORATE
GENERAL
SECRETARIATE
GENERAL
ADVISORS TO THE MINISTER OF HEALTH
BUREAU OF
PLANNING &
BUDGETTING
DIRECTORATE GENERAL
OF
COMMUNITY HEALTH
DIRECTORATE GENERAL
OF
DISEASE CONTROL AND
ENVIRONMENTAL HEALTH
DIRECTORATE GENERAL
OF
MEDICAL CARE
CENTER FOR
HEALTH DEVELOPMENT
STUDIES
CENTER FOR
HEALTH PROMOTION
BUREAU OF
FINANCE AND
EQUIPMENT
SUPPLIES
BUREAU OF
LAW AND
ORGANIZATION
BUREAU OF
GENERAL
AFFAIR
DIRECTORATE GENERAL
OF PHARMACY
SERVICES AND
MEDICAL EQUIPMENT
NATIONAL INSTITUTE
OF HEALTH HUMAN
RESOURCES
DEVELOPMENT AND
EMPOWERMENT
NATIONAL INSTITUTE
OF
HEALTH RESEARCH
AND DEVELOPMENT
CENTER FOR
DATA AND
INFORMATION
BUREAU OF
PERSONNEL
CENTER FOR
CRISIS RESPONSES
CENTER FOR
HEALTH ASSURANCE
CENTER FOR
PUBLIC
COMMUNICATION
CENTER FOR
HEALTH FACILITIES
AND INFRASTRUCTURE
Annex 5: Network Co-ordination Between CHDI, Other MOH Units, and Regional
Level
Annex 6: Diagram Concerning the Relation Among All Stakeholders Committed in HIS
NATIONAL
DONORS
NATIONAL INSTITUTE
OF HEALTH HUMAN
RESOURCES
DEVELOPMENT AND
EMPOWERMENT
DIRECTORATE GENERAL
OF PHARMACY
SERVICES AND
MEDICAL EQUIPMENT
DIRECTORATE GENERAL
OF
MEDICAL CARE
NATIONAL INSTITUTE
OF
HEALTH RESEARCH
AND DEVELOPMENT
MINISTRY OF
HOME AFFAIRS
FAMILY
PLANNING
COORDINATING
BOARD
CDI, MOH
DIRECTORATE GENERAL
OF
DISEASE CONTROL AND
SECRETARIATE
GENERAL
DIRECTORATE GENERAL
OF
COMMUNITY HEALTH
MINISTRY OF
COMMUNICATION
AND INFORMATION
PROVINCIAL
HEALTH OFFICE
PROVINCIAL
HEALTH OFFICE
DISTRICT
HEALTH OFFICE
PDPKB
Annex
7 :
INDONESIA ESSENTIAL HEALTH INDICATORS

APPLIED TO HEALTHY INDONESIA 2010 INDICATORS
(From various
sources)
A. HEALTH STATUS
INDICATOR
MORTALITY
1. Infant Mortality Rate
2. Underfive years Mortality Rate
3. Maternal Mortality Rate
4. Life Expectancy Rate :
Male
Female
MORBIDITY
1. Morbidity rate of Malaria
2. Recovery rate of lung TB-BTA+
3. Prevalence of HIV
4. Acute Flaccid Paralysis (AFP) rate
at children under 15 years old
5. Morbidity rate of DHF
NUTRITION STATUS
1. Percentage of children under 5 years
with malnutrition
2. Percentage of District free from
leak of Nutrition
B. INTERMEDIATE RESULT
INDICATOR
CONDITION
1. Percentage of Healthy Home
2. Percentage of Healthy Public Places
HEALTH BEHAVIOR
1. Percentage of Household with
Clean and Healthy Behavior
2. Percentage of Integrated community
health pos Purnama and Mandiri
ACCESS AND HEALTH SERVICE
QUALITY
1. Percentage of people to utilize
health centers
2. Percentage of people to utilize
hospitals
3. Percentage of Health Facility with
Health Laboratory Capability
4. Percentage of hospitals within
Four Basic Specialist Health Service
5. Percentage of Generic drug in
their stock
TARGET BY
2010
40
58
150
67,9
Achieved
28,0 (2005)
36,0 (2005)
230 (2000)
66,0 (2005)
69,0 (2005)
5
85
0,9
not available
90 (2004)
106,0 (2005)
0,9
2
not available
not available
15
not available
80
not available
TARGET BY
2010
Achieved
80
80
not available
not available
65
not available
40
not available
15
not available
1,5
not available
100
not available
100
not available
100
not available
C. INPUT AND PROCESS

INDICATOR
HEALTH SERVICE
1. Percentage of Births attended by
skilled
health personnel
2. Percentage of village which has
been done Universal Child
Immunization (UCI) targeted
3. Percentage of village with
outbreak which had been handled
less than 24 hours
4. Percentage of pregnant women
who are treated by Fe pills
5. Percentage of infant whose
got exclusive breast feeding
6. Percentage of Primary School
or Religious Primary School
whose got mouth and dental
care service
7. Percentage of worker whose receiving
Occupational Health service
8. Percentage of Poor family whose
receiving health service
HEALTH RESOURCES
1. Ratio of physicians per100,000 population
2. Ratio of specialist doctor per100,000 population
3. Ratio of Family Doctor per1,000 population
4. Ratio of Dentist per- 100,000
population
5. Ratio of Pharmacist per100,000 population
6. Ratio of Midwives per-100,000
population
7. Ratio of Nurse per 100,000
population
8. Ratio of Nutritionist per100,000 population
9. Ratio of Sanitarian per100,000 population
10. Ratio of Public Health
Expert per- 100,000 population
11. Percentage of population
whose member of health assurance
12. Percentage rate of Health budget
allocation within Government budget
of District/city level
TARGET BY
2010
Achieved by
90
66,0 (2003)
100
not available
100
not available
80
not available
80
not available
100
not available
80
not available
100
not available
40
13 (2003)
not available
not available
11
3,0 (2003)
10
3,0 (2003)
100
25 (2003)
117,5
57,0 (2003)
22
not available
40
3,0 (2003)
40
not available
80
not available
15
not available
13. Health budget allocation of

government budget per-capita/year
HEALTH
MANAGEMENT
1. Percentage of district/city which has
Health System documents
2. Percentage of district/city which has
contingency plan for health problem
due to outbreak/natural disasters
3. Percentage of district/city which
did health profile
4. Percentage of province which
did local health survey
5. Percentage of province which
has Provincial Health Account
OTHER SECTOR CONTRIBUTION
1. Percentage of household who
has water supply access :
Rural
Urban
2. Percentage of fertility spouse
which were family planning
acceptor
3. Traffic accident rate per-100.000
population
4. Percentage of population whose
literacy
100
40,5 (2004)
100
not available
100
not available
100
not available
100
not available
100
not available
85
87 (2004)
69 (2004)
70
not available
10
not available
95
90,4 (2004)

HMN - Indonesia Health Info System 2007

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HMN - Indonesia Health Info System 2007

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Health Metrics Network

Indonesia Health Information System

Centre for Data and Information

Jakarta, Indonesia, August, 2007

Jakarta, Indonesia, 27 September 2007

Director of Centre for Data and Information,

DR. Bambang Hartono, SKM; MPH

DR. Bambang Hartono, SKM;M.Sc (hartonoba@yahoo.com)

DR. Suartini Bambang, MPH;M.Sc (hmn_ina2@dnet.net.id)

Drs. Djoko Tjahjono, MPH (hmn_ina1@dnet.net.id)

Hary Purwanto, SKM; MKes (harypurwanto2001@yahoo.com)

Yudianto, SKM, MSi and his staffs (yudianto@excite.com)

Dr. Doti Indrasanto (hmn_ina1@dnet.net.id)

Prof. Budi Utomo (butomo49@yahoo.co.id)

Iskandar Zulkarnain, SKM; Mkes (iskandarz@depkes.go.id)

Drs. Johan Arief (johan@centrin.net.id)

Email correspondence : hmn_ina2@dnet.net.id

Background of Health Information Systems in Indonesia

Objectives of the HIS assessment

HIS components and standards

Result of HIS Assessment using HMN Tools

Health Status Indicators

Health Systems Indicators

Dissemination and use of information

Analysis and use of information

Policy and advocacy

Priority and planning

Summary of the HIS assessment and policy implication

Organisation of HIS Assessment

Summary of result of HIS Assessment of all Sub-categories

Chart of summary results

Diagram of Ministry of Health Organisation Structure

Diagram of the relation between all stakeholders committed to HIS

Indonesia Essential Indicators

National Family Planning Coordination Board

National Bureau of Statistics

Centre for Data and Information

Centre for Health Data and Information

Country Health Information Systems

Ministry of Home Affairs

Ministry of Communication and Information

Demographic Surveillance System

Geographic Information System

Health Information System

Human Immunodeficiency Virus / Acquired Immune Deficiency

Health Metrics Network

Information, Communication, and Technology

Millennium Development Goals

National Health Information System

Minimum Health Services Standard

Sample Registration System

Strength, Weaknesses, Opportunity, and Threat

World Health Organisation

BACKGROUND OF HEALTH INFORMATION SYSTEMS IN INDONESIA.

OBJECTIVES OF THE HIS ASSESSMENT

To establish baseline information of currently applied HIS.

To obtain stakeholders awareness and understanding their role in HIS.

To implement the HIS assessment result in building up stakeholder commitment and

To provide baseline data in mobilising all HIS resources.

To use performance result of HIS in terms of integration, provide quality information

HIS COMPONENTS AND STANDARDS

Not adequate at all

Present but not adequate