|Humanitarian organization World Vision has put Indonesia in 100th place out of 176 countries in a study on health inequality for children.
In a report titled “The Killer Gap: A Global Index of Health Inequality for Children,” World Vision said this killer gap between the haves and the have nots substantially contributed to the death of thousands of children every day across the globe in rich and poor countries.
“This is a very worrisome reality of the present world,” Andrew Hassett, World Vision International campaign director, said in a statement on Wednesday.
“While we have the science, the resources and the equipment to provide quality health services to mothers, children and infants, many infants and children continue to pay the price for this great gap with their lives.”
Hassett said the study focused on the gap between those people who had good access to health services, and those with difficulty in accessing them.
He said the report concluded the gap existed in every country but in some, the situation was “really surprising.”
Countries with the narrowest gap included France, Denmark, Norway, Luxemburg, Finland, Germany, Sweden, Slovenia, Cuba and Switzerland, the report said.
The countries with the widest gap were Chad, Sierra Leone, Guinea, Mali, Equatorial Guinea, Nigeria, Congo, Afghanistan, Cameroon and Cote D’Ivoire.
Seven of these countries are designated as being among the world’s poorest while the three others are classified as middle-income countries.
“For the past 20 years, there has been a lot of progress — the annual infant mortality rate has drastically gone down but there is still a significant number, 19,000 infants dying each day, and this report is highlighting one of the main causes for this,” Hassett said.
He said that when governments and organizations targeted mortality rates while battling poverty and improving health, they tended to reach out to those who were easiest to access.
“But in many cases, these steps also mean a rising wealth gap between the rich and the poor and children are the most vulnerable to this heavy burden,” he said.
Hassett expressed the hope that the report would push governments to tackle the issue more seriously and take concrete steps to close the gaps in health care access that existed in their countries.
“We know that this can be done, as shown in our report,” Hassett said.
“But what remains is a matter of priority. How important is it to reduce child mortality rate from preventable causes? This is where our leaders need to prove themselves to us,” Hassett said.
Health expert and former chairman of the Indonesian Doctors Association, Kartono Muhammad, said the wide gap between the rich and the poor in Indonesia had come about because of flawed health care policies that left patients receiving poor value for money.
“Of course the gap is wide, because the high cost of medical services and treatment makes it so expensive, even though the quality is quite poor,” he told the Jakarta Globe on Wednesday.
Child health inequality was further exacerbated by poor health knowledge among the population and difficult access to the nearest health facilities especially in remote areas, Kartono said.
He said Indonesia would be able to narrow the gap if the implementation of the National Health Security Scheme, due to come into effect at the start of 2014, proved to be successful.
But Kartono warned the new health care policy would not work properly if the government did not work to fix existing loopholes in the system.
Under the policy all Indonesians must pay monthly premiums for health insurance, while low-income earners’ premiums would be covered by the state.
“It is estimated 86.4 million people will be able to enjoy the coverage, but how will we ensure that everybody who needs treatment will receive appropriate service when we know that the data on those who are eligible to receive the coverage are flawed?” he said.
Kartono also criticized the government’s excuse that the disparity of child health in the country was worsened by the difficult geographic conditions, referring to the many islands and mountains that make getting around an arduous task, especially in remote areas with little in the way of public transport and poor transportation infrastructure.
“The geographic condition is a given factor. It’s been that way all through our history. The government cannot use that anymore as an excuse. The onus has been on them to find solutions to overcome the barriers,” he said.