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the World Bank (5). The
Government of Indonesia
recognizes 6 religions
(Islam, Protestantism,
65,659,726 (25.42)
Catholicism, Hinduism,
44,002,071 (17.04)
109,401,097 (42.35)
Buddhism and Confucia-
21,708,913 (8.40)
nism). Indonesia is quite
17,544,244 (6.79)
diverse in terms of ethnic
258,316,051 (100.00)
groups, with Javanese
the largest group, follow
by Sundanese and Malay,
at 40.1%, 15.5% and 3.7%, respectively. The
proportion of other ethnic groups is less than
3.7%. The official language is Bahasa Indonesia
(4), but the diversity of ethnic groups means that
Indonesia has more than 700 languages.
The prevalence of non-communicable diseases
is higher than that of communicable diseases.
Stroke, cancer, coronary heart disease and diabe-
tes mellitus are the most common causes of death
in Indonesia (Table II) (6). Risk factors, such as
alcohol consumption, are 0.09 (in litres of pure
alcohol) per capita (7). The prevalence of tobacco
smoking is 76.2% (8).
Indonesia has a national health system (NHS),
which was implemented in 1982. This has been
revised several times, including in 2004, 2009
and 2012. In the latest version, Indonesia decla-
red that, by 2019, the country will provide an
affordable health system that can be accessed by
all citizens (9). This policy has been further sup-
ported by the establishment of a Social Security
Administration (SSA) in 2014, called the Badan
Penyelenggara Jaminan Sosial (BPJS) (10, 11).
SSA works on health and employment issues.
Health service provision in Indonesia can be di-
vided into primary, secondary and tertiary levels.
Community-based rehabilitation services (CBR)
are also available in many parts of the country.
Other community-related services, including
maternal and child health centres (integrated
service post/Pos Pelayanan Terpadu (Posyandu))
(12), are spread across the whole of Indonesia and
reach the lowest level of governmental structure.
In general, the health workforce in Indonesia is
quite low; for example, the density of physicians
is 0.21 per 1,000 population (13).
Table I. Population of Indonesia according to age structure (4)
Age structure Male
n (%) Female
n (%)
0–14 years
15–24 years
25–54 years
55–64 years
> 65 years
Total 33,435,020 (12.94)
22,397,086 (8.67)
55,857,415 (21.62)
9,918,897 (3.84)
7,630,251 (2.96)
129,238,669 (50.03) 32,224,706 (12.48)
21,604,985 (8.36)
53,543,682 (20.73)
11,790,016 (4.56)
9,913,993 (3.84)
129,077,382 (49.97)
government and non-state actors (NSAs) documents
(including their websites), interviews by phone and
email with NSAs, which focus on rehabilitation
service delivery. All the information was discussed
and summarized during an authors’ group held in
Hannover, and a list of generic recommendations was
generated as a proposal to strengthen rehabilitation
services at the level of health systems in Indonesia.
RESULTS
General country information, public health
indicators, and health system information
Indonesia is a large country with a population of
approximately 260 million. It is the fourth most
populated country in the world (4). Indonesia
consists of more than 13,000 islands (4), many
of which have poor infrastructure and difficulty
accessing health services.
Indonesia has a young population (Table I);
more than 42% of the population is below 25 years
of age, with 21.6% male and 20.8% female. The
total working age population (25–64 years old)
is 42.3%. Approximately 7% of the population
is over 65 years old. Indonesia is categorized
as a lower middle income country according to
Table II. Eleven main causes of death in Indonesia
(modified; (6))
Deaths
Number Cause of death n (%)
1
2
3
4
5
6
7
8
9
10
11 Stroke
Cancers (in total)
Coronary heart disease
Diabetes mellitus
Influenza and pneumonia
Tuberculosis
Liver disease
Lung disease
Road traffic accident
Hypertension
Kidney disease 328,524 (23.48)
140,457 (10.04)
138,380 (9.89)
100,430 (7.18)
81,129 (5.80)
66,713 (4.77)
48,858 (3.49)
48,090 (3.44)
44,594 (3.19)
42,226 (3.02)
41,042 (2.93)
www.medicaljournals.se/jrm
Total
n (%)
Information on the assessment and
epidemiology of disability
Disability in Indonesia is defined in National
Law number 8, 2016, based on the framework of
the International Classification of Functioning,
Disability and Health (ICF) (15).