PEER Health Home > Focus Area2: Indonesia
The USG strategy in Indonesia is focused on catalyzing action to accelerate Indonesia’s progress toward achievement of Millennium Development Goals (MDGs)
4, 5 and 6; enhancing the use of quality research and evidence in policy and programming; and partnering to address regional and global infectious disease threats. Priority areas for health research should relate to the broad areas of this strategy as described below:
1. Newborn survival: While under-five mortality is declining in Indonesia and is on track to meet the MDG 4 goal, newborn mortality has stagnated. The newborn mortality rate is an ever greater percentage of the under-five mortality rate. Proposed research to improve newborn health must respond to national priorities and address key obstacles to reducing newborn mortality due to primary causes – asphyxia, sepsis and pneumonia, low birth weight, and prematurity.
Research should address an aspect of implementation science and can be in any of the following areas: facility-based care, community-based knowledge, behavior and care, scale-up of existing interventions, innovation including innovative technologies, to improve referral from community to health center or between health facilities, or to improve clinical care, including improving the quality of care, and application or adaptation of innovation and/or technologies from other countries to address priority causes in Indonesia. Applications in priority areas of post-neonatal infant survival will also be considered.
2. Tuberculosis (TB): Indonesia, a country of more than 245 million people as of 2011, is a high burden TB country. Indonesia ranked fourth globally and eighth for multi-drug resistant (MDR) TB. TB is responsible for 6.3 percent of the total disease burden in Indonesia, compared with 3.2 percent in the Southeast Asian region. There is a need for epidemiological research to better understand drivers of TB transmission in Indonesia (poor nutrition, smoking, diabetes, social drivers, health care setting, HIV) and to develop cost effective methods and tools for effective contact tracing at the community level.
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Drug Resistance (MDR, XDR) is a growing challenge for Indonesia. The National TB Program
(NTP) began a Programmatic Management of Drug-Resistant TB Treatment (PMDT) pilot project in 2009 and this year launched a GenExpert pilot project to increase MDR diagnosis and rapid treatment. There is a need to better understand the transmission of MDR TB in Indonesia, examine the patterns and types of resistance, and improve treatment outcomes. Priority research topics include:
- Molecular epidemiology to identify the major points of drug sensitivity transmission.
- Examination of the proportions and types of previously treated people who develop MDR and XDR TB.
- Measurement of reproductive fitness of various drug resistant conferring mutations in Indonesia.
- Evidence based research to determine which high risk populations should be screened for MDR and XDR TB and the optimal method for screening.
- Clinical research to investigate treatment regimens and side-effects.
- Examination of risk factors for health workers.
3. Other areas of interest include: Maternal and child health; HIV/AIDS; neglected tropical diseases; emerging pandemic threats, pandemic influenza and zoonotic diseases; epidemiology; monitoring, evaluation and survey methodologies; and environmental health. Illustrative examples include:
- Research to examine oseltamivir resistance in influenza and transmissibility of H5N1.
- Identification of biomarkers for human response to environmental agents.
- Chronic disease epidemiological trends and modeling of disease burden.
- Evaluation of new infectious diseases diagnostic technologies.