Landscape analysis of Indonesia
Antimicrobial Resistance (AMR) poses a critical public health problem globally, including in Indonesia. Gender and equity issues are known to drive risk of exposure to AMR and create barriers to diagnosis and recommended use of antimicrobials. However, gender and equity considerations remain marginal within existing policy and implementation frameworks at the global level. Through interviews with key stakeholders in Indonesia, this study sought to summarise the issues relating to gender and equity in Indonesia and gain a comprehensive understanding of the extent to which AMR policy, surveillance, data use, and antimicrobial stewardship incorporate gender and equity considerations, and to identify gaps in the integration of an equity perspective. Interviews were conducted with seven key informants from government, academia, civil society, and non-government organisations.
This study highlights that gender and equity are not adequately addressed in Indonesia’s AMR response. The current National Action Plan on AMR (NAP-AMR) and hospital-level AMR policies do not explicitly address equity dimensions. Efforts to address AMR also remain heavily hospital-centred, with most interventions focused on inpatient care. Where equity is considered, it is often interpreted as equitable access to healthcare services. Monitoring and evaluation rely mainly on hospital accreditation processes, which track technical compliance but do not systematically assess equitable access or gendered patterns of antibiotic use.
Addressing these gaps requires the explicit integration of gender and equity into AMR policy frameworks. Stronger leadership from the Ministry of Health is needed to direct hospitals and AMR programme implementers to adopt equity-sensitive approaches. National policies should be complemented by community engagement strategies, empowering parents and local actors to participate in addressing AMR. Clinical guidelines should embed gender and equity considerations, particularly for conditions such as urinary tract infections, tuberculosis, and HIV, where sex and gender dimensions significantly shape risks and treatment outcomes. Finally, adequate funding and planning are essential to support these efforts, alongside investment in awareness-raising to improve public understanding of AMR across different social groups.
