Abstract
SummaryBackgroundAs Indonesia moves to provide health coverage for all citizens, understanding patterns of morbidity and mortality is important to allocate resources and address inequality. The Global Burden of Disease 2016 study (GBD 2016) estimates sources of early death and disability, which can inform policies to improve health care.MethodsWe used GBD 2016 results for cause-specific deaths, years of life lost, years lived with disability, disability-adjusted life-years (DALYs), life expectancy at birth, healthy life expectancy, and risk factors for 333 causes in Indonesia and in seven comparator countries. Estimates were produced by location, year, age, and sex using methods outlined in GBD 2016. Using the Socio-demographic Index, we generated expected values for each metric and compared these against observed results.FindingsIn Indonesia between 1990 and 2016, life expectancy increased by 8·0 years (95% uncertainty interval [UI] 7·3–8·8) to 71·7 years (71·0–72·3): the increase was 7·4 years (6·4–8·6) for males and 8·7 years (7·8–9·5) for females. Total DALYs due to communicable, maternal, neonatal, and nutritional causes decreased by 58·6% (95% UI 55·6–61·6), from 43·8 million (95% UI 41·4–46·5) to 18·1 million (16·8–19·6), whereas total DALYs from non-communicable diseases rose. DALYs due to injuries decreased, both in crude rates and in age-standardised rates. The three leading causes of DALYs in 2016 were ischaemic heart disease, cerebrovascular disease, and diabetes. Dietary risks were a leading contributor to the DALY burden, accounting for 13·6% (11·8–15·4) of DALYs in 2016.InterpretationOver the past 27 years, health across many indicators has improved in Indonesia. Improvements are partly offset by rising deaths and a growing burden of non-communicable diseases. To maintain and increase health gains, further work is needed to identify successful interventions and improve health equity.FundingThe Bill & Melinda Gates Foundation.
Highlights
The Republic of Indonesia, the world’s largest archipelago, consists of more than 17 000 islands straddling the equator, stretching 5200 km from east to west
Overview For this analysis, Indonesia-specific estimates of life expectancy at birth, healthy life expectancy (HALE), causespecific mortality, years of life lost (YLLs), years of life lived with disability (YLDs), disability-adjusted life-years (DALYs), and related risk factors are reported along with national estimates from seven comparator countries to facilitate comparison and benchmarking between 1990 and 2016
Between 1990 and 2016, life expectancy at birth in Indonesia increased by 8·0 years (95% uncertainty intervals (UIs) 7·3–8·8), from 63·6 years (63·2–64·0) to 71·7 years (71·0–72·3; figure 1)
Summary
The Republic of Indonesia ( referred to as Indonesia), the world’s largest archipelago, consists of more than 17 000 islands straddling the equator, stretching 5200 km from east to west. More than half of all Indonesians live on Java, with the rest of the population distributed unevenly across the archipelago, presenting substantial challenges for governance, communication, transportation, and the equitable availability of basic health services. This transition has meant greater autonomy for local and regional heads of government to serve their diverse populations
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