TY - JOUR
T1 - On the road to universal health care in Indonesia, 1990–2016
T2 - a systematic analysis for the Global Burden of Disease Study 2016
AU - Mboi, Nafsiah
AU - Murty Surbakti, Indra
AU - Trihandini, Indang
AU - Elyazar, Iqbal
AU - Houston Smith, Karen
AU - Bahjuri Ali, Pungkas
AU - Kosen, Soewarta
AU - Flemons, Kristin
AU - Ray, Sarah E.
AU - Cao, Jackie
AU - Glenn, Scott D.
AU - Miller-Petrie, Molly K.
AU - Mooney, Meghan D.
AU - Ried, Jeffrey L.
AU - Nur Anggraini Ningrum, Dina
AU - Idris, Fachmi
AU - Siregar, Kemal N.
AU - Harimurti, Pandu
AU - Bernstein, Robert S.
AU - Pangestu, Tikki
AU - Sidharta, Yuwono
AU - Naghavi, Mohsen
AU - Murray, Christopher J.L.
AU - Hay, Simon I.
N1 - Publisher Copyright:
© 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2018/8/18
Y1 - 2018/8/18
N2 - Background: As Indonesia moves to provide health coverage for all citizens, understanding patterns of morbidity and mortality is important to allocate resources and address inequality. The Global Burden of Disease 2016 study (GBD 2016) estimates sources of early death and disability, which can inform policies to improve health care. Methods: We used GBD 2016 results for cause-specific deaths, years of life lost, years lived with disability, disability-adjusted life-years (DALYs), life expectancy at birth, healthy life expectancy, and risk factors for 333 causes in Indonesia and in seven comparator countries. Estimates were produced by location, year, age, and sex using methods outlined in GBD 2016. Using the Socio-demographic Index, we generated expected values for each metric and compared these against observed results. Findings: In Indonesia between 1990 and 2016, life expectancy increased by 8·0 years (95% uncertainty interval [UI] 7·3–8·8) to 71·7 years (71·0–72·3): the increase was 7·4 years (6·4–8·6) for males and 8·7 years (7·8–9·5) for females. Total DALYs due to communicable, maternal, neonatal, and nutritional causes decreased by 58·6% (95% UI 55·6–61·6), from 43·8 million (95% UI 41·4–46·5) to 18·1 million (16·8–19·6), whereas total DALYs from non-communicable diseases rose. DALYs due to injuries decreased, both in crude rates and in age-standardised rates. The three leading causes of DALYs in 2016 were ischaemic heart disease, cerebrovascular disease, and diabetes. Dietary risks were a leading contributor to the DALY burden, accounting for 13·6% (11·8–15·4) of DALYs in 2016. Interpretation: Over the past 27 years, health across many indicators has improved in Indonesia. Improvements are partly offset by rising deaths and a growing burden of non-communicable diseases. To maintain and increase health gains, further work is needed to identify successful interventions and improve health equity. Funding: The Bill & Melinda Gates Foundation.
AB - Background: As Indonesia moves to provide health coverage for all citizens, understanding patterns of morbidity and mortality is important to allocate resources and address inequality. The Global Burden of Disease 2016 study (GBD 2016) estimates sources of early death and disability, which can inform policies to improve health care. Methods: We used GBD 2016 results for cause-specific deaths, years of life lost, years lived with disability, disability-adjusted life-years (DALYs), life expectancy at birth, healthy life expectancy, and risk factors for 333 causes in Indonesia and in seven comparator countries. Estimates were produced by location, year, age, and sex using methods outlined in GBD 2016. Using the Socio-demographic Index, we generated expected values for each metric and compared these against observed results. Findings: In Indonesia between 1990 and 2016, life expectancy increased by 8·0 years (95% uncertainty interval [UI] 7·3–8·8) to 71·7 years (71·0–72·3): the increase was 7·4 years (6·4–8·6) for males and 8·7 years (7·8–9·5) for females. Total DALYs due to communicable, maternal, neonatal, and nutritional causes decreased by 58·6% (95% UI 55·6–61·6), from 43·8 million (95% UI 41·4–46·5) to 18·1 million (16·8–19·6), whereas total DALYs from non-communicable diseases rose. DALYs due to injuries decreased, both in crude rates and in age-standardised rates. The three leading causes of DALYs in 2016 were ischaemic heart disease, cerebrovascular disease, and diabetes. Dietary risks were a leading contributor to the DALY burden, accounting for 13·6% (11·8–15·4) of DALYs in 2016. Interpretation: Over the past 27 years, health across many indicators has improved in Indonesia. Improvements are partly offset by rising deaths and a growing burden of non-communicable diseases. To maintain and increase health gains, further work is needed to identify successful interventions and improve health equity. Funding: The Bill & Melinda Gates Foundation.
UR - http://www.scopus.com/inward/record.url?scp=85049094769&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(18)30595-6
DO - 10.1016/S0140-6736(18)30595-6
M3 - Article
C2 - 29961639
AN - SCOPUS:85049094769
SN - 0140-6736
VL - 392
SP - 581
EP - 591
JO - The Lancet
JF - The Lancet
IS - 10147
ER -
