Project Profile 1054

Project Snapshot

Overview

Cancer remains one of Indonesia’s most pressing health challenges, with roughly 400,000 new cases and 235,000 deaths recorded annually as of 2020, and about 70% of cases diagnosed only at a late stage due to limited access to early detection and treatment. Building on its earlier partnership with the Ministry of Health on national referral hospital strengthening (IDN 1031), IsDB is supporting the modernization of oncology services at six National Referral Hospitals. Project locations were selected through an evidence-based process weighing provincial cancer prevalence, chemotherapy waiting times, existing oncology equipment against IAEA standards, and geographic and demographic coverage, narrowing eight candidate sites down to the six finalized hospitals.

Project Development Objective (PDO)

The PDO is to enhance the availability, accessibility, quality, and delivery of oncology services for children and adults, both male and female, through the modernization of six National Referral Hospitals, alongside targeted training to strengthen the hospitals’ health workforce. The project is expected to help diagnose about 160,000 new cancer cases a year and improve survival prospects for more than 100,000 patients (54,000 women and 46,000 men, including roughly 5,600 children) through earlier diagnosis and better treatment. Project provinces are home to 108.7 million people — about 40% of Indonesia’s population — and inpatient and outpatient oncology visits are projected to grow 75% and 99% respectively between 2021 and 2030.

Project Locations

The six participating hospitals are spread across six provinces and, through the referral network, extend improved oncology services to 21 of Indonesia’s 34 provinces:

• Adam Malik Hospital — Medan, North Sumatra
• Mohammad Hoesin Hospital — Palembang, South Sumatra
• Soeradji Tirtonegoro Hospital — Klaten, Central Java
• 3-in-1 (Neurology, Cardiology and Oncology) Hospital — Surabaya, East Java
• 3-in-1 (Neurology, Cardiology and Oncology) Hospital — Makassar, South Sulawesi
• Dr. R. D. Kandou Hospital — Manado, North Sulawesi

New building construction is limited to four of the six hospitals; civil works at the Surabaya and Makassar 3-in-1 hospitals are fully funded through Indonesia’s national budget and fall outside the scope of IsDB’s Component A financing.

Components

• Component A — Civil Works: construction of four new oncology buildings totaling 70,658 m², including laboratories, ICUs, and research facilities at four hospital sites.
• Component B — Medical and Non-Medical Equipment: procurement, installation, operation, and maintenance of medical and research equipment and hospital furnishings; medical equipment is IsDB-financed, non-medical equipment is GOI-financed.
• Component C — Improving Health Service Quality: staff training on quality-based oncology care, strengthening hospital oncology research and inter-hospital collaboration, cervical and breast cancer awareness campaigns for women and youth, and enhancement of the National Cancer Registry for detection, tracking, and monitoring of cancer patients.
• Component D — Project Management: establishment and operation of the PMU and PIUs, supported by a Detailed Engineering Design Consultant (GOI-financed), a Project Management Supervision Consultant (PMSC), and an Equipment Consultant (EQC).
• Component E — Financial Audit: annual audits conducted by Indonesia’s Financial and Development Supervisory Board (BPKP), financed by the Government of Indonesia.

Financing

Total project cost is estimated at EUR 230.025 million, financed through IsDB’s Forward Lease (Ijarah) instrument for EUR 205.002 million (89.1%) and Government of Indonesia co-financing of EUR 25.023 million (10.9%), covering civil works, medical and non-medical equipment, health-service-quality activities, project management, and financial audit.

Implementation Arrangements

The Ministry of Health, through the Directorate General of Health Services (DGHS), is the Executing Agency. DGHS brings substantial experience managing foreign-financed health projects — including from JICA, JBIC, KfW, and the World Bank — and recently completed the development phase of a related project, IDN 1031. Implementation is coordinated through a PMU at DGHS and four hospital-level PIUs (Adam Malik, M. Hoesin, Soeradji Tirtonegoro, and Kandou), while procurement for the Surabaya and Makassar 3-in-1 hospitals is managed centrally by the Ministry’s Directorate of Health Service Facilities.

Expected Impact

The project is expected to improve early cancer detection, expand access to quality oncology care for children and adults, strengthen the health workforce through training of at least 800 hospital staff, and reinforce Indonesia’s national referral system linking thousands of primary health centers (Puskesmas) across the country.