TTU Success Story: Strengthening Access to Quality Health Services Reduces Poverty

“With the Bupati regulation on Standard Operation Procedure (SOP) of Individual  Health Referral System, it is expected that morbidity and mortality rate in Timor Tengah Utara (TTU) district could be reduced.        Similarly, the implementation of back referral from RSUD of Kefamenanu to Puskesmas will improve the performance of Puskesmas in providing services to patients.”


“Now the community has been more aware of doing a referral from a Puskesmas both for inpatient and outpatient care. Patients who come to the hospital bring complete  reference letter, so in accordance with the regulation the patients need not pay for  medical treatments. Patients  receive  accurate and quick information about the condition of diseases they have”.

dr. Christina Tarigan, Sp.PD, Head of Medical Committee,  District Hospital Kefamenanu, Timor Tengah Utara

Indonesia has experienced rapid economic growth however health outcomes particularly for women and children in rural communities remains poor.  The weak referral system in Indonesia is an enormous barrier to economic development as people are not able to access appropriate and timely health services.

The effect is crippling for families who have to pay for some health services reducing spending on food and education and the delays in receiving appropriate treatment mean further days off work and loss of income. Women in particular are affected as they are often contributing to household earnings as well as to the care of family members.

However, in Timor Tengah Utara changes to the legislation, policy and practice of health referrals will ensure that the best possible care is provided close to home, making cost-effective use of hospitals and primary health care services.

In 2014 Timor Tengah Utara (TTU) District Health Office in partnership with District Government developed legislation and Standard Operating Procedures (SOP) to clarify the roles and responsibilities of health        facilities in the referral process, improve referral system communication and transport and build capacity at decentralized levels to better provide effective, appropriate and timely health services making efficient use of limited resources.

The District Referral System in TTU —with support from the Australian Government through Australia Indonesia Partnership for Health Systems Strengthening (AIPHSS) Program — will ensure that patients receive optimal care at the appropriate health facility; that facilities are used  optimally and cost-effectively reducing health care costs to both the    district and patients and that patients who need specialist services can    access them in a timely way ensuring that primary health services are well utilized and enhanced.

The  District Referral System is a significant step towards reducing    household poverty by improving access and quality to health care for   rural communities, especially for women and children.


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