Potential Role of Social Contracting and Local Governments in Financing and Delivering HIV Services in Indonesia

The following briefs present findings from two HP+ analyses conducted as part of support to the Government of Indonesia to design and implement strategic purchasing reforms for HIV. The briefs focus on the potential role of civil society organizations (CSOs) and subnational governments in financing the HIV response and delivering HIV services.

In the first brief, HP+ looks at the costs and benefits of a CSO contracting mechanism for HIV service delivery. Indonesia’s national health insurance scheme covers 83 percent of the population and includes select HIV services, such as HIV treatment, in its benefits package. As the scheme’s annual deficit continues to increase, the national health insurance agency is exploring opportunities to reduce costs. This could include contracting with CSOs to provide key HIV services such as case finding, linkage to care, adherence support, and loss-to-follow-up tracking. HP+ estimated HIV outcomes and costs to the national health insurance agency from 2020 to 2025 under two scenarios—with and without CSO contracting of HIV services—in order to inform contracting decisions relating to HIV and CSOs.

In the second brief, HP+ explores the potential efficiency gains from implementing strategic, targeted HIV testing across all districts in Indonesia. Given the government of Indonesia’s ambitious national HIV targets combined with projected declines in external financing support for HIV and limited domestic resource availability, subnational governments need evidence on cost-efficient testing strategies to optimize HIV testing under minimum service standards for health. Findings presented in the brief can be used to promote greater efficiency in local testing approaches and support guidance to local governments around strategic and cost-efficient HIV screening under minimum service standards.

See our related brief on strategic health purchasing reforms for HIV.

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