Iron-Deficiency and Nutritional Anaemia in Indonesia's National Health Insurance (JKN)

Executive summary

This report describes how people with iron-deficiency and nutritional anaemia use Indonesia's National Health Insurance scheme (JKN), using the BPJS Kesehatan Sample Data for 2015 to 2024. It covers the population served with an anaemia diagnosis (ICD-10 D50 and D64), the gap between that served count and measured anaemia in the community, who is affected by age and sex, geography and equity, the severity that reaches hospital, and the cost of care.

All population figures are survey-weighted national projections from the household sample and describe the population recorded with an anaemia diagnosis, not the true prevalence in the whole population. Anaemia is rarely coded as a primary diagnosis and usually appears as a secondary condition in pregnancy or chronic disease, so served counts are a lower bound on the real burden. A community comparison using measured haemoglobin from the 2023 Indonesia Health Survey (SKI) is provided as context, and cost figures are verified-paid claim values, not official budget realisation.

Questions this report answers

• How many people are served by JKN with a nutritional-anaemia diagnosis, and how has that changed from 2015 to 2024?
• How wide is the gap between measured community anaemia and what the claims system records as a diagnosis?
• Who is affected, including women of reproductive age, young children, and older people, and how does access vary across regions?
• How severe is the anaemia that reaches hospital, and how much does anaemia-related care cost the scheme?

Key findings

• About 4.83 million people were served by JKN with a nutritional-anaemia diagnosis over 2015 to 2024, yet only about 184 thousand people were recorded with anaemia as a primary diagnosis in 2024, roughly 310 per 100,000 members.
• The detection gap is wide: measured haemoglobin in the 2023 Indonesia Health Survey put community anaemia at about 17.4 percent of those tested across all ages, far above what the claims system captures as a recorded diagnosis.
• The burden falls on women and nutrition-sensitive groups: about 65 percent of served patients are women, and around 1.76 million are women of reproductive age (15 to 49), the core of the national nutrition and stunting agenda.
• Community anaemia is highest where it is least likely to be served: measured prevalence reached about 44.8 percent in Papua Selatan, 38.7 percent in Papua Barat, and 32.0 percent in Papua, alongside 26.2 percent measured anaemia among young children nationally.
• Severity that reaches hospital is real: about 18.3 percent of anaemia patients in hospital settings received a claim that included a blood transfusion, a marker of severe anaemia that could be prevented earlier upstream.
• Anaemia-related cost is large but must be read carefully: hospital claims that included an anaemia code totalled about Rp 34.8 trillion, while anaemia recorded as the primary diagnosis accounted for about Rp 4.7 trillion, the more attributable figure.