Indonesia - Supporting Primary Health Care Reform Project

Overview & Synopsis

Ratings for the Supporting Primary Health Care Reform Project for Indonesia (I-SPHERE) were as follows: outcome and Bank performance was satisfactory, and monitoring and evaluation (M and E) quality was substantial. Some lessons learned included: the program-for-results (PforR), introduced by the I-SPHERE program, has demonstrated its ability to achieve significant positive impacts in a short period while adapting to unpredictable situations, such as COVID-19. Additionally, the PforR has bolstered foundational reforms by enhancing the planning, budgeting, and implementation capacities of local governments, leading to improved service delivery and accountability at the decentralized level, which ensures long-term sustainability and impact. Furthermore, the program has significantly contributed to the Ministry of Health (MoH’s) system transformation agenda by promoting data-driven decision-making, enhancing health information systems, and fostering a culture of continuous improvement. To ensure successful health operations, MoH should implement robust program management frameworks and cultivate strategic partnerships. To maximize the effectiveness and efficiency of health programs, systematically integrate data analytics into health financing, resource allocation, and decision-making processes. To ensure responsible and sustainable health programs, robust environmental and social safeguards should be integrated at every stage. To drive systemic change and enhance accountability in health programs, implement the PforR instrument, which shifts from input-based financing to outcome-focused funding by linking resources to measurable improvements in health spending effectiveness. To ensure sustained program success, prioritize human resource capacity and program adaptability through targeted strategies. To ensure the long-term sustainability and impactful reach of health programs, prioritize the establishment of robust multi-stakeholder partnerships involving development agencies, government bodies, and local communities. Lastly, to maximize the impact of health system reforms, prioritize the mainstream implementation of the PforR instrument.