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Subnational regional inequality in the public health development index in Indonesia
Background: Achieving the Sustainable Development Goal of ‘ensuring healthy lives and promoting well-being for all at all ages’ necessitates regular monitoring of inequality in the availability of health-related infrastructure and access to services, and in health risks and outcomes. Objectives: To...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Taylor & Francis
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011993/ https://www.ncbi.nlm.nih.gov/pubmed/30220248 http://dx.doi.org/10.1080/16549716.2018.1500133 |
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author | Suparmi, Kusumawardani, Nunik Nambiar, Devaki Trihono, Hosseinpoor, Ahmad Reza |
author_facet | Suparmi, Kusumawardani, Nunik Nambiar, Devaki Trihono, Hosseinpoor, Ahmad Reza |
author_sort | Suparmi, |
collection | PubMed |
description | Background: Achieving the Sustainable Development Goal of ‘ensuring healthy lives and promoting well-being for all at all ages’ necessitates regular monitoring of inequality in the availability of health-related infrastructure and access to services, and in health risks and outcomes. Objectives: To quantify subnational regional inequality in Indonesia using a composite index of public health infrastructure, services, behavioural risk factors and health outcomes: the Public Health Development Index (PHDI). Methods: PHDI is a composite index of 30 public health indicators from across the life course and along the continuum of care. An overall index and seven topic-specific sub-indices were calculated using data from the 2013 Indonesian Basic Health Survey (RISKESDAS) and the 2011 – Village Potential Survey (PODES). These indices were analysed at the national, province and district levels. Within-province inequality was calculated using the Weighted Index of Disparity (IDISW). Results: National average PHDI overall index was 54.0 (out of a possible 100); scores differed between provinces, ranging from 43.9 in Papua to 65.0 in Bali. Provinces in western regions of Indonesia tended to have higher overall PHDI scores compared to eastern regions. Large variations in province averages were observed for the non-communicable diseases sub-index, environmental health sub-index and infectious diseases sub-index. Provinces with a similar number of districts and with similar overall scores on the PHDI index showed different levels of relative within-province inequality. Greater within-province relative inequalities were seen in the environmental health and health services provisions sub-indices as compared to other indices. Conclusions: Achieving the goal of ensuring healthy lives and promoting well-being for all at all ages in Indonesia necessitates having a more focused understanding of district-level inequalities across a wide range of public health infrastructure, service, risk factor and health outcomes indicators, which can enable geographical comparison while also revealing areas for intervention to address health inequalities. |
format | Online Article Text |
id | pubmed-7011993 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-70119932020-02-24 Subnational regional inequality in the public health development index in Indonesia Suparmi, Kusumawardani, Nunik Nambiar, Devaki Trihono, Hosseinpoor, Ahmad Reza Glob Health Action Original Articles Background: Achieving the Sustainable Development Goal of ‘ensuring healthy lives and promoting well-being for all at all ages’ necessitates regular monitoring of inequality in the availability of health-related infrastructure and access to services, and in health risks and outcomes. Objectives: To quantify subnational regional inequality in Indonesia using a composite index of public health infrastructure, services, behavioural risk factors and health outcomes: the Public Health Development Index (PHDI). Methods: PHDI is a composite index of 30 public health indicators from across the life course and along the continuum of care. An overall index and seven topic-specific sub-indices were calculated using data from the 2013 Indonesian Basic Health Survey (RISKESDAS) and the 2011 – Village Potential Survey (PODES). These indices were analysed at the national, province and district levels. Within-province inequality was calculated using the Weighted Index of Disparity (IDISW). Results: National average PHDI overall index was 54.0 (out of a possible 100); scores differed between provinces, ranging from 43.9 in Papua to 65.0 in Bali. Provinces in western regions of Indonesia tended to have higher overall PHDI scores compared to eastern regions. Large variations in province averages were observed for the non-communicable diseases sub-index, environmental health sub-index and infectious diseases sub-index. Provinces with a similar number of districts and with similar overall scores on the PHDI index showed different levels of relative within-province inequality. Greater within-province relative inequalities were seen in the environmental health and health services provisions sub-indices as compared to other indices. Conclusions: Achieving the goal of ensuring healthy lives and promoting well-being for all at all ages in Indonesia necessitates having a more focused understanding of district-level inequalities across a wide range of public health infrastructure, service, risk factor and health outcomes indicators, which can enable geographical comparison while also revealing areas for intervention to address health inequalities. Taylor & Francis 2018-09-17 /pmc/articles/PMC7011993/ /pubmed/30220248 http://dx.doi.org/10.1080/16549716.2018.1500133 Text en © 2018 WHO. Published by Informa UK Limited, trading as Taylor & Francis Group. http://creativecommons.org/licenses/by/3.0/igo This is an Open Access article distributed under the terms of the Creative Commons Attribution IGO License (http://creativecommons.org/licenses/by/3.0/igo/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. There should be no suggestion that the WHO endorses any specific organization, products or services. This notice should be preserved along with the article’s original URL. |
spellingShingle | Original Articles Suparmi, Kusumawardani, Nunik Nambiar, Devaki Trihono, Hosseinpoor, Ahmad Reza Subnational regional inequality in the public health development index in Indonesia |
title | Subnational regional inequality in the public health development index in Indonesia |
title_full | Subnational regional inequality in the public health development index in Indonesia |
title_fullStr | Subnational regional inequality in the public health development index in Indonesia |
title_full_unstemmed | Subnational regional inequality in the public health development index in Indonesia |
title_short | Subnational regional inequality in the public health development index in Indonesia |
title_sort | subnational regional inequality in the public health development index in indonesia |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011993/ https://www.ncbi.nlm.nih.gov/pubmed/30220248 http://dx.doi.org/10.1080/16549716.2018.1500133 |
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