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Indonesia

Transparency and Participation in Health Data (ID0093)

Overview

At-a-Glance

Action Plan: Indonesia Action Plan 2018-2020

Action Plan Cycle: 2018

Status: Active

Institutions

Lead Institution: Ministry of Social Service

Support Institution(s): 1. Ministry of Health 2. The National Team for the Acceleration of Poverty Reduction 3. Social Security Administration Body for Health, Medialink

Policy Areas

E-Government, Gender, Health, Marginalized Communities, Public Participation, Public Service Delivery, Subnational, Sustainable Development Goals

IRM Review

IRM Report: Indonesia Design Report 2018-2020

Starred: Pending IRM Review

Early Results: Pending IRM Review

Design i

Verifiable: Yes

Relevant to OGP Values: Access to Information , Civic Participation

Potential Impact:

Implementation i

Completion: Pending IRM Review

Description

January 2019 - December 2020
Commitment Description
Lead implementing
agency/actor
Ministry of Social Service
Law Number 40/2004 on National Social Protection
System and Law Number 24/2011 on Social
Protection Administration Body mandate the
government to enforce the implementation of National
Health Insurance. One of the programs is the Health
Contribution Assistance (HCA) for the poor. However,
the data of HCA is not accessible for users and it often
not in accordance with the actual condition. For
instance, as some recipients might have already
passed away, moved away, had a double identity
number, or had changes in financial circumstances
that allowed them to pay the contribution. The
inconsistency in the HCA recipients’ data happened
because people could not verify and validate the data
as they are not aware of the data platform.
On the other hand, the Minister of Social Services
Regulation Number 5/2016 on Recipient of Health
Contribution Assistance (Revised) mandates the
government to implement the mechanism of data
verification and validation participative. According to
the regulation, the public could participate in updating
HCA data through sub-district consultation forum.
However, it is not as effective as the data is not
accessible and the monitoring of its implementation
remains low. This Action Plan is committed to
empowering the participatory data update. It also
encourages the Ministry of Social Service to inform
the HCA data through an application system.
What is the public problem that
the commitment will address?
The commitment aims to support the development of
the application system and people’s participation in
updating the data. This application system will provide
the recipient’s personal information. In addition to that,
all the process of updating data will be implementing
by sub-districts. This commitment also encourages the
involvement of women group, marginalized
community, and indigenous people. The result of the
participatory data updates will be doing with the
issuance of a ministerial decree.

IRM Midterm Status Summary

2. Transparency and Collective Participation in Renewed Data on Recipient of Health Contribution Assistance

Language of the commitment as it appears in the action plan:

The commitment aims to support the development of the application system and people’s participation in updating the data. This application system will provide the recipient’s personal information. In addition to that, all the process of updating data will be implementing by sub-districts. This commitment also encourages the involvement of women group, marginalized community, and indigenous people. The result of the participatory data updates will be doing with the issuance of a ministerial decree.

Milestones:

  1. Information system application on social welfare provides all the process of updating the data as a result from the online verification. As a data platform, the system also provides accurate and valid data, enriched with their export and import features.
  2. The implementation of public consultation meeting through city/village forum or any other platform for renewed data on Recipient of Health Contribution Assistance.
  3. The availability of twelve ministerial decrees on renewed data of the HCA’s recipients based on citizen participation inputs.

Start Date: January 2019                                                               End Date: December 2020

Context and Objectives

In January 2014, the Government of Indonesia established the Social Security Agency for Health (BPJS Kesehatan) to continue efforts to ensure comprehensive, equal, and fair universal healthcare [28] for all citizens. BPJS Kesehatan succeeds Askes, a now-defunct government health insurance program which was only available to civil-sector members.

BPJS Kesehatan categorizes insurance recipients into two categories [29] based on their economic backgrounds. The government covers the premium for those who live in poverty through a premium assistance beneficiaries (PBI) [30] insurance scheme. Those who do not meet the qualifications to be included in the PBI scheme are required pay their own premium. However, the law does not specify the poverty criteria in this context.

For the fiscal year of 2019, [31] the government increased the number of PBI recipients to 96.8 million from 92.4 million in 2018. Consequently, the budget allocation also went up from 25.5 trillion rupiah (1.8 billion USD) to 26.7 trillion rupiah (1.87 billion USD). The government based this decision on the data provided by the Ministry of Social Affairs who collaborated with the Ministry of Home Affairs at the national level and Civil Registry Offices across the nation at the local level. According to the Ministry of Social Affairs, their data are updated on a yearly basis through a verification and validation process to ensure accurate distribution of PBI. [32]

However, studies conducted by MediaLink, a civil society group, in East Java (Wonosobo and Sidoarjo Regencies), Central Java (Brebes Regency), and the Jakarta Special Capital Region [33] suggest that the PBI program does not always benefit the intended recipients. Representative from MediaLink [34] detailed the following issues:

  • Lack of transparency: The Ministry of Social Affairs does not regularly publish data on premium assistance beneficiaries, making it difficult to monitor its distribution.
  • Lack of citizen participation: The Ministry of Social Affairs does not involve citizens at any stage of its yearly data verification and validation. The studies found multiple reports of duplicated, deceased, and unidentified recipients.
  • Unclear methodology and criteria to determine poverty: The Ministry of Social Affairs does not disclose the methodology or criteria it uses to collect valid data of premium assistance beneficiaries. A major criticism has been that the Ministry uses the same criteria to determine poverty across the nation, which is not feasible considering the various factors that play into the fulfilment of basic needs in different locations.

President Joko Widodo himself has publicly criticized his own cabinet for providing conflicting data on poverty rates. [35] The Central Bureau of Statistics (BPS) reported only 25.95 million people (9.82% of the total population size) [36] living in poverty in March 2018—much lower than the 92.2 million figure from the Ministry of Social Affairs and the Ministry of Health to allocate the PBI program. Minister of Finance Sri Mulyani suggested that the BPS’s statistic was the lowest poverty rate recorded in Indonesia’s history. [37] In contrast, however, the number of PBI recipients categorized as living in poverty by the Ministry of Social Affairs has consistently increased every year. [38]

The Chief Statistician at the BPS has publicly admitted the government’s statistical inconsistency. In an article released in October 2018, [39] the Chief Statistician explained that the Bureau measures poverty data using a standardized methodology based on the World Bank’s Handbook on Poverty and Inequality. Meanwhile, the government collects data using a different methodology. This has resulted in the publication of contrasting figures as the government tends to see poverty relative to the relevant programs. However, this practice should not continue as it can hamper the efficiency and effectiveness of government programs and public service delivery.

This commitment has the potential to provide a solution to a long-running problem in Indonesia. Successful implementation could provide the government with a policy framework to use in other similar areas. Statistical incoherence is not a problem that is exclusive to poverty data. For example, in 2016, the Ministry of Agriculture [40] reported a surplus of 13.03 million tons of rice. However, the BPS [41] reported a surplus of only 2.85 million tons. Beyond confusion, data discrepancy can misdirect the government into enacting policies that do not meet the needs and demands of the citizens.

These inconsistencies are problematic in many ways. A portion of the poor population risks not receiving the much-needed assistance intended for them. It also opens up possibilities for people to trick the system, as indicated by findings of invalid entries of recipients included in the list of beneficiaries. Additionally, given the magnitude of budget allocation for the program, invalid beneficiaries data can result in corruption by public officials to direct funds for unintended recipients or uses.

This commitment intends to address all three aspects of these problems. The development of an information system application will allow citizens to access PBI recipient data with a built-in online verification feature to enhance the efficiency of the government’s data validation process. To support this, the government has committed to incorporating citizen participation elements in the data verification and validation process through existing consultation mechanisms such as the development planning forum (Musrenbang) as well as village forums (Musdes). This will allow citizens to provide feedback to the government by proactively reporting invalid entries and indicating those who live in poverty but have been excluded from the recipient list. To ensure continued improvement, the Ministry of Social Affairs committed to issuing a Ministerial Decree verifying an updated data of PBI recipients on a monthly basis.

With proper implementation, this commitment carries a moderate potential to prevent corruption and mismanagement of public funds. By making the process transparent and involving citizens, the government can ensure that those who benefit from the premium assistance actually qualify as recipients. By the end of this action plan cycle, this commitment might trigger some changes to the management of universal healthcare provision in Indonesia, especially with the government’s commitment to update the recipient list on a monthly basis, a progress compared to the existing yearly update.

Next Steps

In order to properly address the problem that this commitment seeks to solve, the Ministry of Social Affairs should disclose the methodology and criteria that it has been using to assess poverty. The stark contrast between the Ministry’s figure and the one reported by the BPS suggests that the two institutions are using different methodologies.

Public data discrepancies has also been one of the reasons behind the development of the One Data Indonesia policy with its three principles: one data standard, one standard metadata, and data interoperability. [42] However, despite the draft having been complete for years, [43] the Presidential Regulation on One Data has yet to be signed into effect.

In implementing this commitment, the government could consider focusing on the following aspects:

  • Publish premium assistance beneficiary data (including allocation and distribution) to ensure transparency throughout the process;
  • Optimize existing avenues of citizen participation such as village forums (Musdes) and development planning forums (Musrenbang) as well as public consultation forums (FKP) rather than develop a new mechanism;
  • Proactively engage vulnerable and marginalized communities to ensure their inclusion in the premium assistance scheme; and
  • Coordinate with the BPS as the authoritative government statistical bureau to streamline the methodology and criteria used in collecting poverty data.

[28] Social Security Agency for Health, “Sejarah Perjalanan Jaminan Sosial di Indonesia” (2018), https://bpjs-kesehatan.go.id/bpjs/index.php/pages/detail/2013/4.

[29] Government of Indonesia, “Undang-Undang No. 40/2004 tentang Sistem Jaminan Sosial Nasional” (2004), http://www.depkes.go.id/resources/download/general/UU%20No.%2040%20Th%202004%20ttg%20Sistem%20Jaminan%20Sosial%20Nasional.pdf.

[30] Premium Assistance Beneficiaries (PBI) is the common translation used by multiple official documents to refer to the government’s “Penerima Bantuan Iuran” insurance scheme (see National Team for the Acceleration of Poverty Reduction, “The Road to National Health Insurance (JKN)” (2015), http://www.tnp2k.go.id/images/uploads/downloads/FINAL_JKN_road%20to%20national%20health%20insurance.pdf.) The English translation of Indonesia’s fifth action plan’s original text refers to this term as “Health Contribution Assistance,” a translation that is not found in any other publications. In this report, the IRM researcher uses “Premium Assistance Beneficiaries” (PBI) to refer to the same subject matter.

[31] CNN Indonesia, “Jokowi Tambah 4 Juta Orang Miskin Penerima Bantuan Iuran BPJS” (9 Jan. 2019), https://www.cnnindonesia.com/ekonomi/20190109131334-78-359541/jokowi-tambah-4-juta-orang-miskin-penerima-bantuan-iuran-bpjs.

[32] Ibid.

[33] Darwanto (MediaLink), interview by IRM researcher, 7 Mar. 2019.

[34] Ibid.

[35] Hendra Kusuma, “Jokowi Pertanyakan Simpang Siur Data Kemiskinan” (Okezone, 2016), https://economy.okezone.com/read/2016/04/26/20/1372844/jokowi-pertanyakan-simpang-siur-data-kemiskinan.

[36] Central Bureau of Statistics, “Persentase Penduduk Miskin Maret 2018 Turun Menjadi 9.92 Persen” (2018), https://www.bps.go.id/pressrelease/2018/07/16/1483/persentase-penduduk-miskin-maret-2018-turun-menjadi-9-82-persen.html.

[37] BBC, “Empat Hal di Balik Angka Kemiskinan Indonesia yang Disebut Mencatat ‘Sejarah’” (18 Jul. 2018), https://www.bbc.com/indonesia/trensosial-44861258.

[38] CNN Indonesia, “Jokowi Tambah 4 Juta Orang Miskin Penerima Bantuan Iuran BPJS.”

[39] Hendra Kusuma, “Kepala BPS Blak-Blakan Soal Data dan Fakta Angka Kemiskinan di RI” (Detik Finance, 2018), https://finance.detik.com/wawancara-khusus/d-4160586/kepala-bps-blak-blakan-soal-data-dan-fakta-angka-kemiskinan-di-ri.

[40] Samuel Pablo, “Data Beras BPS dan Kementan Berbeda, Ini Penjelasannya” (CNBC Indonesia, 2018), https://www.cnbcindonesia.com/news/20181025105653-4-38964/data-beras-bps-dan-kementan-berbeda-ini-penjelasannya.

[41] Ibid.

[42] Open Government Indonesia National Secretariat, “Sosialisasi Rancangan Peraturan Presiden tentang Satu Data Indonesia” (2017), https://ogi.bappenas.go.id/news/223/sosialisasi-rancangan-peraturan-presiden-tentang-satu-data-indonesia.

[43] CNN Indonesia, “Pemerintah Terbitkan Perpres Satu Data Akhir Tahun Ini” (27 Nov. 2018), https://www.cnnindonesia.com/ekonomi/20181126142128-92-349299/pemerintah-terbitkan-perpres-satu-data-akhir-tahun-ini.

Commitments

  1. Platform for Improved Legislative Data and Information

    ID0106, 2018, Capacity Building

  2. Make Legislative Information More Accessible

    ID0107, 2018, E-Government

  3. Improving Documentation and Access to Information on Parliamentary Sessions

    ID0108, 2018, E-Government

  4. Formulation of the Open Parliament Indonesia Roadmap

    ID0109, 2018, Capacity Building

  5. Establishing the Open Parliament Indonesia Institution

    ID0110, 2018, Legislative

  6. Extractives Data Management

    ID0092, 2018, Anti-Corruption

  7. Transparency and Participation in Health Data

    ID0093, 2018, E-Government

  8. Public Service Data

    ID0094, 2018, E-Government

  9. Participatory Education Budget

    ID0095, 2018, Capacity Building

  10. Participatory Village Government Planning

    ID0096, 2018, Capacity Building

  11. Civic Participation in E-Legislation Portal

    ID0097, 2018, E-Government

  12. Election Data Openness

    ID0098, 2018, Access to Information

  13. Health Service Data

    ID0099, 2018, E-Government

  14. Public Consultation Reform

    ID0100, 2018, Capacity Building

  15. LAPOR!-SP4N Quality Improvements

    ID0101, 2018, Capacity Building

  16. Complaint System for Environment

    ID0102, 2018, Anti-Corruption

  17. Government Procurement Transparency

    ID0103, 2018, Anti-Corruption

  18. Strenthening Open Data

    ID0104, 2018, Access to Information

  19. Improvements to Legal Aid

    ID0105, 2018, Access to Justice

  20. Open Government Strategic Plan

    ID0047, 2016,

  21. Public Agency Consultation Guidlines

    ID0048, 2016, Capacity Building

  22. Good Governance Manual and Public Consultations to Reach SDGs

    ID0049, 2016, Capacity Building

  23. Geospatial Information Management

    ID0050, 2016, Capacity Building

  24. Monitoring Public Services by Ombudsman

    ID0051, 2016, E-Government

  25. Ombudsman Overseeing Public Services

    ID0052, 2016, Public Service Delivery

  26. Public Services at Ministry of Education and Culture

    ID0053, 2016, Capacity Building

  27. Public Services at Ministry of Religious Affairs

    ID0054, 2016, Public Service Delivery

  28. Development of LAPOR into SP4N

    ID0055, 2016, Capacity Building

  29. Public Complaints Administration Integration into LAPOR!-SP4N

    ID0056, 2016, Capacity Building

  30. LAPOR!- SP4N as Citizen Aspiration and Complaints Platform

    ID0057, 2016, Capacity Building

  31. 1 Million Complaints Via LAPOR! by 2016

    ID0058, 2016, E-Government

  32. LAPOR! Public Accountability

    ID0059, 2016, Public Participation

  33. Interconnectivity of SOEs to LAPOR!

    ID0060, 2016, Capacity Building

  34. Environment and Forrest Sector Public Complaints

    ID0061, 2016, E-Government

  35. Strengthened Village Governance

    ID0062, 2016, Capacity Building

  36. Public Information Disclosure Through Ministry of Health

    ID0063, 2016, E-Government

  37. Public Information Disclosure Through Ministry of Education and Culture

    ID0064, 2016, E-Government

  38. Public Information Disclosure Through Ministry of Research Technology and Higher Education

    ID0065, 2016, E-Government

  39. Public Information Disclosure at Higher Education Institutions

    ID0066, 2016, E-Government

  40. Budget Transparency Information System

    ID0067, 2016, E-Government

  41. Inter Agency Data Governance

    ID0068, 2016, Capacity Building

  42. Open Data Implementation

    ID0069, 2016, Capacity Building

  43. Public Complaints Channels

    ID0070, 2016, Capacity Building

  44. Information Disclosure at Village Levels

    ID0071, 2016, E-Government

  45. Increase in Number of Open Data

    ID0072, 2016, Access to Information

  46. Improved Public Services

    ID0073, 2016, Capacity Building

  47. Transparency in the Regional Government Budget System

    ID0074, 2016, E-Government

  48. Procurement Disclosure in Bandung

    ID0075, 2016, Anti-Corruption

  49. Enhancing the LAPOR! Application

    ID0076, 2016, E-Government

  50. Public Complaints Services in the City of Bandung

    ID0077, 2016, Public Participation

  51. Information Disclosure on Citizens’ Proposals to DPRD

    ID0078, 2016, E-Government

  52. Greater Public Participation in Disseminating Development Information

    ID0079, 2016, Education

  53. "One Data Indonesia” in Semarang.

    ID0080, 2016, Access to Information

  54. One Data Basis for Semarang

    ID0081, 2016, Access to Information

  55. Enhanced Public Information Disclosure

    ID0082, 2016, E-Government

  56. Public Monitoring of Services in Semarang

    ID0083, 2016, Capacity Building

  57. Access to Information on DPRD

    ID0084, 2016, Capacity Building

  58. Data Governance of DPRD

    ID0085, 2016, Fiscal Openness

  59. Infrastructure for Fublic Information Disclosure

    ID0086, 2016, Capacity Building

  60. Public Information Communications Strategy

    ID0087, 2016, Subnational

  61. Information Through Jakarta.Go.Id Portal

    ID0088, 2016, Capacity Building

  62. Public Services Complaint Channel

    ID0089, 2016, Public Participation

  63. Strengthening of Data Governance

    ID0090, 2016, Access to Information

  64. Public Participation in Development Planning

    ID0091, 2016, E-Government

  65. Strengthening Transparency Infrastructure of Public Bodies

    ID0028, 2014, Public Service Delivery

  66. Strengthening Infrastructure of Central and Local Information Commission

    ID0029, 2014, Capacity Building

  67. Strengthening Institutional and Human Resources Infrastructure for Public Services

    ID0030, 2014, Public Participation

  68. Improve Quality of Openness in Health Services

    ID0031, 2014, Health

  69. Improve Quality of Openness in Education Services

    ID0032, 2014, E-Government

  70. Accelerate Open and Good Governance Practices in Law Enforcement

    ID0033, 2014, E-Government

  71. Accelerate Open and Good Governance Practices in Goods and Services Procurement

    ID0034, 2014, Anti-Corruption

  72. Accelerate Open and Good Governance Practices in Business Development and Investment Sector

    ID0035, 2014, Capacity Building

  73. Accelerate Open and Good Governance Practices in Land Affairs

    ID0036, 2014, Land Rights and Spatial Planning

  74. Accelerate Open and Good Governance Practices in Management of Migrant Workers

    ID0037, 2014, Citizenship & Immigration

  75. Accelerate Open and Good Governance Practices in Hajj Management

    ID0038, 2014, Public Service Delivery

  76. Accelerate Open and Good Governance Practices in Natural Resources Management

    ID0039, 2014, Anti-Corruption

  77. Improve Public Participation in Development Planning

    ID0040, 2014, E-Government

  78. Improve Public Participation in House of Representative and Regional Representative Council

    ID0041, 2014, Legislative

  79. Improve Public Participation in Environmental Preservation

    ID0042, 2014, Environment and Climate

  80. Community Empowerment to Handle Poor Society and People with Disabilities and Special Needs

    ID0043, 2014, Health

  81. Community Empowerment to Support Environmental Sustainability

    ID0044, 2014, Environment and Climate

  82. Community Empowerment to Strengthen Agriculture Sector

    ID0045, 2014, Capacity Building

  83. Community Empowerment to Develop Creative Sector

    ID0046, 2014, E-Government

  84. Motor Vehicle Services

    ID0013, 2013, Infrastructure & Transport

  85. Public School Funding

    ID0014, 2013, Anti-Corruption

  86. Hajj Services: Ministry of Religious Affairs

    ID0015, 2013, Anti-Corruption

  87. Marriage Services: Office of Religious Affairs

    ID0016, 2013, Public Service Delivery

  88. Toll Roads

    ID0017, 2013, Public Service Delivery

  89. Land Affairs Transparency

    ID0018, 2013, E-Government

  90. Forest Management

    ID0019, 2013, Anti-Corruption

  91. Transparency and Accountability in Natural Resources Management Activity

    ID0020, 2013, Access to Information

  92. Oil, Gas, and Mining Revenue Transparency

    ID0021, 2013, Anti-Corruption

  93. Appointments of Information and Documentation Management Officials (PPID) in National Agencies and Enactments of their Standard Operating Procedure

    ID0022, 2013, Access to Information

  94. Starred commitment Formulation of a Working Plan and a Well-Operated Tracking System for Business/Investment Licensing Servies in 10 Provinces and 10 Regencies/Cities

    ID0023, 2013, E-Government

  95. Encouraging the Acceleration of the Operational Formation for Information Services in Local Government through the Formation of Local Government's PPID and its Tools

    ID0024, 2013, Access to Information

  96. Encouraging Comprehensive Implementation of Open Government in Pilot Province/Regency/City

    ID0025, 2013, Subnational

  97. Integration of Performance-Based Budgeting

    ID0026, 2013, Fiscal Openness

  98. Ensuring the Publication of Budget Plan (RKA/DIPA)

    ID0027, 2013, Fiscal Openness

  99. Poverty Reduction

    ID0001, 2011, E-Government

  100. Education Subsidies

    ID0002, 2011, Education

  101. Health Subsidies

    ID0003, 2011, Health

  102. Police

    ID0004, 2011, Dispute Resolution & Legal Assistance

  103. High Corruption Risk

    ID0005, 2011, E-Government

  104. Civil Service Recruitment

    ID0006, 2011, Capacity Building

  105. Land Administration

    ID0007, 2011, E-Government

  106. National Budget Information

    ID0008, 2011, Anti-Corruption

  107. District Budget Information

    ID0009, 2011, Fiscal Openness

  108. e-Procurement

    ID0010, 2011, Anti-Corruption

  109. One-Map Portal

    ID0011, 2011, E-Government

  110. Environmental Openness

    ID0012, 2011, Anti-Corruption

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