PKMK UGM: Inclusive Healthcare Services for People with Disabilities

FK-KMK UGM. The Center for Health Policy and Management at the Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada (PKMK FK-KMK UGM), with support from INKLUSI, unveiled research findings on healthcare services for people with disabilities in the pursuit of Universal Health Coverage (UHC). The presentation took place in a hybrid format on Wednesday, October 30, 2024, at the Tahir Graduate Building Auditorium, FK-KMK UGM, with representatives from the Ministry of Health, BPJS Health, NGOs, disability organizations, and other stakeholders in attendance.

“To achieve UHC, no one should be left behind. There are often concerns about the financial investment required, but inclusivity in healthcare services is paramount,” stated Dr. Andreasta Meliala, DPH., M.Kes., MAS., Director of PKMK FK-KMK UGM, in his opening remarks.

Conducted across three regions—Bali, DI Yogyakarta, and East Nusa Tenggara (NTT)—the study engaged 2,666 respondents with disabilities. Findings reveal that 66.3% of participants lack necessary assistive devices, and 75% do not receive therapy services. Although 88.75% are covered by the National Health Insurance (JKN), 11.25% remain without access due to limited information, accessibility issues, and financial barriers.

Research Team Chair Dr. Dra. Retna Siwi Padmawati explained that the study, conducted from June 2023 to September 2024, involved stakeholders including INKLUSI partners, SIGAB, and YAKUM, as well as relevant ministries. “This research is an initial step and has yet to cover all disability categories. Nonetheless, we hope it will serve as evidence-based advocacy for a more inclusive health policy,” said Retna.

Tri Hartini, a member of the PKMK FK-KMK UGM research team, identified three main challenges facing healthcare access for people with disabilities: (1) physical access constraints, including high transportation costs and lack of support assistance; (2) limited inclusive infrastructure, such as minimal wheelchair ramps and guiding blocks; and (3) insufficient communication skills among healthcare providers, including limited sign language proficiency.

The research also highlights that BPJS Health, Indonesia’s main health insurance provider, currently supplies only seven of the 50 assistive device types recommended by the World Health Organization (WHO). For example, adaptive hearing aids cost around IDR 10 million per ear, a cost far exceeding BPJS Health’s coverage.

Based on these findings, PKMK FK-KMK UGM proposed four intervention strategies to improve healthcare inclusivity for people with disabilities. The first is strengthening healthcare governance through the development of regulatory frameworks and a roadmap for an inclusive health system. The second is the expansion of specialized healthcare services, such as disability-friendly community health centers and extending JKN coverage for assistive devices.

The third recommendation is to enhance inclusive healthcare facilities by improving accessible infrastructure and increasing the capacity of healthcare providers. Lastly, PKMK suggests reforming healthcare financing through special insurance schemes and transportation subsidies, especially for people with disabilities in remote areas. Tri Hartini also emphasized the importance of telemedicine to address geographical challenges, especially in archipelagic regions where many areas have cellular connectivity.

“We hope more marginalized groups can participate in Indonesia’s social, cultural, and political development,” added Irene Widjaya, Head of Partnerships and Policy at AIPTIS/INKLUSI.

With these recommendations, PKMK FK-KMK UGM encourages the government to adopt more inclusive policies for people with disabilities, reflecting UHC’s principle of equitable access. This initiative aligns with the Sustainable Development Goals (SDGs), namely Good Health and Well-being (SDG 3), Quality Education (SDG 4), Industry, Innovation, and Infrastructure (SDG 9), Reduced Inequalities (SDG 10), Responsible Consumption and Production (SDG 12), and Partnerships for the Goals (SDG 17). (Isroq Adi Subakti/Reporter).