How Tech Startups are Bringing Healthcare to Indonesia's Rural Areas
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Healthcare in Indonesia has never been recognised as world-class; and local doctor visits have always been a crapshoot. If your daughter comes down with a fever or even a case of strep throat, it might be fine to visit the local clinic, but you’d still want to get a good doctor referral from your friends ahead of time.
If your family discovers that your father has a brain tumor (and you’re in any way part of the nation’s middle-class) he would have to be on the next flight to Singapore or Malaysia. It would be unthinkable to roll the dice on a local brain surgeon, even in major cities like Jakarta or Surabaya.
On the other hand, if your family lives in one of the Indonesia’s remote or rural areas, options become far more limited. In all likelihood, your father won’t be leaving the country.
The World Health Organization (WHO) calls reliable medical care a “basic human right,” and yet one of the major barriers to creating a quality healthcare system in Indonesia is a painful lack of qualified specialists and nurses. This is especially visible in the nation’s rural areas, where 50 per cent of Indonesia’s more than 260 million population resides.
In this country, only around 600 specialist physicians graduate each year, and many of them choose to start careers in the pharma or insurance sectors because the money is just better. Stakeholders will tell you that this shortage of doctors is challenging, particularly when it comes to building and staffing new hospitals in second tier cities.
The uneven geographical distribution of medical professionals is tough (as it is in other countries too) because doctors can be reluctant to practice in rural areas, according to a recent EY report. Nearly 50 per cent of all healthcare professionals in Indonesia disproportionately practice on the islands of Java and Bali.
While the country’s ratio of hospital beds to population is the lowest in ASEAN and among the lowest in the world, the average bed occupancy rate of 64 per cent in recent years was well below the Ministry of Health’s ideal ratio of between 80 per cent and 85 per cent.
Another key indicator to be aware of is that around 70 per cent of childbirths in rural areas take place at home. Meanwhile, almost 33 per cent of childbirths in urban areas still take place at home, according to a WHO estimate made a few years back.
Building hospitals and staffing them up can take years. Meanwhile, recent studies claim that the Indonesian healthcare industry at large is ripe for investment and overhaul today. So this begs the question: How can new tech ease common healthcare woes at scale in Indonesia’s poor, rural, and remote areas?
Much like how the local fintech industry is all about basic financial inclusion, the health-tech space in Indonesia needs to find ways to provide basic medical inclusion. We can already see startups leveraging the internet in interesting ways.
Backed by the nation’s homegrown ride-hailing giant, one startup I find interesting is a health-tech platform that connects patients with doctors, insurance, labs, and pharmacies in one mobile app. It provides a network of 19,000 licensed doctors and 1,000 partner pharmacies via medical delivery service and licensed medical lab services. Users can communicate with medical professionals via chat, video and voice call.
Another interesting example is an internet of things (IoT)-driven company that empowers rural midwives to record fetal heartbeat and uterine contractions during pregnancy via smartphone. The results are sent automatically to OB-GYN doctors on standby for further analysis and sent back to the midwife shortly thereafter. The goal of this company is to lower the mortality rate of mothers and babies in poor and rural Indonesia via an affordable cardiotocography device, accurate and timely diagnosis, and better governance of the process overall.
It looks like the pharmacy game is quickly going online, too. There are online pharmacies in Indonesia that operate 24*7. After a consultation, drug orders are shipped via a one-hour delivery option from the nearest participating pharmacy. If there’s no pharmacy anywhere close to user's location, its app offers one-day delivery and courier packages. Users can also redeem doctor prescriptions via the app.
The healthcare space in Indonesia is definitely at an early stage of its development, with a substantial imbalance between demand and supply. Following the country's implementation of Universal Health Coverage via Social Security Administrator for Health (BPJS Kesehatan) in 2014, it’s now plain to see that the sector is primed to surge tomorrow for those who invest today.