Name : Airindya Bella Kusumaningrum

Student ID : 34586288

Assistive Technology Provision for Persons with Disabilities in Indonesia: A

Critical Analysis

Despite Indonesia's development in healthcare and social welfare, disparities in assistive

technology (AT) for persons with disabilities access remain a glaring challenge, highlighting
issues of equity and inclusivity (Siyaranamual, M., & Larasati, D., 2022). As this essay navigates
through the policy about AT, it aims to critically evaluate its effectiveness, dissect the nuances of
its implementation, and confront the barriers that hinder its full realization. Robust
recommendations are also needed for strengthening this vital aspect of public health policy,
ensuring that every citizen, regardless of their physical abilities, is afforded the dignity and
opportunities they rightly deserve. This exploration is not just about policy assessment but also
reflects Indonesia's commitment to nurturing an inclusive society where assistive technology
becomes a bridge, not a barrier, for its people to thrive.

Existing Health Policy for Disability in Indonesia

The Law No. 8 of 2016 concerning Persons with Disabilities in Indonesia marks a pivotal shift in
the nation's approach to disability. This groundbreaking legislation represents a paradigm shift
from a charity-based perspective, where persons with disabilities were viewed primarily as
recipients of aid, to a human rights-based approach, emphasizing respect, protection, and
fulfillment of fundamental human rights. This transformation in perspective is not just a
legislative change but reflects a deeper societal evolution toward recognizing and valuing the
dignity as well as rights of all individuals, including those with disabilities.

Under this human rights-based framework, persons with disabilities are acknowledged as having
the right to health, essential for leading independent lives, pursuing education, and engaging in
employment. This right is not just a theoretical concept but translates into tangible policies and
actions that impact the daily lives of those with disabilities. The law's recognition of these rights
underscores the importance of providing support structures that enable individuals with
disabilities to live fulfilling, autonomous lives.

In alignment with this commitment, the Indonesian government, both at the central and regional
levels, is mandated to establish Disability Service Units (Unit Layanan Disabilitas – ULT). These
units are a critical component in the practical realization of the rights of persons with disabilities.
They are envisioned as hubs of support, providing essential services and facilitating access to
resources necessary for persons with disabilities to thrive in society.

According to Article 55 of Law No. 8 of 2016, ULT is formed and funded through regional
budgets, ensuring that local governments play a direct role in addressing the needs of their
disabled constituents. This decentralized approach allows for tailored solutions that reflect the
unique contexts and challenges of different regions, thereby enhancing the effectiveness of the
services provided.
One of the primary responsibilities of these units is to ensure the availability and acquisition of
assistive devices for persons with disabilities, tailored to their specific needs and the type of
disability (Ministry of Social Affairs [MSA], 2020). These assistive health devices are crucial
tools that optimize the functionality of body parts for individuals with disabilities, based on
medical recommendations. They are not mere gadgets but are lifelines that enable persons with
disabilities to navigate their environments more effectively, enhancing their independence and
quality of life.

The financial support for these assistive devices varies according to regional government
regulations. This indicates an understanding that the needs of persons with disabilities may differ
significantly across regions (MSA, 2021). Thus, local governments are best positioned to
determine the appropriate level of financial assistance required. This decentralized approach,
while allowing for contextualized support, also raises questions about the uniformity and
equality of support across different regions.

Effectiveness of Disabilities Policies in Indonesia

A crucial aspect of assessing policy effectiveness is empirical data, which is notably absent at the
national level. There has yet to be a comprehensive, nationwide study to gauge the performance
and impact of disability policies as well as the effectiveness of ULT on the equity of AT
provision. Furthermore, a qualitative study by Novita et al (2022) conducted in Jember district
revealed that several persons with disabilities reported improved access to healthcare facilities
and the provision of health aids.

Nevertheless, there was a startling disparity in four major cities; Bandung, Solo, Makassar, and
Kupang. Approximately 91% of persons with disabilities in these cities had never received any
assistive devices from their local governments (Indonesia Corruption Watch [ICW], 2019). This
statistic is a glaring indicator of the policy's ineffectiveness in ensuring equitable access to
essential resources for persons with disabilities.

Moreover based on the state-owned Health Care and Social Security Agency (BPJS) Law no.7
(2018) about the management of health facility claims administration, the process of acquiring
AT requires the involvement of healthcare facilities and professionals to determine the specific
needs of each individual based on their disability type. This step is crucial for the provision of
appropriate and functional assistive devices. The healthcare system itself is generally
commendable in its services for the broader population but falls short in adequately addressing
the special needs of persons with disabilities. Facilities often lack essential features like
handrails, wheelchairs, computers with number-reading capabilities, Braille letters, accessible
toilets, and special counters or lanes for persons with disabilities (ICW, 2019). These deficits,
quantified in significant percentages, underscore the gaps in the healthcare infrastructure that
directly impact the effectiveness of disability policies.

A further complicating factor is the readiness of healthcare workers (HCWs) to handle the
specific needs of persons with disabilities. A staggering 74.1% of HCWs are reported to be
inadequately prepared for this task (ICW, 2019). This is particularly concerning given that
medical assessments and evaluations from doctors are prerequisites for receiving assistance in
obtaining AT (MSA, 2021). The disconnect between the policy's intentions and the healthcare
system's capacity to support it creates a bottleneck in service delivery.

Implementation of the Disabilities Policies in Indonesia

Indonesia's disability policies, comprehensive in design, face substantial implementation
challenges related to data management, coordination, funding, workforce capacity, and planning.
These multifaceted issues significantly impede the effectiveness of these policies.

A major challenge is the inconsistency in data from key national surveys like the National Socio-
Economic Survey (Susenas) and the Basic Health Research (Riskesdas). As highlighted in the
SMERU Research Institute report (2020), this discrepancy leads to a fragmented understanding
of the real number of persons with disabilities and their needs, impacting service delivery and
device provision. Without accurate data, policy implementation can be misdirected, failing to
meet the actual needs of the disabled community.

Another significant issue is the lack of coordination across different sectors involved in disability
services, such as health, education, and social services. This often results in operational silos,
leading to inefficiencies and redundancies that weaken the impact of disability policies (Tuti, R.,
& Lisa, A., 2020).

Financial constraints also pose a challenge. The limited budget for social rehabilitation programs
for persons with disabilities restricts the reach and effectiveness of these services, especially in
providing essential assistive devices. Adequate funding is vital for expanding and sustaining
these services (ICW, 2021).

Furthermore, there is a shortage of skilled social workers with expertise in disability issues,
leading to suboptimal service delivery. This gap in skilled personnel affects the quality of support
provided to persons with disabilities (Tuti, R., & Lisa, A., 2020).

The planning and budgeting for assistive device procurement also fall short of the required
strategic and responsive approach. Insufficient planning and budget allocations often lead to
delays or inadequacies in providing essential tools for daily living and social participation (Tuti,
R., & Lisa, A., 2020; ICW, 2021).

Beyond systemic issues, societal attitudes pose significant barriers. Social stigma around
disability results in a lack of understanding and support, limiting the provision of adequate
assistive devices and excluding persons with disabilities from societal participation. This stigma
not only affects physical access to services but also creates psychological barriers, discouraging
individuals from seeking support (Adioetomo, 2014).

Administrative hurdles further impede access to services and devices. Many persons with
disabilities are not registered on family cards, essential for obtaining IDs, thus barring them from
accessing government-provided assistive technology and services (Tuti, R., & Lisa, A., 2020).

Age limitations on assistive device recipients, restricting aid to those under 59, and eligibility
criteria based solely on poverty line thresholds also hinder access. These criteria exclude older
persons with disabilities and those with slightly higher incomes but facing increased living costs
due to their disability (Tuti, R., & Lisa, A., 2020).

Disability Policy Recommendations for Indonesia

In response to the challenges and barriers identified in the implementation of Indonesia's
disability policies, several key recommendations emerge. These recommendations aim to
enhance the effectiveness of the policies, ensuring that they are inclusive, equitable, and
responsive to the needs of persons with disabilities.

1. Establishing national technical guidelines for inclusive provision

To address the inconsistencies and inefficiencies in the provision of Assistive Technology (AT),
there is a pressing need for national technical regulations or guidelines. These should outline
clear, standardized procedures for AT provision, ensuring that all persons with disabilities,
regardless of their location or specific condition, have equitable access to the devices they need.
These guidelines should be comprehensive, covering aspects such as eligibility criteria, types of
devices available, application processes, and distribution mechanisms (ICW, 2021).

2. Maximizing subsidized individual-based inclusive services

Adopting a model similar to the application-based system used in Malaysia, as noted by Shi
(2022), could significantly improve service delivery. This approach involves individual-based
services where persons with disabilities can apply for specific aids and services tailored to their
unique needs. Such a system, supported by government subsidies, would ensure that more
personalized and effective support is provided, moving away from a one-size-fits-all approach to
a more nuanced, individual-centric model.

3. Enhancing assistive technology provision and awareness in Indonesia

Singapore's approach to enhancing Assistive Technology (AT) offers valuable insights for
Indonesia. Recognizing gaps in AT adoption, Singapore has emphasized increasing awareness
among persons with disabilities and social service agencies. The formation of a dedicated
workgroup aims to improve independent living and employment opportunities for persons with
disabilities. The workgroup identified a lack of familiarity with AT solutions among social
service providers, affecting service delivery. To address this, Singapore's government expanded
the Tech Able space to boost awareness and use of AT devices, meeting assessment and
prescription needs. They also initiated a Community of Practice to enhance sectoral expertise,
involving therapists, engineers, designers, and healthcare professionals, fostering knowledge
sharing in AT use (Shi, 2022). Indonesia can draw on these strategies to advance its own AT
services and support systems.

4. Formulating regulations for the existence of inclusive health facilities

The current health infrastructure in Indonesia needs to be more accommodating of the special
needs of persons with disabilities. Regulations must be formulated to mandate the existence of
inclusive health facilities. These facilities should be equipped with necessary adaptations such as
handrails, wheelchair access, assistive technologies like number-reading computers and Braille
letters, and disability-friendly toilets. Special counters or lanes should also be established for
persons with disabilities to ensure they receive prompt and appropriate services (ICW, 2021).
5. Monitoring and evaluating the performance of the directorate in the ministry directly
involved with persons with disabilities
Effective monitoring and evaluation mechanisms are essential to assess the performance of the
directorate in the Ministry responsible for disability affairs. Regular reviews should be conducted
to evaluate the impact of policies, the efficiency of service delivery, and the overall satisfaction
of persons with disabilities with the services provided. These evaluations should be transparent
and involve feedback from the disabled community, ensuring that their voices are central to the
policy evaluation and improvement process (ICW, 2021).

Conclusion
Indonesia's journey towards inclusive healthcare and social welfare for persons with disabilities,
particularly in Assistive Technology (AT) provision, highlights significant disparities and
challenges. Despite progressive legislation like Law No. 8 of 2016, which marks a paradigm
shift from a charity-based to a human rights-based approach, practical implementation reveals
gaps between policy and practice.

The effectiveness of disability policies is hampered by the absence of comprehensive national

studies on the performance of Disability Service Units (ULT). A stark example of this is the 2019
ICW survey, which found that 91% of persons with disabilities in four major cities had not
received assistive devices from local governments. Additionally, the healthcare system, while
generally robust, falls short of accommodating the special needs of persons with disabilities. The
lack of essential features like handrails, wheelchair access, and Braille letters in healthcare
facilities exemplifies this gap.

Implementation challenges stem from inaccurate and outdated data, lack of coordination across
sectors, insufficient funding, a shortage of skilled social workers, and inadequate planning for AT
procurement. Societal stigma and bureaucratic hurdles further exacerbate these issues, limiting
access to services and assistive devices.

To address these challenges, Indonesia needs to establish national technical regulations for
inclusive AT provision, maximize individual-based services, formulate regulations for inclusive
health facilities, and implement effective monitoring and evaluation mechanisms. These
recommendations aim to enhance the effectiveness of policies, ensuring they are inclusive,
equitable, and responsive to the needs of persons with disabilities. Such comprehensive measures
are crucial for building a more inclusive society, where AT serves as a bridge to opportunity and
dignity for all.
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