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In 2004 the Indonesian government made a commitment to provide its entire population with health insurance coverage through a mandatory public health insurance scheme. It has moved boldly already provides coverage to an estimated 76.4 million poor and near poor, funded through the public budget. Nevertheless, over half the population still lacks health insurance coverage, and the full fiscal impacts of the government's program for the poor have not been fully assessed or felt. In addition, significant deficiencies in the efficiency and equity of the current health system, unless addressed will exacerbate cost pressures and could preclude the effective implementation of universal coverage (Ue and the desired result of improvements in population health outcomes and financial protection. For Indonesia to achieve UC, systems' performance must be improved and key policy choices with respect to the configuration of the health financing system must be made. Indonesia's health system performs well with respect to some health outcomes and financial protection, but there is potential for significant improvement. High-level political decisions are necessary on key elements of the health financing reform package. The key transitional questions to get there include: [ the benefits that can be afforded and their impacts on health outcomes and financial protection; [ how the more than 50 percent of those currently without coverage will be insured; [ how to pay medical care providers to assure access, efficiency, and quality; [ developing a streamlined and efficient administrative structure; [ how to address the current supply constraints to assure availability of promised services; [ how to raise revenues to finance the system, including the program for the poor as well as currently uninsured groups that may require government subsidization such as the more than 60 million informal sector workers, the 85 percent of workers in firms of less than five employees, and the 70 percent of the population living in rural areas.
World Development Report 1994 examines the link between infrastructure and development and explores ways in which developing countries can improve both the provision and the quality of infrastructure services. In recent decades, developing countries have made substantial investments in infrastructure, achieving dramatic gains for households and producers by expanding their access to services such as safe water, sanitation, electric power, telecommunications, and transport. Even more infrastructure investment and expansion are needed in order to extend the reach of services - especially to people living in rural areas and to the poor. But as this report shows, the quantity of investment cannot be the exclusive focus of policy. Improving the quality of infrastructure service also is vital. Both quantity and quality improvements are essential to modernize and diversify production, help countries compete internationally, and accommodate rapid urbanization. The report identifies the basic cause of poor past performance as inadequate institutional incentives for improving the provision of infrastructure. To promote more efficient and responsive service delivery, incentives need to be changed through commercial management, competition, and user involvement. Several trends are helping to improve the performance of infrastructure. First, innovation in technology and in the regulatory management of markets makes more diversity possible in the supply of services. Second, an evaluation of the role of government is leading to a shift from direct government provision of services to increasing private sector provision and recent experience in many countries with public-private partnerships is highlighting new ways to increase efficiency and expand services. Third, increased concern about social and environmental sustainability has heightened public interest in infrastructure design and performance.
Every year, the World Bank’s World Development Report (WDR) features a topic of central importance to global development. The 2018 WDR—LEARNING to Realize Education’s Promise—is the first ever devoted entirely to education. And the time is right: education has long been critical to human welfare, but it is even more so in a time of rapid economic and social change. The best way to equip children and youth for the future is to make their learning the center of all efforts to promote education. The 2018 WDR explores four main themes: First, education’s promise: education is a powerful instrument for eradicating poverty and promoting shared prosperity, but fulfilling its potential requires better policies—both within and outside the education system. Second, the need to shine a light on learning: despite gains in access to education, recent learning assessments reveal that many young people around the world, especially those who are poor or marginalized, are leaving school unequipped with even the foundational skills they need for life. At the same time, internationally comparable learning assessments show that skills in many middle-income countries lag far behind what those countries aspire to. And too often these shortcomings are hidden—so as a first step to tackling this learning crisis, it is essential to shine a light on it by assessing student learning better. Third, how to make schools work for all learners: research on areas such as brain science, pedagogical innovations, and school management has identified interventions that promote learning by ensuring that learners are prepared, teachers are both skilled and motivated, and other inputs support the teacher-learner relationship. Fourth, how to make systems work for learning: achieving learning throughout an education system requires more than just scaling up effective interventions. Countries must also overcome technical and political barriers by deploying salient metrics for mobilizing actors and tracking progress, building coalitions for learning, and taking an adaptive approach to reform.
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