Academic Health System Framework for Health Services Transformation: A Perspective View from West Java, Indonesia

Dwi Agustian,1 Insi Farisa Desy Arya,1 Qorinah Estiningtyas Sakilah Adnani,1 Guswan Wiwaha,1 Muhammad Hasan Bashari,2 Windi Nurdiawan,3 Ria Bandiara,4 Wijana Hasansulama,5 Afiat Berbudi,2 Gaga Irawan Nugraha,2 Wiryawan Permadi,3 Ruswana Anwar,3 Irvan Afriandi,1 Arief Kartasasmita,6 Yudi Mulyana Hidayat,3 Tri Hanggono Achmad,2 John Norcini7 1Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia; 2Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia; 3Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia; 4Department of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia; 5Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia; 6Department of Ophthalmology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia; 7Department of Psychiatry, SUNY Upstate Medical University, Philadelphia, PA, USACorrespondence: Dwi Agustian, Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jl. Prof. Eyckman No. 38, Bandung, West Java, 40161, Indonesia, Email [email protected]: Although the field of medicine has made significant progress in recent decades, low and middle-income countries continue to face significant difficulties in addressing the unprecedented obstacles to improving health. Medical schools should play a critical role in driving health services reform and take on a new leadership role in strengthening the health system. This paper discusses a conceptual framework and outlines the Academic Health Systems (AHS) agenda in Indonesia. A comprehensive analysis was conducted on the existing literature and frameworks regarding AHS, applying the system thinking method, which engages stakeholders actively. The findings and interpretations from interviews, focus groups, and collaborative workshops were consolidated and a set of proposed frameworks, fundamental principles, and a route for enhancing the health system in Indonesia were put forward. Our recommendations include transformative learning, community engagement, and translational research as pillar principles of AHS program. These recommendations have the potential to be modified and implemented in other low- and middle-income countries.Keywords: academic health system, medical education, Indonesia, health system reform, health services transformation