1. What is the meaning of the gap of health facilities?

The Gap of Health Facilities is an inequity of a health facility from one region
to another region. This is a big problem underlying a country, because it is one of
the benchmarks of a country can be said developed countries, developing
countries or poor countries. This gap can be caused by several factors.
2. Why there is a gap of health facilities in indonesia?
a. Poor access to the remote area
Poor access to the remote area is one of the main problem in Indonesia. Poor
access can have an impact on many things, such as health. The poor access
causes health facilities, such as ambulance, hearse, and medicine stocks
difficult to get in the area.
b. The lack of experts in remote area
Most of experts such as doctors, midwives, and nurses in Indonesia are
concentrated in urban areas. High salaries do not guarantee the experts to work
in remote areas. For example is a case in the Southeast Sulawesi, where the
central government has set up the salary of 10 million rupiah per month. It still
does not attract many doctors to work there.
c. The lack of health facilities
Health facilities includes health services (Puskesmas and hospitals) and health
instrumentation. Generally in remote areas, health centers are not used
optimally. In addition, instrumentation health in remote areas is not adequate.
This problem certainly cannot be separated from the bad access roads which
lead to the hampered of health instrument distribution.
d. The lack of health counseling in remote areas
Counseling is an important media to share knowledge in the community.
Through counseling, the experts can explain many things related to health.
However, in some remote areas there was virtually no health counseling. Some
areas even still believe in mystical things to solve the problems of health.
3. Which areas that includes The Gap of Health Facilities
an area called underdeveloped areas, based from the five criterias, they are:
economy, human resources, facilities and infrastructure (health), local financial
capacity, the accessibility and characteristics of the area. based on the presidential
regulation about the underdeveloped area years 2015-2019. The Underdevelopes
areas in indonesia are
1. Aceh Province (Aceh Singkil Region)
2. North Sumatera Province (Nias Region, South Nias Region, North Nias Region,
West Nias Region)
3. West Sumatera Province (Kepulauan Mentawai Region, South Solok Region, West
Pasaman Region
4. South Sumatera Province (Musi Rawas Region, North Musi Rawas Region)
5. Bengkulu Province (Seluma Region)
6. Lampung Province (West Lampung Region, West Pesisir Region)
7. East Jawa Province (Bondowoso Region, Situbondo Region, Bangkalan Region,
Sampang Region)
8. Banten Province (Pandeglang Region, Lebak Region)
9. West Nusa Tenggara (West Lombok Region, East Lombok Region, Sumbawa
Region, Dompu Region, Bima Region, West Sumbawa Region, North Lombok

Region.
10. East Nusa Tenggara (West Sumba Region, East Sumba Region, Kupang Region,
Belu Region, Alor Region, Lembata Region, Ende Region, Manggarai Region, Rote
Ndao Region)
13. South Kalimantan Province (North Hulu Sungai)
14. East Kalimantan Province (Nunukan Region and Mahakam Ulu Region)
16. South Sulawesi Province (Janeponto Region)
17. Southeast Sulawesi Province (Konawe Region, Bombana Region, Konawe Island
Region)
18. Gorontalo Province (Boalemo Region, Pohuwato Region, North Gorontalo
Region)
19. West Sulawesi Province (Polewali Mandar Region)
20. Maluku Province (Buru Region, Kepulauan Aru Region, West Seram Region, East
Seram Region, Southwest Maluku Region, South Buru Region)
21. North Maluku Province (West Halmahera Region, Kepulauan Sula Region, South
Halmahera Region, East Halmahera Region, Morotai Island Region, Taliabu Island
Region)
22. West Papua Province (Teluk Wondama Region, Teluk Bintuni Region, South
Sorong Region, Sorong Region, Raja Ampat Region, Tambrauw Region, Maybrat
Region)
23. Papua Province (Merauke Region, Jayawijaya Region, Nabire Region, Kepulauan
Yapen Region, Biak Numfor Region, Paniai Region, Puncak Jaya Region)
4. What is the impact of gap of health facilities in Indonesia?
a. High Infant mortality rate
The Gap of Health Facilities is one of major problems that must be resolved.
because the gap of health facilities may lead to some impacts to community
1. Increased Infant mortality rate. It can't be denied that the infant mortality rate
can be quite high, although in 2015 already decreased.the distributions of
health facilities are expected to be able to reduce infant mortality.

Infant mortality rate

35000
30000
25000
20000
15000
10000
5000
0

2013

2014
Angka Kematian Bayi

2. High Maternal Mortality Rate

2015

Maternal Mortality Rate (MMR) is one indicator to view the health status of
women.
One of the causes of maternal deaths are late to recognize the danger signs
because they do not know the pregnancy is risky, too late to reach the facility
for delivery, and too late to get service. Including lack of access to maternal
health care quality, which caused the spread of the health service which has
not been optimal. The quality and effectiveness of inadequate maternal health
care, maternal health referral system is not yet stable, and weak health
management at various levels.
The Department of Health set a target of 90 per cent of births assisted by
medical personnel in 2010. A comparison with the results of surveys Central
Bureau of Statistics survey in 2009, the percentage of delivery using the
services of health professionals (doctors, midwives and medical personnel) as
much as 77%, which is approximately 22 % were still using the services of
non-medical personnel.
Even if there are already services for maternal health care, such as midwives
trained, the amount is not adequate to the number of existing population and
geographical area.
3. High Rate of Malnutrition
High rate of malnutrition is one of the references that occur Gaps health
facilities in Indonesia. A total of 1,918 children in East Nusa Tenggara suffer
from malnutrition during January-May 2015. Recorded 11 children under the
age of five die of malnutrition. In addition, there are 21.134 toddlers are
malnourished. Cases of malnutrition occur in almost all districts in NTT.
Most cases in the District of Southwest Sumba, Kupang, South Central Timor
District, and North Central Timor district. In addition to poverty, high rates of
malnutrition are also influenced by the lack of understanding mothers on
nutritious food. It became the responsibility of the state to continue to improve
health facilities so as to reduce the rate of malnutrition in Indonesia.
5. What is the solution to solve this problem?
A. Alleviate the cost of education for doctor, with some provisions such as after graduate they
must be willing to placed in every place in Indonesia.
As we know medical education cost in Indonesia is quiet expensive. Favorite campus with
cost could reach IDR 200 million still be demanded. This fact shows that Indonesian students
have big interest in medical education.
B. Government and citizen can cooperate to build infrastucture. So the access to get in the
remote area is getting easier.
C. Build a counseling team to inform the citizens. This counseling team tasked to inform
about health and health facilities.
D. Goverment can Increase the budget that allocated for health facilities.
6. Who should be involved to solve this problem?
1. Government
Central or regional government should understand well in countries such as
equitable distribution of health facilities.Therefore, the Government should pay

more attention to the people not only in Papua but throughout Indonesia. By way
of reward as well as concern for health workers who want to become volunteers in
remote areas will attract a lot of attention to health workers. Extension quiet
diseases that may occur in the area is done directly by the health workers to the
countryside will increase public awareness of dangerous diseases and the
importance of cleanliness and opportunities to the community by the spread of
dangerous diseases as well as the high number of deaths will decrease.
2. Society Experts
Experts especially in the health sector in Indonesia are very much like Doctors
Association, nurses Association, midwives Association, pharmacists Association
etc. An association was expected to help resolve the problem the gap facility in
Indonesia for example predictably create a plan to visits a places that need of
health experts.
3. Departments Of Health
Each area have Departments of Health. Departments of Health is very important
to help the government solve the problem.
4. Students College
The number of students in Indonesia very much. Students College can help
resolve the problem of gap of health facilities in Indonesia in various ways, for
example by conducting social activities to areas that have few health facilities.
5. People (Volunteer)
Actually, People has a major influence on the problem Gaps of health facilities in
Indonesia. People in other areas can volunteer to go into areas that have a
complete lack of health facilities. With the role and awareness to help others, the
gap of health facilities will be solved.
7.