Indonesia
The largest Muslim-majority population in the set, with a national insurance scheme and an archipelagic delivery problem.
9 domains reviewed · 9 high-confidence · 4 dated estimates · 9 material gaps
WHO region: South-East Asia. World Bank income group: Income group not yet retrieved.
- Domains reviewed
- 9 of 9
- Hospice: 3 of 4
- Backed by a primary document
- 0 of 9
- Open questions
- 13
- Sources behind this dossier
- 17
- Newest source 2026
Lessons from Indonesia
- A legal mandate without a costed benefit package produced a mandate without a mechanism. The insurance tariff should be defined at the same time as any statutory commitment, not after.69
- A structured screening tool found far more patients in need than clinicians did unaided. A training programme should embed screening in hospital workflow rather than rely on judgement.72
- NGO and volunteer networks carried delivery while financing matured, but the evidence stays concentrated in Java and Sumatra cities. They have not yet shown they can close remote gaps without funded outreach.71,69
- A nonprofit cancer foundation with ties to local government can run home hospice at small scale where the public system does not yet provide it.71
- Existing neighbourhood health volunteer systems can be trained to identify people needing palliative care and to follow them at home under primary care supervision.71
Palliative care
Is morphine available in Indonesia?
Opioid supply. Is a therapeutic opioid physically available in the wards that need it? Every country on this question
- 0.01 DDD per 1,000 inhabitants per daySOURCE-CHECKED
Strong opioid consumption, including methadone, Indonesia, 200570
Last checked 2026-09-24.
Cite this figure: - 0.03 DDD per 1,000 inhabitants per daySOURCE-CHECKED · 2014 DATA
Strong opioid consumption, including methadone, Indonesia, 201470
Last checked 2026-09-24.
The largest percentage rise in the five-country comparison, from the lowest base.
Cite this figure:
Fentanyl, not morphine, led strong opioid consumption across the decade to 2014. Use rose steeply from a very low base. Low cancer pain treatment is attributed to poor assessment, fear of addiction and overly tight regulation.70,73
What is consumption after 2014, and what share of morphine is produced domestically?
Help answer it:Search PubMedHow does Indonesia regulate opioids for pain?
Narcotics regulation. What licensing regime governs stocking and dispensing, and when did it last change? Every country on this question
Palliative care moved from a non-binding 2007 ministerial guideline to a mandated service under the 2023 Health Law, with a 2023 ministerial decree adding community palliative homes.69
What does the 2023 narcotics regulation require for a district hospital to stock and dispense morphine?
Help answer it:Search PubMedWho can prescribe morphine in Indonesia?
Prescriber authority. Who is legally allowed to prescribe, and can that group be widened? Every country on this question
Doctors in Indonesia need a license to prescribe opioids, and the ACE study authors describe the licensing procedure as complex. They also report that opioid prescriptions are limited to a few days and that each prescription carries burdensome reporting.374
Which doctors (specialists, general practitioners, primary care physicians) can obtain the license, and has the rule changed since 2018?
Help answer it:Search PubMedHow does palliative care reach patients in Indonesia?
Service delivery. Through what structure does care actually reach a patient at home? Every country on this question
- 333 centresSOURCE-CHECKED · 2020 DATA
Jakarta primary health centres trained in palliative care, Indonesia, 202071
Last checked 2026-09-24.
Described as covering the whole capital.
Cite this figure: - 713 patientsSOURCE-CHECKED · 2020 DATA
Cancer patients given palliative care in the Jakarta programme, Indonesia, 202071
Last checked 2026-09-24.
A further 583 patients without cancer were served.
Cite this figure: - 114 branchesSOURCE-CHECKED
Indonesian Cancer Foundation branches, Indonesia, 202371
Last checked 2026-09-24.
Cite this figure:
Services cluster in a few cities, with Surabaya's city team dating from 1992 and a Jakarta programme run through primary health centres with the Indonesian Cancer Foundation. Reporting comes mainly from Java and Sumatra, and the 2026 policy brief proposes a tiered national model.69,71
How many palliative teams operate outside Java and Sumatra?
Help answer it:Search PubMedWho pays for palliative care in Indonesia?
Financing. Who pays for the drug, the visit and the workforce? Every country on this question
The 2023 Health Law mandates palliative care, but the 2024 presidential regulation on national health insurance set no palliative benefits package, eligibility or tariff. The policy brief calls this a mandate without a mechanism, and community services lean on charity and volunteers.69
Does the national formulary reimburse oral morphine, and at which facility levels?
Help answer it:Search PubMedHow are palliative care clinicians trained in Indonesia?
Training and recognition. What credential exists, who awards it, and does anyone recognize it? Every country on this question
- 2,353 participantsSOURCE-CHECKED
People trained by the Indonesian Cancer Foundation in palliative care, Indonesia, 202271
Last checked 2026-09-24.
Caregivers, volunteers and professionals across ten provinces, 2015 to 2022.
Cite this figure: - 61.30 percentSOURCE-CHECKED · 2019 DATA
Hospital patients with a chronic disease meeting palliative criteria on screening, Indonesia, 201972
Last checked 2026-09-24.
Clinicians identified 17.7 percent (nurses) and 9.7 percent (physicians) of the same patients. One hospital.
Cite this figure:
The 2026 policy brief calls for a national competency-based training strategy across the health ministry and nursing and medical associations, implying none is yet unified. A hospital study found clinicians recognised a small fraction of the need a screening tool identified.69,72
Is palliative medicine a recognised subspecialty, and how many hold it?
Help answer it:Search PubMedHow does Indonesia prevent opioid misuse without blocking pain relief?
Opioid safeguards. How are misuse and diversion controlled, and are treatment and naloxone available, without blocking pain relief? Every country on this question
A 2015 review describes extremely low opioid use for cancer patients in Indonesia and cites fear of addiction and overly tight regulation among the causes. People who inject drugs and providers in Indonesia, Ukraine and Vietnam described complicated procedures to start opioid agonist treatment, misconceptions about methadone and stigma.573,574
Has Indonesia's opioid consumption for pain changed since the 2023 Health Law mandated palliative care, and is naloxone available in community settings?
Help answer it:Search PubMedHow do children get palliative care in Indonesia?
Children's palliative care. How do children with life-limiting conditions get palliative care and the medicines they need? Every country on this question
Rachel House provides nurse-led home-based pediatric palliative care in Jakarta, and families of 12 children with cancer described holistic, family-centered support. At one academic hospital, all 49 children who died of cancer died in hospital although 37% preferred home, and 46% of children with depression received no intervention.578,579
How many children in Indonesia receive palliative care each year outside Rachel House, and are oral morphine formulations for children available?
Help answer it:Search PubMedHospice care in Indonesia
How the hospice model works here, who can use it, who pays and who it reaches. Covered 3 of 4.
What does hospice care look like in Indonesia?
Hospice model. What does hospice mean here, who runs it, and in what settings? Every country on this question
In Indonesia, hospice care is largely home-based and run by nonprofits. The Indonesian Cancer Foundation began home hospice programs in 1995 with teams of doctors, nurses and volunteers, and it is now developing hospice buildings in South Jakarta. This account is written by the foundation itself.71
Are there inpatient hospices outside the foundation, and does the public sector run any?
Help answer it:Search PubMedWho can get hospice care in Indonesia?
Hospice eligibility. Who can enter hospice, on what criteria, and how late do patients arrive? Every country on this question
Patients reach the Indonesian Cancer Foundation home hospice program late: 79% died at home after a median of 1 to 2 months of care. The program serves cancer patients the foundation describes as vulnerable. No formal admission criteria are published.71
Does the foundation or the national program use written criteria for hospice admission?
Help answer it:Search PubMedWho pays for hospice care in Indonesia?
Hospice funding. Who pays for hospice care: a public benefit, insurance, charity or families? Every country on this question
Does the national health insurance (JKN) pay for any hospice-type care, or is it charity or out-of-pocket funded?
Help answer it:Search PubMedHow many people reach hospice in Indonesia?
Hospice reach. How many dying people use hospice, and who is left out? Every country on this question
The Indonesian Cancer Foundation reports serving 621 patients over the first 12 years of its home hospice program. It now provides an average of 80 services per year, and its Jakarta palliative service served 355 patients in 2022. These are small numbers for a country the authors describe as having 240 million people.71
What share of dying cancer patients outside Jakarta can reach any hospice service?
Help answer it:Search PubMedWhat fills the gap in Indonesia
How people get care outside formal services: families, faith communities, volunteers, health workers, healers, other medicines and charity. Described, not scored.
- Family caregiving
- Faith communities
Muslim women with advanced breast cancer described prayer, dhikr, Qur'anic recitation and religious gatherings as central coping resources. Muslim patients with advanced lung cancer at one hospital included dying in religious ways and in a desirable place in their idea of a good death.388,389
Single-site evidence- Volunteers and compassionate communities
Community health volunteers chosen from within their own communities number about 1.5 million, and some are trained in palliative care to follow patients at home under primary care supervision. A tradition of mutual assistance within tiered neighbourhood units supports neighbour help with basic care and daily needs.71
National evidence- Phone and remote support
The Indonesian Cancer Foundation in Jakarta runs a 24-hour palliative call center staffed by nurses and doctors. It reported 731 teleconsultations with remote delivery of symptom medicines during the COVID-19 pandemic.71
Single-site evidenceSelf-reported
Sources cited here
- 70Zin CS.
Ten years of strong opioid analgesics consumption in Malaysia and other Southeast Asian countries. Journal of Pharmacy and Bioallied Sciences 2020;12(Suppl 2):S846-S851. DOI 10.4103/jpbs.JPBS_252_19. Strong opioid consumption from 2005 to 2014 in defined daily doses per 1,000 inhabitants per day, from Pain and Policy Studies Group data drawing on INCB reports; fentanyl, then pethidine, then morphine in Indonesia.
- 73Setiabudy R, Irawan C, Sudoyo AW.
Opioid use in cancer pain management in Indonesia: a call for attention. Acta Medica Indonesiana 2015;47(3):244-250. Abstract read. Attributes extremely low opioid use to poor pain assessment, dosing failure, fear of addiction and overly tight regulation.
- 69Prima A, Gayatri D, Afiyanti Y, Effendy C.
Integrating palliative care into the Indonesia health system: a policy brief to enhance accessibility, quality, and sustainability. F1000Research 2026;14:1324. DOI 10.12688/f1000research.171110.2. Traces the move from a non-binding 2007 ministerial decree to a mandate under Law No. 17 of 2023 and a 2023 ministerial decree introducing community palliative homes; reports that Presidential Regulation No. 59 of 2024 defined no palliative benefits package, eligibility or tariff under national health insurance; describes services concentrated in a few cities and proposes a tiered model from primary health centres upward.
- 374Thinh DHQ, Sriraj W, Mansor M, et al.
Analgesic Prescription Patterns and Pain Outcomes in Southeast Asia: Findings From the Analgesic Treatment of Cancer Pain in Southeast Asia Study. J Glob Oncol 2018;4:1-10. Cross-sectional study of 462 cancer outpatients at 22 large urban hospitals in six Southeast Asian countries, with a discussion of national opioid prescribing rules; two coauthors are Mundipharma employees (industry conflict). Full text read.
- 71Eng V, Sudoyo AW, Nuhonni SA, Hendrianto K.
Indonesia's unique social system as key to successful implementation of community- and home-based palliative care. JCO Global Oncology 2023;9:e2200290. DOI 10.1200/GO.22.00290. The Indonesian Cancer Foundation network and training, the Jakarta primary health centre programme, Surabaya's city team from 1992, and the community health volunteer system; states that reporting is concentrated in Java and Sumatra cities.
- 72Effendy C, Silva JFDS, Padmawati RS.
Identifying palliative care needs of patients with non-communicable diseases in Indonesia using the SPICT tool: a descriptive cross-sectional study. BMC Palliative Care 2022;21:13. DOI 10.1186/s12904-021-00881-5. Single hospital in Yogyakarta, 2019.
- 573Setiabudy R, Irawan C, Sudoyo AW
Opioid Use in Cancer Pain Management in Indonesia: a Call For Attention. Acta Med Indones 2015;47(3):244-50. Narrative review of opioid underuse for cancer pain in Indonesia. Abstract read.
- 574Kiriazova T, Go VF, Hershow RB, et al.
Perspectives of clients and providers on factors influencing opioid agonist treatment uptake among HIV-positive people who use drugs in Indonesia, Ukraine, and Vietnam: HPTN 074 study. Harm Reduct J 2020;17(1):69. Qualitative interviews with 37 HIV-positive people who inject drugs and 25 providers on opioid agonist treatment uptake in Indonesia, Ukraine and Vietnam; findings pooled across countries. Abstract read.
- 575Putranto R, Mudjaddid E, Shatri H, et al.
Development and challenges of palliative care in Indonesia: role of psychosomatic medicine. Biopsychosoc Med 2017;11:29. Review of palliative care development in Indonesia and the role of psychosomatic medicine, written by the Cipto Mangunkusumo psychosomatic and palliative division. Abstract read.
- 576Kristanti MS, Setiyarini S, Effendy C
Enhancing the quality of life for palliative care cancer patients in Indonesia through family caregivers: a pilot study of basic skills training. BMC Palliat Care 2017;16(1):4. Pre-post pilot of basic skills training for 30 family caregivers of palliative cancer patients in Yogyakarta; no control group. Abstract read.
- 577Septian RB, Pangastuti HS, Nisman WA
"As Caregivers, We Also Need Someone Who Listens": Family Perspectives on Providing Palliative Care for Stroke Patients. J Palliat Care 2025;41(2):223-230. Qualitative phenomenological study of 10 family caregivers of stroke patients receiving home-based palliative care in Indonesia. Abstract read.
- 578Effendy C, Uligraff DK, Sari SH, et al.
Experiences of family caregivers of children with cancer while receiving home-based pediatric palliative care in Indonesia: a qualitative study. BMC Palliat Care 2022;21(1):104. Qualitative study of family caregivers of 12 children with cancer receiving home-based pediatric palliative care from Rachel House, Jakarta; co-authors are Rachel House staff, so a self-evaluation. Abstract read.
- 579Pangarso AWS, Mulatsih S, Sitaresmi MN, et al.
Discovering needs for palliative care in children with cancer in Indonesia. Pediatr Blood Cancer 2024;71(7):e30985. Interviews with parents of 49 children who died of cancer at one Indonesian academic hospital in 2019 to 2020; single site. Abstract read.
- 390Purba CIH, Johnston B, Kotronoulas G
An Exploration of Family Caregivers' Health Care Needs When Caring for Patients With Cancer in the Resource-Challenged Context of West Java, Indonesia. Semin Oncol Nurs 2022;39(3):151369. Convenience-sample survey of 220 family caregivers in West Java on unmet supportive care needs. Abstract read.
- 391Martina D, Kustanti CY, Dewantari R, et al.
Advance care planning for patients with cancer and family caregivers in Indonesia: a qualitative study. BMC Palliat Care 2022;21(1):204. Interviews with 16 patients and 15 family caregivers at hospitals in Jakarta and Yogyakarta on disclosure and decision-making. Abstract read.
- 388Fadilah A, Huang SH, Sheu SJ, et al.
The Spiritual Experiences of Indonesian Women With Advanced Breast Cancer: A Phenomenological Study. Res Nurs Health 2026;49(2):170-179. Interviews with 7 women, mostly Muslim, at one palliative clinic. Abstract read.
- 389Pribadi DRA, Shih WM, Wu GH, et al.
Perspectives of Indonesian Muslim patients with advanced lung cancer on good death: A qualitative study. Eur J Oncol Nurs 2022;62:102251. Interviews with 10 Muslim patients at one teaching hospital in Central Java. Abstract read.