Appraisal of universal health insurance and maternal health services utilization: pre- and post-context of the Jaminan Kesehatan Nasional implementation in Indonesia
IntroductionThe Indonesian government introduced universal health insurance through the National Social Security System (JKN) in 2014 to enhance overall healthcare. This study compares maternal health care (MHC) service utilization before and after JKN implementation in Indonesia.MethodUsing 2012 an...
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1301421/full |
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| author | Tati Rahmawati Hui-Min Hsieh Hui-Min Hsieh Hui-Min Hsieh Hui-Min Hsieh Hui-Min Hsieh |
| author_facet | Tati Rahmawati Hui-Min Hsieh Hui-Min Hsieh Hui-Min Hsieh Hui-Min Hsieh Hui-Min Hsieh |
| author_sort | Tati Rahmawati |
| collection | DOAJ |
| description | IntroductionThe Indonesian government introduced universal health insurance through the National Social Security System (JKN) in 2014 to enhance overall healthcare. This study compares maternal health care (MHC) service utilization before and after JKN implementation in Indonesia.MethodUsing 2012 and 2017 data from Indonesia Demographic and Health Surveys (DHS), we conducted a two-period cross-sectional design study following the Anderson model. We assessed how the JKN policy and population characteristics influenced healthcare utilization for women aged 15–49 who had given birth in the last 5 years. Multivariable logistic regression models were used to assess the impact of the JKN policy and related factors.ResultIn two waves of Indonesia DHS with 14,782 and 15,021 subjects, this study observed a significant increase in maternal healthcare service utilization post-JKN implementation. Women were more likely to have at least four antenatal care visits (adjusted odds ratio, AOR = 1.17), receive skilled antenatal care (AOR = 1.49), obtain skilled birth assistance (AOR = 1.96), and access facility-based delivery (AOR = 2.45) compared with pre-JKN implementation.ConclusionThis study revealed a significant positive impact of JKN on enhancing MHS utilization. The introduction of universal health insurance coverage likely reduced financial barriers for specific demographics, resulting in increased service utilization. Our study may offer valuable insights for Asian countries with similar demographics and health insurance implementations. |
| first_indexed | 2024-04-25T00:06:33Z |
| format | Article |
| id | doaj.art-04465102b9524ad081673996544495f2 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-25T00:06:33Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-04465102b9524ad081673996544495f22024-03-14T04:37:06ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-03-011210.3389/fpubh.2024.13014211301421Appraisal of universal health insurance and maternal health services utilization: pre- and post-context of the Jaminan Kesehatan Nasional implementation in IndonesiaTati Rahmawati0Hui-Min Hsieh1Hui-Min Hsieh2Hui-Min Hsieh3Hui-Min Hsieh4Hui-Min Hsieh5Department of Public Health, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Public Health, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanCenter for Big Data Research, Kaohsiung Medical University, Kaohsiung, TaiwanResearch Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, TaiwanIntroductionThe Indonesian government introduced universal health insurance through the National Social Security System (JKN) in 2014 to enhance overall healthcare. This study compares maternal health care (MHC) service utilization before and after JKN implementation in Indonesia.MethodUsing 2012 and 2017 data from Indonesia Demographic and Health Surveys (DHS), we conducted a two-period cross-sectional design study following the Anderson model. We assessed how the JKN policy and population characteristics influenced healthcare utilization for women aged 15–49 who had given birth in the last 5 years. Multivariable logistic regression models were used to assess the impact of the JKN policy and related factors.ResultIn two waves of Indonesia DHS with 14,782 and 15,021 subjects, this study observed a significant increase in maternal healthcare service utilization post-JKN implementation. Women were more likely to have at least four antenatal care visits (adjusted odds ratio, AOR = 1.17), receive skilled antenatal care (AOR = 1.49), obtain skilled birth assistance (AOR = 1.96), and access facility-based delivery (AOR = 2.45) compared with pre-JKN implementation.ConclusionThis study revealed a significant positive impact of JKN on enhancing MHS utilization. The introduction of universal health insurance coverage likely reduced financial barriers for specific demographics, resulting in increased service utilization. Our study may offer valuable insights for Asian countries with similar demographics and health insurance implementations.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1301421/fullNational Social Security SystemJaminan Kesehatan Nasionaluniversal health coveragematernal careDemographic and Health Surveys (DHS) |
| spellingShingle | Tati Rahmawati Hui-Min Hsieh Hui-Min Hsieh Hui-Min Hsieh Hui-Min Hsieh Hui-Min Hsieh Appraisal of universal health insurance and maternal health services utilization: pre- and post-context of the Jaminan Kesehatan Nasional implementation in Indonesia Frontiers in Public Health National Social Security System Jaminan Kesehatan Nasional universal health coverage maternal care Demographic and Health Surveys (DHS) |
| title | Appraisal of universal health insurance and maternal health services utilization: pre- and post-context of the Jaminan Kesehatan Nasional implementation in Indonesia |
| title_full | Appraisal of universal health insurance and maternal health services utilization: pre- and post-context of the Jaminan Kesehatan Nasional implementation in Indonesia |
| title_fullStr | Appraisal of universal health insurance and maternal health services utilization: pre- and post-context of the Jaminan Kesehatan Nasional implementation in Indonesia |
| title_full_unstemmed | Appraisal of universal health insurance and maternal health services utilization: pre- and post-context of the Jaminan Kesehatan Nasional implementation in Indonesia |
| title_short | Appraisal of universal health insurance and maternal health services utilization: pre- and post-context of the Jaminan Kesehatan Nasional implementation in Indonesia |
| title_sort | appraisal of universal health insurance and maternal health services utilization pre and post context of the jaminan kesehatan nasional implementation in indonesia |
| topic | National Social Security System Jaminan Kesehatan Nasional universal health coverage maternal care Demographic and Health Surveys (DHS) |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1301421/full |
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