Puskesmas (Indonesian: Pusat Kesehatan Masyarakat, English: Community Health Centre) are

government-mandated community health clinics located across Indonesia. They are overseen by
the Indonesian Ministry of Health and provide healthcare for population on sub-district level. The
concept was designed by G.A. Siwabessy, the first Indonesian Minister of Health. Community
and preventative health programs formed another component of Indonesia's health
system.[1] There is approximately 9718 Puskesmas around the country according to the Ministry
of Health of Indonesia.[2]
Community health services in Indonesia were organized in a three-tier system with Puskesmas
at the top. Usually staffed by a physician, these centres provided maternal and child health care,
general outpatient curative and preventative health care services, pre- and postnatal care,
immunization, and communicable disease control programs. Specialised clinic services were
periodically available at some of the larger clinics.
There are two kinds of Puskesmas, those with beds and those without one. The puskesmas
without beds generally acts as a public outpatient treatment facility, is rarely open after mid-day,
and is definitely not likely to be either open or prepared to deal with an obstetric emergency
outside of clinic hours. This centre is usually staffed by a Bidan (nurse) and a general practitioner
who provide preventative and curative services related to 18 different health programmes
including Antenatal care and family planning program. These Puskesmas however have been
characterised as under-burdened and problematic as these health centre tend to bypass serious
patient to higher level of health services. Should a critically ill patient appear at this type of
facility, the staff are more likely to simply send the patient on to the next level of care than to
attempt to administer first aid or try to prepare the patient for transfer.[3]
The Puskesmas with beds are mostly located in more