Health Care Access Come Rain or Shine : A Multifactorial Accessibility Study of Public Primary Health Care in Indonesia

Geographic disparities in health outcomes persist across Indonesia, fueled in part by inequities in the physical access to and quality of health services. This note deploys a novel model to assess spatial patterns of accessibility of public primary care in Indonesia. It focuses on access to public community health centers, or Puskesmas, integrating large datasets on settlement patterns and population density, terrain, land cover, seasonality, road infrastructure and a variety of modes of transportation. Three core findings emerge: (i) physical inaccessibility and quality gaps in public primary health care pose a double burden for vulnerable communities; (ii) accessibility challenges are not limited to remote areas but also affect pockets of geographic areas across more densely populated islands; and, (iii) accessibility differs not only in space but also in time, with the monsoon season posing additional challenges for millions of Indonesian patients in need of care