Indonesia began rolling out free health screenings across the country, fulfilling a popular campaign pledge by President Prabowo Subianto to boost preventative health care even as the former general reins in other spending in the world’s fourth most populous nation.
The programme, expected to cost about 4.7 trillion rupiah ($288 million) this year, comes as investors closely watch how the new president reconciles his ambitious social agenda, including a signature free-meal programme for students, with plateauing growth and fiscal constraints. It debuted Monday despite a wider spending freeze that has left many ministries in limbo, with officials under pressure to free up budgets for the president’s priority programmes.
“This is not just a public policy initiative, but a deeply personal priority for the president,” said D. Nicky Fahrizal, a Jakarta-based researcher at the Center for Strategic and International Studies. Still, “for a programme to remain relevant, it must align with fiscal capacity.”
The new programme will eventually give Indonesia’s population of more than 280 million people access to preventative screenings for conditions such as congenital heart disease, diabetes and cancer. For now, the checks are available primarily to children under the age of six and adults 18 and older, as well as for people with birthdays in the first two months of the year. Kids aged seven to 17 will get access to free screenings later this year.
There were queues at public health facilities around the main island of Java and in other parts of the archipelago, television broadcasts showed.
The programme is “a birthday gift from the state,” Ossy Dermawan, deputy minister of agrarian affairs and spatial planning, said while visiting a clinic outside of Jakarta, Liputan 6 broadcast. Participants must get their check-up in the three months following their birthday.
In Surabaya, Health Minister Budi Gunadi Sadikin presented a group of participants with a birthday cake.
Officials spared the programme despite broader spending freezes, which are largely designed to give government agencies time to identify funds that can be reallocated to Prabowo’s social welfare programmes. The president today said he wants unnecessary spending stopped, but that he faces some opposition within the civil service.
“In the bureaucracy, there are those who already feel immune to the law, feel like they have become little kings,” Prabowo said in a speech today. “I want to save money and that money is for the people. To feed the children of the people, to fix all the schools in Indonesia.”
Low life expectancy
The free health checks are among the president’s most popular policies, according to a recent survey, and helped push his approval ratings to the highest level since he took office in October.
They mark a change from a system in which Indonesians typically pay a small fee for basic health checks. The programme is also open to all citizens, not just those enrolled in an existing national health insurance system, marking a potential shift in health care accessibility.
Southeast Asia’s largest economy has long struggled to improve its health care access and quality, particularly in rural areas. The country’s average life expectancy at birth was 68.3 years in 2021, with strokes, heart disease and tuberculosis among the leading causes of death, according to the World Health Organization.
A 2023 national health survey found that 21.5% of children under five suffer from stunted development, while more than 31,000 young children were diagnosed with congenital heart disease. In the 2021 Global Health Security Index, Indonesia ranked 45th out of 195 countries, underscoring the scale of challenge Prabowo faces in improving health care services.
Indonesia in 2023 revised a health care law to address gaps in coverage, but the system remains overburdened, with preventive care historically overlooked in favour of treatment.
“Prevention is far better and much cheaper than treatment,” Agus Harimurti Yudhoyono, coordinating minister for infrastructure and regional development, said while visiting a clinic outside of Jakarta, television broadcasts showed. “This is a form of commitment to the people.”