The Right to Health in Evidence-based Policymaking

The Case of Indonesia, 2009-2017

  • Farah Purwaningrum Sydney Asia Pacific Migration Centre - the University of Sydney, Australia
  • Fiona McDonald Co-Director of the Australian Centre for Health Law Research - Queensland University of Technology, Australia
  • Stephanie Doris Short Director of Sydney Asia Pacific Migration Centre - the University of Sydney, Australia


The right to health is included in United Nations (UN) Sustainable Development Goals (SDG) number 3, “Good health and well-being”. This goal aims to ensure healthy life and to promote well-being for all, at all ages. The SDGs, which build on the Millennial Development Goals (MDGs), provide a significant expansion to the development agenda. Inclusive development is part and parcel of the SDGs. Evidence-based policymaking studies provide explanations of normative and legitimate expectations for policymakers, namely, to use scientific evidence and specific indicators in their policymaking process. The right to health, as constructed, in evidence-based policymaking discourse is in contention. This paper addresses the various types of meaning Indonesian policymakers attach to the right to health through their discourses in norms of health policy. This study provides an analysis of discourses, regulatory analysis, and historical narratives (based on analysis of health regulations and newspaper articles) pertaining to evidence-informed policy in the health sector in Indonesia from 2009-2017. Our findings elucidate how the right to health manifests in the processes of evidence-based policymaking. We do so by way of a two-pronged analysis, i) discourse analysis at the macro level in Indonesia about the right to health as a norm and ii) health policymaking at the micro level, in the Indonesian district of Gunungkidul,within the region of Yogyakarta.

Author Biographies

Fiona McDonald, Co-Director of the Australian Centre for Health Law Research - Queensland University of Technology, Australia

Fiona is an Associate Professor at the Faculty of Law at Queensland University of Technology. Fiona is also an Adjunct Associate Professor at the Department of Bioethics, Dalhousie University, Canada. Fiona is a Co-Director of the Australian Centre for Health Law Research. She is also a member of Dalhousie University’s Technoscience and Regulation Research Unit. Prior to her appointment Fiona was a research associate at the Health Law Institute at Dalhousie University, Canada and a legal advisor to New Zealand’s Health and Disability Commissioner.  Fiona’s research encompasses issues related to health governance and has four broad themes:

  • the governance of health and systems (with a focus on rural bioethics and disaster response)
  • the governance of health technologies
  • the governance of health professionals
  • the governance of health organisations.

Fiona’s work has been published in a range of international journals, she has presented at a number of international conferences, and she has received grants, contracts and scholarships to conduct research in this area.


Research interests

  • Health governance
  • Health systems law and policy
  • Rural bioethics
  • Bioethics
  • Regulation.
Stephanie Doris Short, Director of Sydney Asia Pacific Migration Centre - the University of Sydney, Australia

Professor Stephanie Short Leads Workforce Development Activities in the World Health Organization Collaborating Centre in Workforce Development in Rehabilitation and Long Term Care. She is Deputy Director of the Sydney Asia Pacific Migration Centre, Faculty of Arts and Social Sciences and Academic Lead of the Shaping Health Systems Research Group, World Universities Network.

Under her supervision, she has guided PhD students and junior academic colleagues from diverse backgrounds, with former students and colleagues now holding senior positions in academe, government and industry.

She has chaired reviews, working parties and conferences. In 2010 Professor Short was elected to the Board of the Sociology of Health Research Committee of the International Sociological Association, for an eight-year term, and in 2014 she was elected Secretary-Treasurer for a four-year term.

Professor Stephanie Short is Convenor of HealthGov, an international research network that brings together researchers, health professionals and regulators to provide ideas and evidence to underpin good practice, safer practice and improved access to health care. She is a member of the Editorial Committee of 'Health Sociology Review', the 'Asia Pacific Journal of Health Management' and the 'International Journal of Health Governance'. In 2012 she was awarded a visiting research position at the Brocher Foundation in Geneva, Switzerland, and she has successfully secured approximately $6 million in competitive grants over the years. Currently Prof Short is a chief investigator on an ARC Discovery Project 'Strengthening Health Workforce Migration to Australia and Canada'.


Ahmad, Sauqi, and Ridwan. 2002. Maternal Behaviour in Child Rearing and Its Relation with the Child’s Health and Nutritional Status in the Rural area of East Lombok (Perilaku Ibu dalam Mengasuh Anak dan Hubungannya dengan Status Gizi dan Kesehatan Anak Balita di Pedesaan Lombok Timur). Lombok, Mataram.

Alston, Phillip, and Gerard Quinn. 1987. "The Nature and Scope of States Parties' Obligations under the International Covenant on Economic, Social and Cultural Rights " Human Rights Quarterly 9 (2):156-229.

Anna, Lusia Kus. 2017. "Pengaruh Ibu Kurang Gizi pada Kesehatan Janin (Effects of Mother Suffering Malnutrition on Fetal Health)." Kompas, 23rd of May 2017. pengaruh.ibu.kurang.gizi.pada.kesehatan.janin?page=all.

Atmarita. 2005. "Nutrition Problems in Indonesia." An Integrated Seminar and Workshop on Lifestyle-Related Diseases held in Gadjah Mada University, Yogyakarta, 19-20 March 2005.

Backman, Gunilla, Paul Hunt, Rajat Khosla, Camila Jaramillo-Strouss, Belachew Mekuria Fikre, Caroline Rumble, David Pevalin, David Acurio Páez, Mónica Armijos Pineda, Ariel Frisancho, Duniska Tarco, Mitra Motlagh, Dana Farcasanu, and Cristian Vladescu. 2008. "Health systems and the right to health: an assessment of 194 countries." The Lancet 372 (9655):2047-2085. doi: 10.1016/S0140-6736(08)61781-X.

Bahdi, Reem. 2002. "Globalization of Judgment: Transjudicialism and the Five Faces of International Law in Domestic Courts." George Washington International Law Review 34 (555):1-72.

Barrera, A. 1988. The Role of Maternal Schooling and its Interaction with Public Health Programs in Child Health Production. In Center Discussion Paper Yale, New Haven: Yale University: Economic Growth Center.

Berger, S.G, S. de Pee, M.W Bloem, S Halati, and R.D Semba. 2008. "Malnutrition and morbidity among children not reached by the national vitamin A capsule programme in urban slum areas of Indoensia." Public Health 122:371-378.

Bloem, M, R Tjiong, Graciano F, Sari M, and de Pee S. 1998. Nutrition and health-related issues resulting from Indonesia's crisis. Summary and recommendations. Jakarta, Indonesia.

Bloem, Martin W, Regina Moench-Pfanner, and Dora Panagides. 2003. Health & Nutritional Surveillance for Development: Helen Keller International Asia Pacific Regional Office.

Brownson, R, E Baker, T Leet, and K Gillespie. 2003. Evidence Based Public Health: Oxford University Press.

Brownson, R, J Gurney, and G Land. 1999. "Evidence-based decision making in public health." Journal of Public Health Management and Practice 5 (5).

CESCR. 2000. General Comments No.14 year 2000 of the Committee on Economic, Social and Cultural Rights. edited by Social and Cultural Rights (CESCR)- United Nations The Committee on Economic.

Donnelly, Jack. 1986. "International Human Rights. A Regime Analysis." International Organization 40 (3):599-642.

Fairclough, Norman. 1993. "Critical discourse analysis and the marketization of public discourse: the universities." Discourse and Society 42 (2):133-168.

Fairclough, Norman, Guiseppina Cortese, and Patrizia Ardizzone. 2007. Discourse and Contemporary Social Change. 1st ed. Bern: Peter Lang AG, Internationaler Verlag der Wissenschaften. .

George, Asha, Kerry Scott, Surekha Garimella, Shinjini Mondal, Rajani Ved, and Kabir Sheikh. 2015. "Anchoring contextual analysis in health policy and systems research: A narrative review of contextual factors influencing health committees in low and middle income countries." Social Science & Medicine 133:159-167.

Gloppen, Siri. 2005. "Public Interest Litigation, Social Rights and Social Policy." Arusha Conference on “New Frontiers of Social Policy”, December 12-15, 2005.

Hartono, Mimin Dwi. 2017. "Vaksinasi dan Hak Anak atas Kesehatan (Vaccination and Children’s Right to Health)." Kompas, 12th of August 2017.

Head, Brian W. 2008. "Three Lenses of Evidence-Based Policy." Australian Journal of Public Administration 67 (1):1-11.

Head, Brian W. 2013. "Evidence-Based Policymaking – Speaking Truth to Power?" Australian Journal of Public Administration 72 (4):397-403.

Heywood, Mark. 2009. "South Africa’s Treatment Action Campaign: Combining Law and Social Mobilization to Realize the Right to Health." Journal of Human Rights Practice 1 (1):14-36.

Jones, Harry. 2012. Promoting evidence-based decision-making in development agencies. London: Overseas Development Institute.

Jonnsson, K, G Tomson, C Jonsson, S Kounnavong, and R Walstrom. 2007. "Health systems research in Lao PDR: Capacity development for getting research into policy and practice." Health Research Policy and Systems 5 (11).

JR, Behrman, and Wolfe BL. 1984. "More evidence on nutrition demand. Income seems overrated and women's schooling underemphasized." J Devel Econ 14:105-128.

Kay, Adrian. 2011. "Evidence-Based Policy-Making: The Elusive Search for Rational Public Administration." Australian Journal of Public Administration 70 (3):236-245. doi: 10.1111/j.1467-8500.2011.00728.x.

Keller, Reiner. 2005. "Analysing Discourse. An Approach from the Sociology of Knowledge." Forum Qualitative Sozialforschung/Forum: Qualitative Social research 6 (3).

Kelsen, Hans. 1966. "On the Pure Theory of Law." Israel Law Review 1 (1):1-8.

Kompas. 2010a. "Launched: forum for health policy (Diluncurkan, Forum Kebijakan Kesehatan)." Kompas, 26th of April 2010. Accessed 11th of January 2018.

Kompas. 2010b. "Reducing the number of cases of undernutrition through integrated health community post/menekan gizi buruk melalui posyandu." Kompas, 15th of December 2010. /read/2010/12/15/1152197/menekan.gizi.buruk.melalui.posyandu.

Kompas. 2012. "Health budget allocation has yet to reach 5 percent (Anggaran Kesehatan Belum Capai 5 Persen)." Kompas, 24th of Agust 2012. Accessed 11th of January 2018.

Kompas. 2015. "Health budget allocation goes up (anggaran kesehatan naik)." Kompas, 06th of July 2015. Accessed 11th of January 2018.

Koskenniemi, Martti , and Päivi Leino. 2002. "Fragmentation of International Law? Postmodern Anxieties." Leiden Journal of International Law 15:553-579.

Liverani, Marco, Benjamin Hawkins, and Justin O Parkhurst. 2013. "Political and Institutional Influences on the Use of Evidence in Public Health Policy. A Systematic Review." PLoS 8 (10). doi: 10.1371/journal.pone.0077404.

McDonald, Fiona, Ambar Yoganingrum, Farah Purwaningrum, Dini Ariani, and Stephanie Doris Short. 2009. Evidence-based decision making to strengthen local governance: nutritional health interventions in Bantul and Gunungkidul. In ANU Policy Brief 10: Crawford School of Economics and Government, ANU College of Asia and the Pacific, The Australian National University.

Menski, Werner F. 2017. "Human Rights in Southeast Asia Are We Moving Backward? ." The Journal of Southeast Asian Human Rights 1 (2):109-127. doi:

Otto, J.M, W.S.R Stoter, and J. Arnscheidt. 2008. "Using legislative theory to improve law and development projects." In Lawmaking for Development : Explorations into the Theory and Practice of International Legislative Projects, edited by Julia Arnscheidt, Benjamin van Rooij and Jan Michiel Otto. Amsterdam, NETHERLANDS, THE: Leiden University Press.

Purwaningrum, Farah, and Stephanie Doris Short. 2018. "Epistemic layers in development planning: A case study of the health sector in the Gunungkidul District, Indonesia." The International Journal of Health Planning and Management 33 (4):e1200-e1210. doi: 10.1002/hpm.2607.

Reed, BA, Habicht JP, and Niameogo C. 1996. "The effects of maternal education on child nutritional status depend on socio-environmental conditions." International Journal of Epidemiology 25 (3):585-592.

Risse, Thomas, and Kathryn Sikkink. 2009. "The socialization of international human rights norms into domestic practices: introduction " In The Power of Human Rights, International Norms and Domestic Change, edited by Thomas Risse, Stephen C Ropp and Kathryn Sikkink, 1-38. Cambridge, UK: Cambridge University Press.

Ruel MT, Habicht JP, Pinstrup-Andersen P, and Gröhn Y. 1992. "The mediating effect of maternal nutrition knowledge on the association between maternal schooling and child nutritional status in Lesotho." American Journal of Epidemiology 135 (8):904-914. doi: 10.1093/oxfordjournals.aje.a116386.

Simpson, Gerry. 2009. Great Powers and Outlaw States. Unequal Sovereigns in the International Legal Order: Cambridge University Press.

Skoufias, Emmanuel. 2006. "Parental Education and child Nutrition in Indonesia." Bulletin of Indonesian Economic Studies 35 (1):99-119.

Slaughter, Anne-Marie. 1994. "A Typology of Transjudicial Communication." University of Richmond Law Review 29 (1).

Sparke, Matthew. 2009. "Unpacking Economism and Remapping the Terrain of Global Health." In Global Health Governance: Crisis, Institutions and Political Economy, edited by Adrian Kay and Owain David Williams, 131-159. London: Palgrave Macmillan UK.

Sutcliffe, Sophie, and Julius Court. 2005. Evidence-Based Policymaking: What is it? How does it work? What relevance for developing countries? London: Overseas Development Institute.
The-Jakarta-Post. 2017a. "Govt devises policy to mitigate BPJS Kesehatan’s financial deficit." The Jakarta Post 10th of November, 2017.

The-Jakarta-Post. 2017b. "Govt to accelerate programs to overcome stunting among Indonesians." The Jakarta Post, 9th of November 2017. Accessed 11th of January 2018.

Thomas, Duncan, John Strauss, and Maria Helena Henriques. 1987. Child Survival Nutritional Status and Household Characteristics: Evidence from Brazil. In Center Discussion Paper Yale, New Haven: Yale University: Economic Growth Center.

Twining, William. 2000. Globalisation & Legal Theory. London: Butterworths.

White, Louise G. 1994. "Policy Analysis as Discourse." Journal of Policy Analysis and Management 13 (3):506-525.
How to Cite
PURWANINGRUM, Farah; MCDONALD, Fiona; SHORT, Stephanie Doris. The Right to Health in Evidence-based Policymaking. Journal of Southeast Asian Human Rights, [S.l.], v. 4, n. 1, p. 168-199, june 2020. ISSN 2599-2147. Available at: <>. Date accessed: 03 aug. 2021. doi:

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