NTU 620 HEPI Lab

Indonesia Health system reform and JKN

‪Can Health Insurance Coverage Improve Quality of Reproductive and Maternity Care in Low-and Middle-Income Countries? A Multi-Country Propensity Score Matching Study‬‪T Marthias, K Anindya, S Vellakkal, N Ng, T Hone, D La, Y Zhao, H Wang, RP Aji, JT Lee…‬, ‪2023 World Congress on Health Economics, 2023‬

Impact of Indonesia’s national health insurance scheme on inequality in access to maternal health services: A propensity score matched analysisReducing inequality in maternal, neonatal and infant mortality are key targets in the Sustainable Development Goals. This study is the first to evaluate the impact of Indonesia’s national health insurance scheme, Jaminan Kesehatan Nasional (JKN), on ...

Comparative health system performance in six middle-income countries: cross-sectional analysis using World Health Organization study of global ageing and health - Riyadh Alshamsan, John Tayu Lee, Sangeeta Rana, Hasan Areabi, Christopher Millett, 2017Objective To assess and compare health system performance across six middle-income countries that are strengthening their health systems in pursuit of universal...

Associations between Indonesia’s national health insurance, effective coverage in maternal health and neonatal mortality: a multilevel interrupted time-series analysis 2000–2017Background We assessed the effect of Indonesia’s national health insurance programme ( Jaminan Kesehatan Nasional ( JKN )) on effective coverage for maternal and child health across geographical regions and population groups. Methods We used four waves of the Indonesia Demographic and Health Survey from 2000 to 2017, which included 38 880 women aged 15–49 years and 144 000 birth records. Key outcomes included antenatal and delivery care, caesarean section and neonatal and infant mortality. We used multilevel interrupted time-series regression to examine changes in outcomes after the introduction of the JKN in January 2014. Findings JKN introduction was associated with significant level increases in (1) antenatal care (ANC) crude coverage (adjusted OR (aOR) 1.81, 95% CI 1.44 to 2.27); (2) ANC quality-adjusted coverage (aOR 1.66, 95% CI 1.38 to 1.98); (3) ANC user-adherence-adjusted coverage (aOR 1.80, 95% CI 1.45 to 2.25); (4) safe delivery service contact (aOR 1.83, 95% CI 1.42 to 2.36); and (5) safe delivery crude coverage (aOR 1.45, 95% CI 1.20 to 1.75). We did not find any significant level increase in ANC service contact or caesarean section. Interestingly, increases in ANC service contact and crude coverage, and safe delivery crude coverage were larger among the poorest compared with the most affluent. No statistically significant associations were found between JKN introduction and neonatal and infant mortality (p>0.05) in the first 3 years following implementation. Interpretation Expansion of social health insurance led to substantial improvements in quality of care for maternal health services but not in child mortality. Concerted efforts are required to equitably improve service quality and child mortality across the population in Indonesia. Data are available in a public, open access repository. The data sets are publicly accessible after registration (<https://www.dhsprogram.com>).

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