Health at the doorstep: Integrated Primary Care transforms health in Plantungan

In the highlands of Kendal, Central Java, seeking medical care once meant early mornings, long walks and hours of waiting. At Puskesmas Plantungan, the main community health centre serving almost 35 000 residents, up to 150 patients would arrive each day, crowding hallways and stretching staff thin.

Today, the picture looks very different. Since the Ministry of Health launched the national Integrated Primary Care (ILP) programme in 2023 – a key part of its Health Transformation Agenda – the district’s residents have gained access to essential health services closer to home, within their communities.

"We used to see 100 to 150 patients a day," says Dr Karyadi, Head of Puskesmas Plantungan. "Now only about 30 come in. The queues have gone because services have spread out to the villages."

As Dr Karyadi notes, patients in the district can now visit two auxiliary health centres (pustu) and 10 village health posts (poskesdes) – each staffed by a midwife, nurse and two health cadres – in addition to the puskesmas.

^{A Puskesmas Plantungan health worker, Muhamad Farid Makruf, prepares equipment for his visit to a nearby auxiliary health centre.     Credit: Puskesmas Plantungan}

For Nurhadi, a nurse supervisor who has worked at Puskesmas Plantungan for over a decade, the change is evident not only for patients but in his daily work. "Before the ILP, we mostly treated symptoms. Now we educate patients, prevent illness and follow up on their recovery. We also join community gatherings such as religious events to deliver health education."

The programme marks a nationwide shift from focusing on treatment alone to prevention, early detection and continuous care at all stages of life. It also reflects a deliberate effort to strengthen community participation, engagement and ownership in health, for improved health outcomes.  

For example, in 2024 Puskesmas Plantungan trained 60 caregivers from 12 villages, enabling them to support relatives with chronic conditions at home. "When elderly patients visit, we ask that a family member comes with them," explains Nurhadi. "The families are trained to recognize signs of complications, and now they know what to do if something goes wrong." 

For specialized care, the main puskesmas continues to provide essential support, including rehabilitative services and guided exercises, with follow-up care managed closer to home.

“Once a patient’s condition is stable, we send them back to the pustu or poskesdes,” says Dr Nailul Hikmah, supervising physician for adult and elderly care. “They no longer have to travel far for routine monitoring.”

Closer care, stronger systems

Since 2023, when the ILP was launched, the World Health Organization (WHO), together with national and local partners, has provided ongoing implementation support, including for monitoring and evaluation, and context-specific adaptations.   

“The ILP reflects Indonesia’s bold, decisive efforts to reorient health services to the primary level, a global best practice that WHO is proud to support,” says Professor Roderick Salenga, Team Lead for Health Systems at WHO Indonesia. “Puskesmas Plantungan proves that closer-to-community services improve access, empower patients, and strengthen the path to universal health coverage, health system resilience and Sustainable Development Goal 3.”

Across Indonesia, the challenge now is to scale Plantungan’s success, ensuring that every community benefits from more accessible, people-centred care.  

As Dr Karyadi put it, "We may not have the most advanced equipment, but we have a system that works.” It is a system based on one simple truth: that better health begins with care delivered where people live.

^{Puskesmas Plantungan, along with its auxiliary health centres and village health posts, serves almost 35 000 residents. Implementation of the Integrated Primary Care programme has brought health care closer to the people of Plantungan. Credit: Puskesmas Plantungan}

Written by Bunga Manggiasih, National Professional Officer (Communication), WHO Indonesia