To get a full picture of how social accountability can improve the quality of health services in Indonesia, one only has to travel to the border areas in East Nusa Tenggara (NTT) province.
On a scorching afternoon in August 2015 in Bijaepasu sub-district, a six hour drive from the provincial capital Kupang, a queue was forming in front of the village health center or puskesmas. The crowd seemed undeterred by the temperature that hovered around 40 degrees Celcius.
Leaning against its deteriorating walls were mothers and babies, elderly women and men. The queue was long and slow moving. The health center workers appeared overwhelmed. There were barely any medical equipment or supplies.
“Lima tahun pertama akan sangat menentukan (perkembangan) 80 tahun ke depan,” filantropis dan jutawan Bill Gates, pernah berkata, terkait pentingnya pendidikan anak usia dini (PAUD).
Pendidikan anak usia dini kerap disebut dalam Strategi Pendidikan 2020 Bank Dunia, yang memaparkan agenda 10 tahun ke depan di bidang pendidikan, dengan tujuan “Pembelajaraan untuk Semua”. Dengan moto “investasi awal, investasi yang pintar dan investasi untuk semua,” strategi ini mengatakan bahwa investasi pendidikan anak usia dini akan menopang pembangunan dan pertumbuhan sebuah negara, terutama untuk negara perkenomian berkembang seperti Indonesia.
“The first five years have so much to do with how the next 80 turn out,” billionaire philanthropist Bill Gates once said, summing up the importance of early childhood education.
Early education is featured prominently in the World Bank’s Education Strategy 2020, which lays out a ten-year agenda focused on the goal of “learning for all.” With the tagline ‘Invest early, invest smartly, and invest for all,’ the strategy says that an investment in early education will support the development and growth of a nation, particularly for emerging economies such as Indonesia.
Di Indonesia masa pasca desentralisasi, sebagian besar tanggung jawab untuk menyediakan layanan publik berada di tangan pemerintah daerah. Begitu juga dengan pengelolaan uang pemerintah. Saat ini pemerintah daerah mengelola hampir setengah dari total keuangan negara. Transfer ke daerah sudah naik tiga kali lipat dalam nilai riil dibanding sejak desentralisasi dimulai.
Namun, perbaikan dalam indikator kesehatan dan pendidikan belum bergerak banyak, sehingga hasil dari bertambahnya transfer uang ke daerah tampaknya masih kurang memuaskan.
In post decentralization Indonesia, the responsibility to deliver services falls largely at the hands of the local government. So, too, does the management of public money. Local governments currently manage about half of Indonesia’s public finances. Transfers to the regions increased by more than threefold in real terms since the onset of decentralization.
However, with few improvements in health and education indicators, the results of these increased transfers are not encouraging.
Nearly 50 years ago, books such as Asian Drama: An Inquiry Into The Poverty Of Nations, by the Swedish economist and Nobel laureate Gunnar Myrdal, offered a dire prediction of famine and poverty for the region in coming decades.
Globally, around 2 billion people do not use formal financial services. In Southeast Asia, there are 264 million adults who are still “unbanked”; many of them save their money under the mattress and borrow from so-called “loan sharks”, paying exorbitant interest rates on a daily or weekly basis. Recognizing the importance of financial inclusion for economic development, the leaders of the Association of South East Asian Nations (ASEAN) have made this one of their top priorities for the next five years.
Last week, the World Bank Group presented the latest data on financial inclusion in ASEAN to senior representatives of the ministries of finance and central banks of all 10 ASEAN member countries (Brunei Darussalam, Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam). The session, held in Kuala Lumpur, is one of the joint activities the new World Bank Research and Knowledge Hub and Malaysia is undertaking to support financial inclusion around the world.
In the last three decades, East Asia has reaped the demographic dividend. An abundant and growing labor force powered almost one-third of the region’s per capita income growth from the 1960s to the 1990s, making it the world’s growth engine.
Now, East Asia is facing the challenges posed by another demographic trend: rapid aging. A new World Bank report finds that East Asia and Pacific is aging faster – and on a larger scale – than any other region in history.
More than 211 million people ages 65 and over live in East Asia and Pacific, accounting for 36 percent of the global population in that age group. By 2040, East Asia’s older population will more than double, to 479 million, and the working-age population will shrink by 10 percent to 15 percent in countries such as Korea, China, and Thailand.
Across the region, as the working-age population declines and the pace of aging accelerates, policy makers are concerned with the potential impact of aging on economic growth and rising demand for public spending on health, pension and long-term care systems.
As the region ages rapidly, how do governments, employers and households ensure that hard-working people live healthy and productive lives in old age? How do societies in East Asia and Pacific promote productive aging and become more inclusive?
The latest cyclical warming of Pacific Ocean waters, first observed centuries ago and formally tracked since 1950, began earlier this year and already has been felt across Asia, Africa and Latin America.
Weather experts predict this El Niño will continue into the spring of 2016 and could wreak havoc, because climate change is likely to exacerbate the intensity of storms and flooding in some places and of severe drought and water shortages in others.
El Niño’s impacts are global, with heavy rain and severe flooding expected in South America and scorching weather and drought conditions likely in the Horn of Africa region.
Unprecedented economic growth in the last three decades propelled East Asia into an economic powerhouse responsible for a quarter of the world’s economy.
Hundreds of millions of people across the region, including in China, Indonesia, Malaysia, Thailand and Vietnam, lifted themselves out of extreme poverty and enjoyed greater prosperity, largely because of more labor-intensive and inclusive growth.
The success didn’t come without challenges. As of last year, 100 million people in East Asia still live on $1.25 a day. About 260 million still live on $2 a day or less, and they could fall back into poverty if the global economy takes a turn for the worse or if they face health, food and other shocks at home. Their uncertain future shows the increasing inequality of East Asia’s galloping growth.