The Indonesian Ministry of Health has stepped in to address critical weaknesses in Papua’s main referral hospitals. Recent audits found that the management and operations in these hospitals fell significantly below required standards, following several high-profile maternal deaths that shocked the community.
Officials led by Ockti Palupi Rahayuningtyas, Director of Health Service Governance at the Ministry, visited Papua under direct orders from the Minister of Health. They conducted a joint audit with the National Committee for Patient Safety on four major hospitals: RSUD Yowari, RSUD Abepura, RS Bhayangkara, and RS Dian Harapan. The team identified unhealthy management practices, poor internal coordination, and unreliable medical services endangering patient safety.
Bold Kemenkes’ Emergency Audit Findings
Investigations revealed systemic failures in both hospital administration and the delivery of essential health services. These shortcomings are not just operational issues but reflect critical problems in financial management, workforce discipline, and emergency response systems. The Ministry stressed that the situation requires an immediate and uncompromising overhaul, not just incremental fixes.
Dr. Ockti emphasized that internal reform must come first. Comfortable working conditions for doctors and staff lead to safer, higher-quality patient care. Addressing poor management structures is essential to prevent repeating previous tragedies.
Detailed Recommendations for Hospital Reform
Based on the audit results, the Ministry issued a series of emergency and long-term recommendations divided into three priority levels: immediate, intermediate, and structural. All recommendations are mandatory, with government scrutiny to ensure compliance.
- Immediate Actions:
- Deploy additional obstetricians (SpOG) and enable round-the-clock specialist backup.
- Reactivate the obstetric emergency operating room at RSUD Abepura to handle critical deliveries during the festive period.
- Intermediate Measures:
- Strengthen the skills of human resources, especially in Emergency Obstetric and Neonatal Services (PONEK).
- Fix referral systems that have frequently failed; delays and inadequate handover have contributed to poor outcomes.
- Reform remuneration to a performance-based model to boost motivation and accountability.
- Establish rapid mechanisms to fill specialist vacancies, preventing dangerous staff shortages.
- Structural Reforms:
- Fully rebuild hospital governance, covering financial transparency, clinical quality, human resource development, medical education, and research capabilities.
Top 10 Urgent Recommendations from Kemenkes
To address direct threats to patient safety, Kemenkes issued ten critical recommendations hospitals must implement without delay:
- Increase the number of obstetricians (SpOG) on duty and establish a back-up system.
- Ensure that ER doctors are involved in all obstetric emergencies.
- Ban the use of oxytocin induction unless the hospital is fully prepared for surgical intervention.
- Mandatory monitoring of fetal heart rate (DJJ) and contractions (HIS).
- Ensure laboratory services are available 24/7.
- Provide ambulances and trained drivers on standby at all times.
- Mandate confirmation of receiving hospitals before patient transfer.
- Require complete referral and ambulance observation forms for every patient transfer.
- Daily audits of medical records at each facility.
- Intensive and ongoing programs for both PONEK and In-House Training (IHT).
Critical Need for Consistent Quality Standards
The severity of the findings highlights that many basic services expected in any hospital were often missing. These included incomplete medical documentation, unreliable emergency transport, and gaps in specialist availability, directly risking patient lives. According to Yuli Astuti Saripawan, Director of Referral Medical Services, poor managerial oversight sits at the root of these problems.
Government Support and Public Expectation
The Governor of Papua, Matius D. Fakhiri, expressed full commitment to follow all national health directives. However, there remains a gap between policy promises and actual service improvements visible on the ground. Communities across Papua, especially in remote rural areas, expect transparent progress and equal rights to safe, timely healthcare.
This intervention by the Ministry is a defining moment for healthcare in one of Indonesia’s most challenging regions. The coming months will determine whether these critical reforms produce enduring change or remain unfulfilled commitments in the country’s easternmost province.
