The Supporting Essential Health Actions and Transformation (SEHAT) Program is a collaborative initiative between the Indonesian Government and the Asian Development Bank (ADB). It utilizes results-based lending (RBL) to support the implementation of the Health System Transformation Agenda. The Ministry of Health serves as the executing agency, making this program a strategic instrument for accelerating the strengthening of primary care in Indonesia.
The SEHAT Program aims to implement national primary care transformation to improve public access to health services that are high-quality, gender-responsive, and climate-adaptive. Supported by US$350 million in funding, the program reinforces the following pillars:
Pillar 1: Primary Care Transformation.
Pillar 5: Health Human Resources (HR) Transformation.
Pillar 6: Health Technology Transformation.
The program has been active since November 2023 and, following an extension, is scheduled to run until December 2027.
The implementation of the SEHAT Program focuses on four primary areas of strengthening:
Lifecycle-Based Integration of Primary Care (ILP): Standardizing ILP across all primary care facilities, including Puskesmas (Community Health Centers), Pustu (Auxiliary Health Centers), and Posyandu (Integrated Healthcare Posts). This includes providing standardized medical equipment (such as ultrasound machines for Puskesmas and anthropometry kits for Posyandu), developing SOPs, and ensuring facility accreditation.
Strengthening Public Health Laboratories: Enhancing Level 1 Public Health Labs (Labkesmas) at the Puskesmas level to support early detection and monitoring of both communicable and non-communicable diseases, including those influenced by climate change.
Improving Health Personnel Capability: Developing clinical competencies for primary care and laboratory staff, while increasing awareness regarding climate change and gender responsiveness through comprehensive training modules.
Digital Integration and Interoperability: Expanding the integration of primary care facilities with SatuSehat, the national health data platform, to improve reporting effectiveness, data analysis, and service coordination.
The SEHAT Program utilizes performance-based achievement indicators known as Disbursement-Linked Indicators (DLIs), agreed upon by the ADB and the Indonesian Government. Achievement verification is conducted by the Financial and Development Supervisory Agency (BPKP) acting as the Independent Verification Agency (IVA).
The DLIs include:
Improvement of maternal and child health services.
Reduction in stunting prevalence.
Capacity strengthening for Puskesmas, Posyandu, and primary Labkesmas.
Capacity strengthening for primary care human resources.
Increasing the number of Puskesmas and Labkesmas integrated with SatuSehat.
The program has completed several milestones, including the first Review Mission in 2024, the second Review Mission in April 2025, and a Mid-Term Review (MTR) in November 2025. These activities included field visits to the Aceh Province, specifically engaging with Puskesmas and indigenous communities in the Pidie Jaya and Aceh Jaya Districts.
Through the SEHAT Program, the Indonesian Government and ADB are reinforcing the foundation of integrated, high-quality, and sustainable primary health services as a concrete step toward a resilient health system.
For further information, please visit: https://www.adb.org/projects/54224-001/main.
