{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T09:09:26Z","timestamp":1779872966896,"version":"3.53.1"},"update-to":[{"DOI":"10.12688\/f1000research.171110.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000}}],"reference-count":19,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"No Applicable"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Abstract* Background Indonesia faces a growing double burden of non-communicable diseases, particularly cancer. The latest data from the Global Cancer Observatory (Globocan) indicates over 408,661 new cases and 242,099 cancer-related deaths in 2022, with a projected 63% increase in the case burden between 2025 and 2040 without strategic intervention. Although a new legal framework through Health Law No. 17 of 2023 and the Minister of Health Decree (KMK) No. HK.01.07\/MENKES\/2180\/2023 has mandated palliative care as an integral component of health services, its implementation still faces significant systemic barriers. Policy and Implications This policy brief analyzes the disconnection between the policy mandate and on-the-ground reality, identifying critical gaps in accessibility, healthcare workforce capacity particularly among nursesand financing mechanisms through the National Health Insurance (JKN) program. The failure to effectively integrate palliative care not only causes unnecessary suffering for millions of patients but also burdens the health system with inefficient costs and suboptimal end-of-life care, reflected in the high \u201cfinancial toxicity\u201d experienced by patients. Recommendations We recommend a four-pillar strategy: (1) Formalize and standardize palliative services within the JKN benefits package with a clear financing model to address regulatory ambiguity; (2) Develop a national competency-based palliative education and training strategy for all health workers, with a focus on empowering nurses in primary care; (3) Implement a decentralized and tiered palliative care delivery model centered on Community Health Centers (Puskesmas) to ensure equitable access; and (4) Launch a national public education campaign to destigmatize palliative care and increase awareness. Conclusion The integration of palliative care is not merely an option but a strategic and ethical imperative for achieving Universal Health Coverage (UHC) in Indonesia. It is a cost-effective investment to improve patients\u2019 quality of life, support families, and ensure the sustainability of the national health system in facing future non-communicable disease challenges.<\/ns3:p>","DOI":"10.12688\/f1000research.171110.2","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T08:54:09Z","timestamp":1779872049000},"page":"1324","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrating Palliative Care into the Indonesia Health System: A Policy Brief to Enhance Accessibility, Quality, and Sustainability"],"prefix":"10.12688","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0289-8083","authenticated-orcid":false,"given":"Ashar","family":"Prima","sequence":"first","affiliation":[{"name":"Postgraduate Student, Faculty of Nursing Depok West Java Universitas Indonesia"},{"name":"Medical-Surgical Nursing Department, Faculty of health and Pharmacy Bekasi West Java 17113 Universitas Bani Saleh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dewi","family":"Gayatri","sequence":"additional","affiliation":[{"name":"Basic Science and Fundamendal Nursing Department, Faculty of Nursing Depok West Java 16424 Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yati","family":"Afiyanti","sequence":"additional","affiliation":[{"name":"Maternity and Women Health Department, Faculty of Nursing Depok West Java 16424 Universitas Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christantie","family":"Effendy","sequence":"additional","affiliation":[{"name":"Medical-Surgical Nursing Department Yogyakarta 55281 Universitas Gadjah Mada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"405-410","DOI":"10.33755\/jkk.v11i3.888","article-title":"Strengthening Palliative Care Systems in Indonesia: A Strategic Policy Brief to Address Health System Gaps.","volume":"11","author":"R Agustina","year":"2025","journal-title":"Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal)."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1007\/s11912-021-01044-8","article-title":"Global Perspectives on Palliative Care for Cancer Patients: Not All Countries Are the Same.","volume":"23","author":"J Brant","year":"2021","journal-title":"Curr. 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Clin."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e2200290","DOI":"10.1200\/go.22.00290","article-title":"Indonesia\u2019s Unique Social System as Key to Successful Implementation of Community- and Home-Based Palliative Care.","volume":"9","author":"V Eng","year":"2023","journal-title":"JCO Global Oncology."},{"key":"ref5","first-page":"24-32","article-title":"Gambaran Pelayanan Paliatif di Indonesia: Systematic Review.","volume":"9","author":"N Hidayah","year":"2024","journal-title":"Jurnal Vokasi Kesehatan."},{"key":"ref6","article-title":"Cancer Today: Data Visualization Tools for Exploring the Global Cancer burden in 2022.","year":"2025"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e2426304-e2426304","DOI":"10.1001\/jamanetworkopen.2024.26304","article-title":"Early Integrated Palliative Care in Patients With Advanced Cancer: A Randomized Clinical Trial.","volume":"7","author":"E Kang","year":"2024","journal-title":"JAMA Netw. 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The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}