IMFIN brief 24: Indonesia, the challenge of protecting immunization in the transition to universal health coverage

How have health financing reforms, decentralization, and the expansion of social health insurance affected the immunization program in Indonesia?

Key points

• Indonesia’s transition from Gavi support is happening during a time of rapid health system changes, including decentralization of the health delivery system and a transition to universal health coverage under a single national health insurance system.
• Immunization is provided free to the population through the public health service delivery network regardless of health insurance coverage status. Nonetheless, inequities in access to immunization between insured and uninsured children may be emerging.
• The high level of decentralization in Indonesia also poses challenges to sustaining and strengthening the national immunization program.
• As JKN coverage expands, the key to financial and institutional sustainability of the immunization program will be better integration with the universal health coverage system, especially as the government introduces new vaccines over time.