Low-cost health centers fail to give good service

JAKARTA (JP): More people are turning in the economic crisis to low-cost community health centers, known locally as Puskesmas, but many are reportedly coming away disappointed with services.

A survey organized by the respected Indonesian Consumers Foundation (YLKI) examined several centers in all 27 provinces. One finding was that a rise in fees at many health centers was not accompanied by enhancement of services.

Nazaiy Aziz from the Aceh branch of YLKI said beginning in February the centers were visited by people of all age brackets, not merely those categorized as poor.

The increase in the consultation fee from Rp 500 (30 U.S. cents) to Rp 1,000 might not be a burden to many, Nazaiy said, but services and attitudes of the centers' officials were often disappointing.

"I saw an official withhold drugs from an ailing patient while telling him the supply was limited, and ordering the patient to go to the drug store," he said in a discussion Tuesday.

However, secretary-general of the Indonesian Medical Association (IDI) Hasbullah Tabrany said the problems mentioned by Nazaiy were merely the ones readily apparent, and that many others also existed.

He said the low income of health officials and limited subsidies had overburdened Puskesmas in its set mission to provide preventive and curative services while enhancing health levels in communities.

There are about 7,000 community health centers nationwide, according to the University of Indonesia's School of Public Health.

Former IDI chairman Kartono Mohamad said in the discussion that the government should introduce changes and allow Puskesmas to focus on just one or two of its set missions.

Service could be developed later in better circumstances, program officer of the Ford Foundation Rosalia Sciortino said.

It was more important for the country to launch immediate action to deal with the impact of the prolonged economic crisis, she added.

"Quality of services is important," she said. But she believed that poor service was still acceptable as long as medical treatment was up to standard.

The country should be aware of more immediate health problems such as the limited blood supply, medical equipment, drugs and proper nutrition for infants and children.

She said priority should be put on treatment for children and mothers, especially those in remote areas.

According to the Central Bureau of Statistics, by June of this year the number of poor in the country reached 79.9 million, or 40 percent of the total population. Almost 70 percent of the poor live in villages with limited access to nutritious food and adequate medical services. (emf)