About Indonesia

Indonesia is the world’s largest island country and fourth-most populous nation — comprised of more than 17,000 islands home to over 267 million people.

Despite steady advances in health care over the past decade, significant disparities remain between urban and rural areas. Many women and children struggle to access quality health services, and high rates of mortality and malnutrition persist. There is also urgent need to help manage and treat diabetes, tuberculosis, and respiratory diseases — all three among the leading causes of death in the country.

The archipelago nation is also one of the most vulnerable and disaster-prone countries on earth. As the climate crisis intensifies, so does the threat of deadly natural disasters like the 2018 Sulawesi earthquake and tsunami. Meanwhile, the more subtle impacts of climate change (rising temperatures, shorter growing seasons, unpredictable rainfall) could limit essential food and water supplies and erode the nation’s health.

The Challenges

Maternal and child health

Many rural districts in Indonesia struggle with high maternal mortality rates, often because formal health services are either too expensive or far away. In 2018, there were 177 maternal deaths per 100,000 live births nationwide.

Infant mortality is also a major concern. For every 1,000 babies born, 25 will die before turning 5. Many of these deaths are the result of malnutrition. Millions of Indonesian children suffer from stunting and wasting. In 2018, 10% of children were reportedly malnourished, while close to 1 in 3 were stunted.

The rise of noncommunicable diseases

Noncommunicable diseases such as respiratory infections and diabetes account for the majority of all premature deaths in Indonesia.

Diabetes is a top health concern: Death and disability from diabetes increased by 38% between 2006 and 2018. Today, more than 10 million people in Indonesia are living with diabetes, translating to a prevalence rate of 6.2% and making it one of the 10 worst countries for diabetes in the world.

It’s estimated nearly half of all cases in the country actually remain undiagnosed, especially among young people, who make up almost half of the country’s population.

Location is one of the greatest hurdles to health care in Indonesia, and lack of access to services in rural areas makes early detection (and prevention) of diabetes especially challenging. It’s likely that the numbers will only continue to increase if efforts to prevent and manage the condition are not effectively implemented.

High incidence of TB

Indonesia is one of eight countries that account for the majority of all global TB cases. New cases in the country increased by 28% between 2017 and 2018, reaching 316 cases per 100,000 people, but many people with TB are never diagnosed and never access health care.

TB remains one of the top 5 causes of death in the country and also takes a huge economic toll, costing the nation nearly $7 billion in 2015.

Bringing HOPE to Indonesia

Our history in Indonesia

HOPE’s work in Indonesia dates back to 1960, with the maiden voyage of the SS HOPE.

Since 2005, we have implemented highly successful maternal, newborn, and child health programs on the islands of Sumatra and Java, in districts and regions where mortality remains especially high. In 2012, our programs expanded to support women in the workplace and to provide diabetes education for primary care physicians. We have also worked to reduce morbidity and mortality related to asthma.

HOPE has also shown up on the front lines of Indonesia’s most urgent natural disasters, starting with the 2004 tsunami and more recently the 2018 earthquake and tsunami. Earlier that year, in March 2018, we created a local entity, Yayasan Project HOPE, to be able to respond locally for emergency response and to implement Project HOPE’s health projects.

Responding to disaster & crises

HOPE stands ready to respond in times of crisis and disaster. In response to COVID-19, HOPE has mobilized personal protective equipment and facilitated live remote trainings for frontline health workers in Indonesia. At the same time we are addressing immediate patient and health worker needs, we are also focused on building health system capacity across the nation to prevent, control, and tackle infectious diseases in the future.

Learn more about our ongoing response to COVID-19

When natural disasters strike, HOPE sends staff and volunteers to provide critical medical support and deliver lifesaving medicine and relief. We also stay for the long haul, to help islands rebuild their health systems long after the headlines fade.

In September 2018, after a deadly tsunami devastated the island of Sulawesi, HOPE was one of the first to arrive in the hard-hit city of Palu with medical volunteers, supplies, and medicines. Our response extended beyond urgent care: To prevent malaria and other vector-borne diseases, we distributed 112,000 insecticide nets to over 58,000 households. To restore access to clean water and sanitation, we installed three water purification systems at health clinics and trained unit operators and community members in their continued maintenance and use. We also screened 10,000 people for malaria and 13,000 for NCDs.

Read: Field Update: The Devastation in Palu, Indonesia Lives On

HOPE is also focused on building local capacity to respond in times of emergency. Thanks to support from Medtronic, we recently launched our very first regional emergency response hub. Based in Jakarta, the hub will strengthen our emergency response programming and build a roster of regionally-based volunteers ready to respond when the next tsunami, typhoon, or cyclone hits.

Reaching women and children with care

Our work in Indonesia centers around improving health outcomes for mothers, newborns, and children.

Since 2005, HOPE has been working with local government and community partners to improve access to skilled maternal, newborn, and child care, particularly in areas where mortality remains high.

Outreach events have been especially effective in keeping families active and invested in their health. In villages, volunteers and midwives hold monthly wellness clinics to reach some of the nation’s the most vulnerable mothers and children. Mothers are invited to bring their children for wellness checks and to receive health education and essential supplements.

View photos: Mothers in Indonesia Couldn’t Reach Care, So it Came to Them

Training and equipping health workers

Strengthening the health workforce is key to improving health outcomes for women, newborns, and children. Throughout Indonesia, HOPE trains health center staff, midwives, and volunteers on basic and essential maternal and newborn care.

In 2013, HOPE began working with the Serang District Health Office to train health center staff on emergency and obstetric neonatal care and to train community midwives on the package of Minimum Activities for Mothers and Newborns. The current program is supported by Johnson & Johnson through Give2Asia.

Midwives and volunteers are essential to bridging the gap between rural villages and formal care and are trained to walk alongside women throughout pregnancy and delivery. Volunteers meet with new mothers every month during pregnancy, encourage them to deliver in public health centers instead of at home, and check in frequently to make sure new mothers are breastfeeding and immunizing their newborns. Midwives, meanwhile, are more prepared to deliver lifesaving care for women who need it most.

View photo essay: In Serang, Midwives Stand in the Gap

HOPE also supports public health centers with new equipment to keep facilities up to date, like incubators and thermometers.

Additionally, with support from AstraZeneca Indonesia, HOPE worked with the Indonesian Ministry of Health to reduce morbidity and mortality related to asthma in Jakarta, Yogyakarta, and Lampung. The program trained health care providers, strengthened care facilities, and increased awareness among patients and their families to support early detection and treatment of asthma.

Our Impact

Over the course of 30 years, HOPE has trained thousands of health workers to improve access to lifesaving care for mothers, newborns, and children across Indonesia. Since 2016, this training has made the difference between life and death for more than 85,000 mothers and 11,000 newborns.

In recent years, wellness fairs and other outreach events on Java have been essential in keeping women and children active and invested in their health. More and more women are delivering safely at health centers instead of at home, and mortality rates are dropping as a result. Health education has also led to increases in breastfeeding and vaccination rates.

Our work to improve treatment and management of asthma has also resulted in substantial impact in the districts of Bandung and Bantul. Last year alone, we helped diagnose more than 5,600 people with asthma, and connected more than 11,600 patients with treatment at community health centers. Many patients experienced greater control of their condition as a result, and fewer patients had to make emergency trips to the hospital.