Targeting around 280 million people, the program will seek to reduce exceptionally high spending on treatment for diseases that should have been long prevented.
According to Health Minister Budi Gunadi Sadikin, the program will prioritize around 200 million Indonesians—particularly those belonging to the lower socio-economic class—who have never been screened before.
Data from the Ministry of Health shows that only 39.8 percent of the population has been screened for infectious diseases.
Further, many individuals aged over 20 years have never undergone essential health checks.
Data shows that 80.82 percent have never measured their waist circumference, 62.6 percent have not checked their blood sugar level, 61.6 percent have not checked their cholesterol level, 36.61 percent have never monitored their weight, and 32.6 percent have never measured their blood pressure.
The ministry expects at least around 100 million people to take advantage of the first-year implementation of the free health screenings.
There will be three categories of screenings: those conducted on the birthdays of children aged 0–6 and people aged 18 years or older; those conducted in schools during each new academic year for children aged 7 to 17; and special screenings for pregnant women and newborns.
The screenings will be conducted at 10 thousand community health centers (puskesmas) and potentially around 15 thousand to 20 thousand private-owned clinics. People will be able to access the service through the SatuSehat mobile application on their devices.
In addition to downloading the mobile application, Minister Sadikin also appealed to the public to obtain membership of the Healthcare and Social Security Agency (BPJS Kesehatan) to prepare for any further response prescribed based on their screening results.
The government has allocated Rp4.7 trillion (over US$288.5 million) for the program and is aiming to reach 60 million Indonesians this year.
The free health screenings are designed for each life cycle, based on various health problems across age groups, which were identified in the 2023 Indonesian Health Survey (SKI).
Among infants and preschoolers, the stunting rate was recorded at 21.5 percent and wasting at 8.5 percent. Among schoolchildren and adolescents, the survey found issues such as smoking (7.4 percent), anemia (15.6 percent), and mental health problems (34.9 percent).
More severe conditions were noted in adults, such as obesity (23.4 percent), hypertension (30.8 percent), and type 1 diabetes mellitus (DM1) (1.6 percent).
In infants, the biggest cause of death was neonatal disorders, which, in some cases, can be prevented from causing fatalities.
Causes of death such as sexually transmitted diseases (except HIV), lower respiratory infections, diarrhea, and tetanus, are also preventable.
Meanwhile, for adolescents, adults, and the elderly, cancer is a preventable cause of death.
In adolescents, anemia is one issue that needs attention. Therefore, the government has included screening for anemia and thalassemia in the program set for junior high school students.
Furthermore, in adults and the elderly, several diseases that cause death, including heart disease, stroke, diabetes mellitus, and tuberculosis, are preventable.
In adults, lower respiratory diseases are also highlighted for screening, and in the elderly, chronic obstructive pulmonary disease (COPD) and cirrhosis cause the highest mortality.
The ministry's director of prevention and control of non-communicable diseases, Siti Nadia Tarmizi, said that in 2023, the cost of treating catastrophic diseases such as stroke, thalassemia, and liver cirrhosis amounted to Rp34.8 trillion (around US$ 2.14 billion).
The figure further emphasizes the importance of free health screenings for the population.
Heart diseases and stroke are the most expensive to treat, with the cost of treatment totaling Rp22.8 trillion.
High blood pressure is a risk factor for the highest burden of disease, both globally and nationally. Data from the Institute for Health Metrics and Evaluation (IHME) 2021 pegs the number of cases of high blood pressure at 225 million globally and around 13 million in Indonesia.
Among the risk factors for the burden of disease, smoking is one of the contributors to morbidity globally. Therefore, Tarmizi said, smoking is one of the issues that will be further explored in the free health screening program. The screening will start from the elementary school (age 5–6) level.
"Is there a risk factor for smoking, so later it needs to be checked for cancer, lungs, and COPD," she added.
Mental health tests
The free health screenings will also check for mental health problems, as they often go underscreened and underdiagnosed, according to Minister Sadikin.
Based on a report by the World Health Organization (WHO), one in eight people globally experience mental disorders. Going by that ratio, Indonesia may have 28 million people with mental disorders.
As this is a stigmatized disease, people are afraid to open up about it. Therefore, the ministry will intervene to address the problem, the minister emphasized.
He said that mental health checks are just as important as basic health screenings, such as blood tests.
For the program, the ministry will use a questionnaire to identify different types of mental health issues, such as attention-deficit/hyperactivity disorder (ADHD), bulimia, eating disorders, autism, and neurological disorders.
He added that the treatment for such illnesses can include consultations with psychologists and medication.
Currently, the ministry is expanding mental health services at community health centers to offer psychological consultations.
The Indonesian Health Survey (SKI) in 2023 recorded the highest prevalence of depression symptoms among young people aged 15–24 years, females, individuals with junior high school or lower levels of education, the unemployed, those still in school, and workers without specialized skills, such as drivers or domestic help.
At the national level, the prevalence of depression across all ages was recorded at 1.4 percent. The highest prevalence was in West Java, while the lowest was in Bali.
The survey found that only 10.4 percent of young people with depression seek treatment. Despite having the highest incidence of depression, this group is the least likely to receive care.
Moving to a preventive health paradigm from a curative one takes time. By providing free screenings, it is hoped that the public will be aware of the importance of managing their most valuable asset—health.
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Translator: Mecca Yumna Ning Prisie, Yashinta Difa
Editor: Arie Novarina
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