Beyond buildings, equipment: Upgrading Indonesia's regional healthcare

Jakarta (ANTARA) - Tucked away and far from the country's main economic heartbeat, Lampung's West Pesisir District is rarely in the national spotlight.

It is not always easy to access referral healthcare there. For years, residents in need of advanced medical treatment had to travel more than three hours just to reach the nearest Type B hospital.

However, the atmosphere in Krui, the capital of West Pesisir, was noticeably different on Wednesday (June 10, 2026). The usually quiet area was suddenly bustling with tight security and protocols ahead of President Prabowo Subianto's arrival.

The president was there to inaugurate the upgraded KH Muhammad Thohir Regional General Hospital (RSUD), which is included in the government's healthcare quick-win program.

The inauguration marked the completion of the physical construction process that began with a groundbreaking on June 13, 2025, funded by the 2025 state budget to the tune of Rp152.98 billion (approximately US$8.6 million).

The transformation goes far beyond a new physical structure. The hospital has been upgraded from a Type D to a Type C facility—a leap that requires the permanent availability of basic medical specialists and various supporting services that were previously nonexistent.

Inpatient bed capacity has expanded from 59 to 101 beds. Essential facilities that locals once struggled to access are now available in Krui, ranging from an emergency room (ER) and outpatient clinics to an intensive care unit, a hemodialysis center, radiology services, and a laboratory.

This upgrade is set to continue. In 2026, the hospital is scheduled to receive additional medical equipment, including a 64-slice CT scanner, mammography machines, and ventilators. By the following year, a cath lab and echocardiography facilities will be added to strengthen the hospital's healthcare capabilities.

On that occasion, President Prabowo announced the Indonesian government's target to build and renovate around 300 to 400 hospitals across districts in Indonesia in the next three years as part of efforts to bolster national health services.

The program will also include the distribution of nearly 1,000 units of modern medical equipment to regional general hospitals.

Yet, in the healthcare sector, a brand-new building and sophisticated equipment are only part of the solution. Ultimately, the quality of care is determined not just by technology but by the availability of healthcare professionals who can operate and utilize it to its fullest potential.

Human resources

The healthcare quick-win program currently covers 66 regional hospitals across remote, border, and island regions.

The facilities of 32 hospitals were upgraded in 2025, with the remaining 34 scheduled for 2026. On the physical front, construction is moving relatively on track. However, as the buildings take shape and the equipment arrives, a far more fundamental question arises: who will operate them?

Ministry of Health data reveals that 39 of the 66 target hospitals still lack the full complement of seven basic and supporting specialties required for a Type C hospital.

The shortage of basic specialists across all targeted hospitals is estimated at 217 doctors. This figure does not even account for the specialist requirements for cancer, heart disease, stroke, and uro-nephrology services, which face a projected shortfall of another 392 doctors.

Overall, the total need for the seven basic specialists across all targeted hospitals stands at 1,270 doctors.

The KH Muhammad Thohir Regional General Hospital is a case in point. Based on the ministry report, the hospital currently has 13 general practitioners, 76 nurses, and 52 midwives.

However, it only has five medical specialties available: pediatrics, obstetrics/gynecology, surgery, radiology, and anesthesiology. Specialists in cardiology, neurology, pathology, and urology—all required to meet the target for intermediate-level healthcare services—are still unavailable.

Plans to fulfill the need for additional specialists are scheduled through the civil servant recruitment channel, the medical specialist utilization program (PGDS), and temporary deployments spanning the 2025–2027 period.

However, the deployment faces structural limitations as these assignments only last for an average of one to two years, lack long-term sustainability, and offer no career certainty. Furthermore, most specialists currently stationed at regional hospitals included in the quick-win program are non-civil servants—a precarious mix of public service agency personnel, resident doctors, and doctors with local contracts.

In response to this issue, the Coordinating Ministry for Human Development and Culture in March 2026 urged that medical specialists at the upgraded regional hospitals be recruited primarily as permanent civil servants rather than contract-based government employees.

The goal is to provide stronger career stability while making regional placements more attractive.

However, while this process cannot happen overnight, the public's need for comprehensive healthcare services is a pressing reality today, not a promise for years down the road.

Outside of the human resources issue, another challenge worth noting is: who will foot the bill for operational costs once construction is complete?

Most regions targeted by the hospital upgrade program have limited regional revenue and still rely heavily on transfers from the central government.

During their initial operational phase, newly established or recently upgraded hospitals are generally unable to generate enough revenue to cover their entire service costs.

Furthermore, INA-CBGs rates—the payment mechanism under the National Health Insurance (JKN) program—do not always fully reflect the actual costs incurred by regional hospitals. This gap is felt most acutely by facilities that have just expanded their service capacity and are still navigating operational adjustments.

This situation could potentially cause severe fiscal strain on local governments. While a hospital may see a high number of patients, its revenue may still fall short of covering all costs.

At the same time, regional fiscal space is often far too tight to plug the deficit. In the worst-case scenario, these budget constraints could trigger a decline in the quality of care, disrupt the procurement of essential medicines, and make it incredibly difficult to retain medical personnel.

Therefore, the program's success is not merely about the buildings or medical equipment. Coordination in ensuring the operational budget after the construction is also vital.

Free Health Screening program

While the government carries out infrastructure construction, its nationwide Free Health Screening (CKG) program continues to run, adding another dimension to the regional healthcare landscape.

In 2025, the initiative reached over 70 million participants. For 2026, the target has been raised to more than 130 million, with progress already surpassing 30 million participants as of May 2026.

Far more than just a routine check-up, the CKG program's role is shifting from simple early detection to a vital gateway for treatment and advanced medical evaluation for citizens who were previously unaware of their health conditions.

This shift, according to the Ministry of Health records, has directly increased the patient load at both primary healthcare facilities and advanced referral healthcare facilities. In other words, more people are now getting diagnosed, and a larger share of them subsequently require hospital referrals.

Indeed, the primary objective of a modern healthcare system is not merely to treat the already ill, but to detect health issues as early as possible so they can be managed before escalating into more severe conditions. A preventive approach is more effective and less costly than a curative one.

The KH Muhammad Thohir Regional General Hospital will soon face this reality with its new building, new facilities, and new capacity.

Therefore, beyond the upgrades, the hospital also requires a skilled workforce and a sustainable healthcare governance model to ensure long-term benefits for the people.

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Translator: Aditya Ramadhan, Raka Adji

Editor: Azis Kurmala

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