Quality of physical resources of health facilities in Indonesia: a panel study 1993-2007.
OBJECTIVE
The merits of mixed public and private health systems are debated. Although private providers have become increasingly important in the Indonesian health system, there is no comprehensive assessment of the quality of private facilities. This study examined the quality of physical resources of public and private facilities in Indonesia from 1993 to 2007.


METHODS
Data from the Indonesian Family Life Surveys in 1993, 1997, 2000 and 2007 were used to evaluate trends in the quality of physical resources for public and private facilities, stratified by urban/rural areas and Java-Bali/outer Java-Bali regions.


METHODS
The quality of six categories of resources was measured using an adapted MEASURE Evaluation framework.


RESULTS
Overall quality was moderate, but higher in public than in private health facilities in all years regardless of the region. The higher proportion of nurses and midwives in private practice was a determinant of scope of services and facilities available. There was little improvement in quality of physical resources following decentralization.


CONCLUSIONS
Despite significant increases in public investment in health between 2000 and 2006 and the potential benefits of decentralization (2001), the quality of both public and private health facilities in Indonesia did not improve significantly between 1993 and 2007. As consumers commonly believe the quality is better in private facilities and are increasingly using them, it is essential to improve quality in both private and public facilities. Implementation of minimum standards and effective partnerships with private practice are considered important.
School of Pharmacy, The University of Queensland, 20 Cornwall St, Woolloongabba, QLD 4012 Australia. s.hollingworth@uq.edu.au.
Aly
A
Diana
Samantha A
SA
Hollingworth
Geoffrey C
GC
Marks
D006268:Health Facilities / Q000592:standards*; D006295:Health Resources / Q000458:organization & administration / Q000592:standards; D006801:Humans; D007214:Indonesia; D017149:Private Sector / Q000592:standards; D017150:Public Sector / Q000592:standards; D019984:Quality Indicators, Health Care / Q000592:standards; D011787:Quality of Health Care / Q000592:standards
Indonesia; health facilities; health resources; private provider; public provider; quality assessment