LARAS, country partner of Mainline within the Bridging the Gaps programme, has successfully lobbied for an improved health insurance coverage for people living with HIV (PLHIV) in the province of East Kalimantan who need to be hospitalized in Jakarta because of complications.

There are 2.103 PLHIV on East Kalimantan (accumulative numbers, source: Provincial Health Department of East Kalimantan per June 2013). In the Provincial hospital in Samarinda basic healthcare and HIV treatment is provided for free. Medication is also available free of charge. However, there is no experience in handling more complicated cases such as babies with HIV, liver or heart disorders and serious co-infections like TB.

JAMSKEDA and JAMKESPROV

Basically, there are two kinds of health insurances provided by the government:

  1. JAMKESDA – Regional health insurance, for patients in provincial or local hospitals
  2. JAMKESPROV – Provincial health insurance, for patients need to refer to hospitals in Java (commonly Jakarta and Surabaya) with advanced facilities and treatments for serious cases

These two health insurances are also available for PLHIV, but many people still do not know that they can actually get support from them. Before, patients with complications needed to go through bureaucratic processes before they could be referred. LARAS supports these patients, including sex workers and people who use drugs, in taking them to the hospital and ensuring that all the insurance documents are in order. These processes are very time-consuming and can be a matter of life and dead.

 It took a minimum of 3 days to process the recommendation letter (proof that our client is poor) from local authorities, 1 day to get a referral letter from the local hospital to the provincial hospital, and 3 days to process the issuance of the provincial health insurance. (Laras Project Leader)

Every person in need will receive access to advanced care

Thanks to LARAS, the Provincial Health Department which issues the heath insurances now acknowledges clients from LARAS and is more aware of the many other PLHIV who need health insurance for advanced referrals. The discussions between LARAS and the Provincial Health Department will be documented in a Memorandum of Understanding that will give every person in need access to advanced treatment which will be covered by the insurance.

 Our hope is that the arrangement of advanced referrals will be much faster and accessible for all people living with HIV

In addition, LARAS has linked the Provincial Health Department to RSCM hospital in Jakarta to refer clients for advanced referrals of HIV/AIDS treatment. The result is that the Provincial Health Department has initiated a MoU with RSCM hospital for future referrals of PLHIV from East Kalimantan. After the MoUs are signed the outreach workers and nurses of LARAS do not need to go through long and difficult procedures anymore to get referral to Jakarta but can arrange for this much faster. This is a great success in getting improved access for all to treatment and care.