Partners’ HPSR report – 2021
Nineteen HPSR-related institutions were identified in Indonesia, most of them in Jakarta and Yogyakarta. The vast majority – around 70% – are university-based, many are independent think tanks, while just one is a local NGO. Variations in knowledge management systems across these institutions limit the amount of information on HPSR portfolios and their precise impact on policy.
HPSR is commissioned by the Government of Indonesia to inform the country’s long-term development planning. A health-sector review, for example, has outlined priority health issues; the Global Burden of Disease study has influenced the drafting of the National Action Plan; and HPSR has helped to shape revisions of the national health insurance system. Evidence from HPSR also has an impact at sub-national level, with research evidence influencing regulations in districts and municipalities. Legislation in 2018 introduced a new procurement mechanism for research and has enabled the Government of Indonesia to contract research from NGOs.
Institutions by type
List of HPSR institutions
One highlight has been the commissioning by the Ministry of National Development Planning (Bappenas) of a health-sector review ahead of Indonesia’s Long-Term National Development Planning. The 2018 Consolidated Report of Health Sector Review (HSR), National Health System Strengthening, provides an overview of priority health issues. This report analysed the situation at the time, as well as health gains and challenges over recent years, and identified strategic issues and policy alternatives for the 2020-2024 National Health Development Planning – the basis for the Ministry of Health (MOH) Strategic Plan.
The number of HPSR reports published in 2018 and 2019 held steady, at 91 and 99 respectively, with the Center for Health Policy and Management at Universitas Gadjah Mada producing a major share in these years. There was an increase in 2020, when 118 reports were published, notably by the Center for Tropical Medicine.
Average number of reports produced per institution each year in Indonesia and overall
Engaging policy-makers and the public
The policy impact of HPSR has been enhanced by multi-actor approaches and strategies to translate, as well as generate, knowledge. Policy-makers have, for example, commissioned the health-sector review to inform policy. Three major and successive revisions of the Presidential Regulation on the National Health Insurance system between 2018 and 2020 have also built on, and emerged from, HPSR reviews and policy discussions between research institutions and the government. The Indonesia Institute of Science also collaborates with academic research institutions to advocate for reform of the National Health System and is working to draft the new regulation.
The Global Burden of Disease study (2019) has become a prominent reference point for the drafting of the National Action Plan for Health Security (NAPHS) 2020-2024, including on non-communicable diseases. In addition, Bappenas partnered with academic research institutions in 2020 to produce several publications, including a book on lessons learned from the COVID-19 pandemic, outlining the health-system response to the crisis.
At subnational level, district and municipality regulations have been influenced by HPSR evidence and the technical assistance provided by research institutions. There are variations in knowledge management systems across Indonesia’s research institutions. As a result, there is limited information on specific HPSR portfolios and their policy impact. However, meetings with policy-makers were just under 300 in both 2018 and 2020. The number of HPSR newspaper articles ranged from around 14000 to 1600 in the time period reported.
Average number of meetings held with policy-makers per institution each year in Indonesia and overall
Average number of media articles published per institution each year in Indonesia and overall
Academic and institutional capacity
Presidential Regulation no. 16/2018 introduced a new procurement mechanism for research. The same law has also enabled the Government of Indonesia to contract NGOs to provide services and conduct research. The Government also offers scholarships for international graduate studies. Scholarships for PhD sandwich programmes are usually reserved for lecturers, while scholarships for graduate studies are also offered to non-lecturers. There is an affirmative mechanism to ensure greater opportunities for applicants from disadvantaged regions.
The Australian Government Department of Foreign Affairs and Trade (DFAT) Knowledge Sector Initiative (KSI) provides grants to build research capacity and promote knowledge generation and translation. One KSI recipient in Indonesia is a university-based research institution working in HPSR, which is also supported by the Alliance for Health Policy and Systems Research mentorship programme for capacity building.
In most universities, the faculties of public health are separated from faculties of medicine, and only a few have both (public health and medicine) in the same faculty. Each academic institution develops its own international partnerships, including joint research programmes, sandwich programmes or double-degree programmes. Some major universities host international guest lecturers, and there are research opportunities or internships for international graduate students in host research institutions.
Academics and researchers in HPSR usually belong to either researcher associations or networks. such as the Health Policy Research Network (HPN). HPN holds an annual forum and has capacity-building programmes that are shared via a website and a weekly e-mail newsletter. Membership is free of charge. However, HPN has no clear governance structure, and most activities are voluntary and are driven by major university members only.
Although less than 100 HPSR faculty members were identified in 2020 as officially registered to a research centre, the number of faculty members focusing on HPSR is likely to be much higher. Indeed, Indonesia reported the highest number of students participating in HPSR courses – around 3900.
Total number of HPSR faculty and staff
Total number of participants in HPSR-related short courses
Indonesia has a national health research budget that sits with the MOH, amounting to a little over US$ 37 million in 2020.
It is difficult to access accurate data on overall health research funding because it is distributed not only through the MOH but also the National Research and Innovation Agency. Until recently, the bulk of funding went to the MOH’s Agency for Health Research and Development, which conducts nationwide surveys, such as the Survey on Health Facility and the Survey of Basic Health. In 2019, the President established a National Research and Innovation Agency (Badan Riset dan Inovasi Nasional, or BRIN) and there are plans to merge all research agencies sitting in different ministries into this agency. A smaller share goes to different directorates within the MOH for various assessments related to HPSR, and these can be commissioned from academic research institutions, NGOs or private companies.
The National Research and Innovation Agency has a total budget of around US$ 84 million, which is allocated across nine research priority areas, including health (mostly for the development of drugs and medical equipment), but there is no definitive ceiling or allocation for each topic. Funds are disbursed for research in public and private universities via a bid mechanism. Prior to 2019, research funding was distributed through the Ministry of Higher Education, Research and Technology.
Other funding comes from UN bodies and development partners such as the World Health Organization, The World Bank, USAID, DFAT (Australia), JICA (Japan), IDRC (Canada) and the United Kingdom of Great Britain and Northern Ireland’s Medical Research Council. Most HPSR institutions also access and receive funding from both international and domestic donors such as the Ford Foundation, the Bill & Melinda Gates Foundation, and local foundations. The total amount of funding is recorded by Bappenas and the ministries that work with UN bodies and other development partners. External funding tends to focus on knowledge generation rather than knowledge translation.
Total institutional expenditure
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Partners’ health policy and systems research report, 2021
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