The Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) still show high prevalence in Indonesia. Data from the 2023 Indonesian Health Survey (SKI) indicates that 1 in 5 toddlers experience stunting, and the incidence of women, including pregnant mothers, suffering from both infectious and non-communicable diseases still occurs, such as the prevalence of anemia among pregnant women at 28%.
Against this backdrop, Dini Kurniawati, a master’s student in the Public Health Science Program at FPH UI 2023, along with a team from Thinkwell, LLC/USAID Health Financing Activity, provided a policy recommendation titled “Potential Cost Savings from Screening Prospective Brides and Grooms to Reduce Disease” in the 2024 Health Policy Recommendation Competition (SiBijaKs) Awards. On October 18, 2024, Dini and her team won 1st place in the general category.
The SiBijaKs Awards 2024 is a competition for writing health policy recommendations, with data from the 2023 Indonesian Health Survey (SKI) as the primary data source. The recommendation format involves policy briefs focused on a specific policy issue, offering alternative solutions for problems requiring immediate attention from policymakers.
Dini Kurniawati and her team recommended expanding premarital screening programs in Indonesia, along with cost calculation formulas and the potential savings for the government’s budget.
“Screening efforts are beneficial to prevent disease transmission among couples and to the fetus. In Indonesia, premarital screening has been implemented in Jakarta since 2017. Therefore, if the Ministry of Health intends to implement premarital screening nationwide, a formula for calculating the required budget and understanding the potential savings from this policy are essential,” said Dini Kurniawati.
The calculation formula developed by Dini and her team projected the number of couples in the next five years, taking into account the unit costs for each screening component and the inflation rate. The proposed screening benefit package consisted of three scenarios: the Minimal Package, which includes physical and mental health screenings, admission costs, and hemoglobin tests; the Moderate Package, which includes the minimal package plus HIV, syphilis, hepatitis B, tuberculosis, diabetes mellitus, and hypertension screenings; and the Comprehensive Package, which adds thalassemia testing to the moderate package. The formula also used two assumptions (with or without considering JKN participation for prospective brides and grooms).
“Financing discussions are quite appealing but not widely written about. We calculated the target number of prospective brides and grooms, multiplying it by the unit cost of each screening. In 2025, based on assumption 1, the estimated cost ranges from IDR 44-256 billion, and with assumption 2, from IDR 26-238 billion. After this calculation, we compared it with the annual budget burden of several previously identified diseases. The results were significantly lower than the previous budget burdens,” explained Dini Kurniawati.
“This can be implemented according to the chosen assumptions or scenarios by the Ministry of Health. In the long term, we hope to generate savings in social security funds, with the government monitoring the use of the screening program and its impact on reducing diseases and the cost savings it generates.”
As a result of winning the SiBijaKs Award 2024, Dini and her team were invited to present their recommendations to the senior officials at the Ministry of Health to discuss the follow-up regarding the policy recommendations, together with the Director-General of Public Health and the Directorate of Productive Age and Elderly (UPL), who are responsible for implementing the screening if it is adopted.
Dini and her team’s achievement is a proud accomplishment and has been recognized by the faculty leadership. “As academics, one of our duties is to contribute our thoughts for improving and solving health issues in our beloved country. Dini Kurniawati and her team have made a real contribution through their achievement in providing health policy recommendations. We hope that such health policy recommendations will continue to emerge from FPH UI students,” said Dr. Ir. Asih Setiarini, M.Sc., Vice Dean for Education, Research, and Student Affairs at FPH UI.
“We hope that what we have proposed can be beneficial for the Ministry of Health in making evidence-based policy decisions. In the future, we also expect a reduction in the prevalence of both infectious and non-communicable diseases as well as hereditary diseases. We hope this policy can support successful pregnancies and contribute to a healthy generation, reducing MMR and IMR,” concluded Dini Kurniawati with her hopes for the future. (wrk)