The Sustainable Development Goals (SDGs) put much emphasis on the attainment of the universal health coverage, globally (1). However, ensuring that health services are accessible to the geographically hard to reach groups remain a critical challenge for most countries (2). Health services in many countries contend with extensively large geographical distances, impassable roads as well as completely isolated islands from the mainstream country and important cities (3).
This essay will discuss about Indonesia, an archipelago with over 17,000 islands (4) in the South East Asia. Indonesia has been selected because of the huge number of geographically isolated islands and the competing goal for the country to achieve universal health coverage (5). According to the 2012 Demographic and Health Survey (DHS), Indonesia had a projected population of about 257 million by 2015 (5), ranking it the world’s fourth most populated country with over 90% of the people living in the islands (6). The country is predominantly mountainous with coastal lowlands and several rivers provide the only feasible means of access to the islands (5). Apart from lack of staff, the health system faces challenges like long distances to nearest health facilities, frequent volcanic eruptions, and lack of communication systems as well isolated referral hospitals (7).
Strategies to improve access to health services in remote areas of Indonesia
The World Health Organisation (WHO) recommends various strategies aimed at improving access to the health services in the remote and hard to reach areas. These strategies include constructing rural health facilities, conducting outreach or mobile clinics, recruit...
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...inics require huge resources like finances, health workers, transport and supplies for sustainability. Peters found that lack of suitable vehicles for transport was the main reason for cancellation of most mobile clinics in Nigeria (27). Furthermore, the high requirement for many professional health workers to reach all the Indonesian Islands may limit the implementation of this strategy considering that there is already a critical shortage of health staff in the country (6). Finally, although the outreach clinics promote the integration of health services (8), they have not been responsive to the social and cultural needs of the local communities because of the limited time available for these programs (2, 8). Most of the health professional involved in mobile clinics come from other areas and provide services to communities with different cultures and behaviours.
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