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Account (NHA), but Indonesia can’t apply just
NHA. This is because the government system is
based on a system of decentralisation, and the
reports of health expenditure from all sources at the
regional level can’t be done completely collated
(Bappeda of West Java, 2016). Therefore, Indonesia
also applied the Provincial Health Account (PHA)
and District Health Account (DHA).
One of the districts in Indonesia which has
already applied DHA is Sampang
(AIPHSS, 2015).
Sampang already had a team in place for the referral
system in 2013 that consisted of a DHA team and a
Human Resources team (AIPHSS, 2015). Therefore
the question is, how good is the sustainability of
DHA in contributing to the strengthening health
system in Sampang?
In 2014, Sampang had 21 community health
clinics, and one hospital. The Ministry of Health
standard of Indonesia said that the ratio between
community health clinics and the total population is
1:30.000. However, the reality in Sampang is that
there are 929,918 people (data from 2014), so that
one community health clinic can serve 39,870
person. Therefore, for the proportion of community
health clinics in Sampang to be correct, there needs
to be 28 community health clinics (Health Office,
2014).
The health funding of Sampang itself comes
from APBN Ministry of Health, APBN Ministry of
Social, provincial APBD (PAD), district/municipal
APBD (DBH, DAU, DAK and PAD), donors,
grants, household health expenditures and social
institutions/foundations. The total health cost of
Sampang in 2014 based on the multiple sources of
its financing was Rp 339,749,065,932.00 (DHA
Team, 2014). The other data mentioned that the
APBN funds in 2014 amounted to Rp
23,652,717,00.00 which was allocated accordingly.
The JKN funds amounted to Rp 21,693,567,000.00,
overseas grants from AIPHSS amounted to Rp
1,878,083,000,00, and BOK amounted to Rp
1,959,150,000,00 (Health Office, 2014) .
Sampang also faces problems to do with the
culture of the community where self-referrals are
high at 30% (AIPHSS, 2015). The implementation
of DHA of Sampang needs sustainability to
strengthen the health system. The aim of this paper
is to identify the sustainability of DHA
implementation in Sampang.
2 METHOD
This paper was prepared using secondary data
collected from existing data sources. The data
sources were PowerPoint presentations, papers,
documents, regional governments, the Department
of Health and overseas coordination boards. The
appropriate references have been attached.
After all of the data was collected, the
information was compiled into a series of sentences
forming a comprehensive paragraph. The author’s
opinions were also added, and the data collected was
used to reinforce the author's opinion.
3 RESULTS
The implementation of DHA in Sampang can be
seen of as sustainable if it meets four criteria such as
the DHA team having the task to manage data
related to district health expenditure from various
cross sectors, various data coming from SKPD or
vertical institutions/centres, commitment from
policy makers/the government, and the interaction
between policy makers and the DHA technical team.
From the results of the DHA implementation in
Sampang, it already had a DHA team in 2012. The
below are the members of the DHA team in
Sampang (DHA Team, 2014):
1. Anas Muslim, ST. M.AP (Bappeda)
2. Yupita Widyaningsih, S.KM (Dinkes)
3. Daqiqus Syafatain, W. S. ST (Dinkes)
4. Taufiqurrahman, S.KM. MM (RSUD)
5. Ahmad Anang M. S.ST (BPS)
The second results of DHA implementation
related to the data source for the analysis of health
financing of Sampang were derived from the
realisation of the 2013 budget in Satuan Kerja
Perangkat Daerah (SKPD) as well as vertical
institutions/centres in Sampang, like the Department
of Health, RSUD, BPS (Susenas), the Office of the
Secretariat of the Regional People's Legislative
Assembly, the General Section of the Regional
Secretariat, Bappeda, BKD, the Department of
Education, the Department of Social, Bapemas,
BPPKB, Food Security, PNPM, PT. Askes, PKH,
PMI and Jampersal For Private Practice Midwives
(DHA Team, 2013).
The third criterion is about the interaction
between the policy makers and the DHA technical
team. This interaction is shown by the existence of
health expenditure arrangements based on the
funding manager of Sampang in 2014, as follows:
INAHEA 2017 - 4th Annual Meeting of the Indonesian Health Economics Association
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