The Derivative Regulations on the Health Law are Appreciated even though Problems Still Remain

Minister of Health Budi Gunadi Sadikin(Antara)

The implementation of Health Law Number 17 of 2023 and its derivative regulations through Government Regulation (PP) number 28 of 2024 has received public appreciation. The new regulations are considered adequate in improving the quality of health services, protecting the public, safeguarding the public interest and helping to overcome various health problems in Indonesia.

Executive Director of the Segara Research Institute, Piter Abdullah Redjalam, said that the regulation is able to accommodate all aspects of the health system in Indonesia, such as regulating various promotive, preventive, curative and rehabilitative efforts.

“PP Number 28 of 2024 states that the Central Government and Regional Governments are responsible for planning, organizing, organizing, fostering and supervising the implementation of health efforts that are quality, safe, efficient, equitable and affordable for the community. These health efforts are aimed at realizing the highest possible level of health for the community. “We appreciate the government’s good intentions,” said Piter in a written statement, Thursday (26/9)

However, he sees that the Health Law still leaves a number of big challenges, especially in following up all the material contained in the Health Law into Government Regulations and other implementing regulations.

Piter gave several examples of challenges. One of them is about the baby’s health. This government regulation states that every baby has the right to receive exclusive breast milk (ASI) from birth until the age of six months, except for medical indications. This exception regarding medical indications is also in line with the International Code of Marketing of Breast-Milk Substitutes (WHO Code).

“In other words, PP Number 28 of 2024 concerning the Implementation of the Health Law recognizes that formula milk can be used to replace breast milk when exclusive breast milk cannot be provided and donor breast milk is not available. “This is a form of confirmation and validation that formula milk can be consumed by babies aged 0-6 months,” said Piter.

Also read: Derivative Regulations of Law Number 17 of 2023 concerning Health Will Soon Be Discussed Across Ministries

WHO published the WHO Code in 1981 with the aim of providing support and protection for the breastfeeding process by regulating trade practices in baby formula and other breast milk substitute (PASI) products. So far, Indonesia has been quite successful in implementing the WHO Code, especially when compared with the average achievements of countries in Asia and the world. Referring to Marketing of BMS: National Implementation of the International Code Status Report 2020, Indonesia’s achievement in 2020 was 50%. Better than the implementation average in the Asian region (41%) and at the global level (11%).

The fairly successful implementation of the WHO Code in Indonesia implies that the provisions for regulating trade practices in infant formula and breast milk substitute products for products for babies up to one year of age implemented by the government have so far not hampered the provision of exclusive breastfeeding in Indonesia.

The existence of formula milk and efforts to encourage exclusive breastfeeding should not be in conflict. PP Number 28 of 2024, as well as WHO, recognizes that formula milk is safe and can be given to babies when breast milk cannot be given by the baby’s mother or by a donor.

Also read: Waiting, Cigarette Sales and Promotion Rules in PP 28/2024

Regarding this, according to Piter, derivative regulations actually do not need to change existing provisions, namely restrictions on promotional activities for formula milk.

“The previous PP, number 69 of 1999, had strictly regulated advertising regarding food intended for babies up to one year old. “The industry has followed the rules of the game because it is strictly regulated,” said Piter.

Piter added that what is more important is education regarding nutritional content which can be carried out jointly between stakeholders. Moreover, recent stunting prevalence figures show less encouraging conditions.

BPS data shows that the rate of exclusive breastfeeding in Indonesia continues to increase from 2020 to 2022 from 68.84% to 72.04% (2022) and 73.9% (2023). However, on the other hand, in 2023 there will be a slowdown in the decline in the stunting prevalence rate, which will only fall by 0.1% from 21.6% in 2022 to 21.5% in 2023.

“Given the existing conditions regarding exclusive breastfeeding and also the need to accelerate the reduction in stunting rates, it is necessary to create conditions that support exclusive breastfeeding such as lactation rooms in offices and public spaces, as well as strengthening access to information on healthy nutritional choices for babies,” explained Piter. (Z-11)

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