scholarly journals Changes in Determinants and Equity of Family Planning Utilization after the Implementation of a National Health Insurance Policy in Indonesia: A Secondary Analysis of The 2012-2016 National Socio-Economic Survey of Indonesia

2020 ◽  
Author(s):  
Siti Khadijah Nasution ◽  
Yodi Mahendradhata ◽  
Laksono Trisnantoro
Keyword(s):  
Health Insurance ◽  
Family Planning ◽  
National Health Insurance ◽  
Rural Areas ◽  
Urban Areas ◽  
National Level ◽  
Insurance Policy ◽  
Health System Improvement ◽  
System Improvement ◽  
Economic Survey

Abstract Background: The Indonesian government has been implementing the National Health Insurance Policy (Jaminan Kesehatan Nasional-JKN) since 2014. The utilization of family planning service is one of the programs to increase maternal and child health status that is included in the benefit package in JKN. This study aimed to describe determinants and to evaluate JKN based on equity indicators, especially in family planning services. Methods: Data were obtained from the 2012-2016 National Socio-Economic Survey (SUSENAS) of Indonesia. Contraceptive Prevalence Rate (CPR) and Long-acting contraceptives (LACs) use were used as indicators to evaluate family planning utilization. Chi-square and logistic regression tests were used to analyze the data. Respondents were married women between 15 and 49 years of age. Results: There was no progress in CPR after the implementation of JKN. At the national level, CPR decreased within five years (2012-2016). Decreasing in urban areas and in the group that does not have health insurance were more than in rural areas and in the group that has health insurance. Utilization of non-LACs, especially injection (56%-57%) and pill (21%-24%), were still high within 2012-2016. At the national level, LACs use increased 3.18% between 2012-2016 (15.54%-18.72%). Increasing in urban areas and in the group that has subsidized health insurance were more than in rural areas and in the group that does not have subsidized. In 2016, the geography factor (rural-urban) and household economic status associated negatively with the use of overall contraceptive methods (p<0.05). Conversely, all the determinants were positively associated with LACs use (p<0.05). Conclusions: Up to 2016, the JKN program did not increase CPR. Conversely, the JKN program obtained only small increases in LACs use. LACs use in rural areas is less than in urban areas. JKN program can increase LACs use in the group that has subsidized health insurance. CPR and LACs coverage could increase through health system improvement, and the societal norms approach. Health system improvement is operationalized through improving supply-side and regulations, increasing coordination among multiple agencies in the family planning program.

scholarly journals Changes in Determinants and Equity of Family Planning Utilization after the Implementation of a National Health Insurance Policy in Indonesia: A Secondary Analysis of The 2012-2016 National Socio-Economic Survey of Indonesia

2019 ◽  
Author(s):  
Siti Khadijah Nasution ◽  
Yodi Mahendradhata ◽  
Laksono Trisnantoro
Keyword(s):  
Health Insurance ◽  
Family Planning ◽  
National Health Insurance ◽  
National Health ◽  
Rural Areas ◽  
Urban Areas ◽  
National Level ◽  
Health System Improvement ◽  
System Improvement ◽  
Economic Survey

Abstract Background: The Indonesian government has been implementing the National Health Insurance Policy (Jaminan Kesehatan Nasional-JKN) since 2014. The utilization of family planning service is one of the programs to increase maternal and child health status that is included in the benefit package in JKN. This study aimed to describe determinants and to evaluate JKN based on equity indicators, especially in family planning services. Methods: Data were obtained from the 2012-2016 National Socio-Economic Survey (SUSENAS) of Indonesia. Contraceptive Prevalence Rate (CPR) and Long-acting contraceptives (LACs) use were used as indicators to evaluate family planning utilization. Chi-square and logistic regression tests were used to analyze the data. Respondents were married women between 15 and 49 years of age. Results: There was no progress in CPR after the implementation of JKN. At the national level, CPR decreased within five years (2012-2016). Decreasing in urban areas and in the group that does not have health insurance were more than in rural areas and in the group that has health insurance. Utilization of non-LACs, especially injection (56%-57%) and pill (21%-24%), were still high within 2012-2016. At the national level, LACs use increased 3.18% between 2012-2016 (15.54%-18.72%). Increasing in urban areas and in the group that has subsidized health insurance were more than in rural areas and in the group that does not have subsidized. In 2016, the geography factor (rural-urban) and household economic status associated negatively with the use of overall contraceptive method (p<0.05). Conversely, all the determinants were positively associated with LACs use (p<0.05). Conclusions: Up to 2016, the JKN program did not increase CPR. Conversely, the JKN program obtained only small increases in LACs use. LACs use in rural areas is less than in urban areas. JKN program can increase LACs use in the group that has subsidized health insurance. CPR and LACs coverage could increase through health system improvement, and the societal norms approach. Health system improvement is operationalized through improving supply-side and regulations, increasing coordination among multiple agencies in the family planning program. Keywords: Equity, National Health Insurance, Family Planning, Indonesia

scholarly journals Changes in Determinants and Equity of Family Planning Utilization after the Implementation of a National Health Insurance Policy in Indonesia: A Secondary Analysis of The 2012-2016 National Socio-Economic Survey of Indonesia

2019 ◽  
Author(s):  
Siti Khadijah Nasution ◽  
Yodi Mahendradhata ◽  
Laksono Trisnantoro
Keyword(s):  
Health Insurance ◽  
Family Planning ◽  
National Health Insurance ◽  
National Health ◽  
Rural Areas ◽  
Urban Areas ◽  
National Level ◽  
Secondary Analysis ◽  
Insurance Policy ◽  
Economic Survey

Abstract Background The Indonesian government has been implementing the National Health Insurance Policy (Jaminan Kesehatan Nasional-JKN) since 2014. The utilization of family planning service is one of the programs to increase maternal and child health status that is included in the benefit package in JKN. This study aimed to describe determinants and to evaluate JKN based on equity indicators, especially in family planning services. Methods Data were obtained from the 2012-2016 National Socio-Economic Survey (SUSENAS) of Indonesia. Contraceptive Prevalence Rate (CPR) and Long-acting contraceptives (LACs) use were used as indicators to evaluate family planning utilization. Chi-square and logistic regression tests were used to analyze the data. Respondents were married women between 15 and 49 years of age. Results There was no progress in CPR after the implementation of JKN. At the national level, CPR decreased within five years (2012-2016). Decreasing in urban areas and in the group that does not have health insurance were more than in rural areas and in the group that has health insurance. Utilization of non-LACs, especially injection (56%-57%) and pill (21%-24%), were still high within 2012-2016. At the national level, LACs use increased 3.18% between 2012-2016 (15.54%-18.72%). Increasing in urban areas and in the group that has subsidized health insurance were more than in rural areas and in the group that does not have subsidized. Health insurance ownership, the geography factor, education, household economic correlated with contraceptive use (p<0.05) in 2015 and 2016, but this correlation was inversely proportional. Conversely, all of the determinants were positively associated with LACs use (p<0.05). Conclusions Up to 2016, the JKN program did not increase CPR. Conversely, the JKN program obtained only small increases in LACs use. LACs use in rural areas is less than in urban areas. JKN program can increase LACs use in the group that has subsidized health insurance. CPR and LACs coverage could be increased by health system improvement and the social approaches, specifically through improving supply-side and regulations, increasing coordination among multiple agencies in the family planning program, and promoting family planning based on values and norms in the society.

scholarly journals Evaluation of Midwifery Care Standard Policy BPJS Health Participants

2020 ◽  
Vol 7 (2) ◽  
pp. 172-184
Author(s):  
Astri Nurdiana ◽  
Ella Nurlailasari
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
National Health Insurance ◽  
Rural Areas ◽  
Urban Areas ◽  
Midwifery Care ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Standard Rate ◽  
Urban And Rural Areas

Enforcement of national health insurance organized through Badan Penyelenggara Jaminan Kesehatan (BPJS) experiences various polemics, one of which relates to financing for midwifery care listed in Permenkes No. 52 of 2016 concerning health service fare standards in the health insurance program, whether the standard rate can cover the needs of services provided by midwives in rural or urban areas or not. The result found that there is no difference in midwifery care fare between urban and rural areas (p>0.05), but there are differences in midwifery care fare between rural and BPJS fare standard (p<0.05) and between urban fare and BPJS fare standard (p< 0.05)

scholarly journals Can a National Health Insurance Policy Increase Equity in the Utilization of Skilled Birth Attendants in Indonesia? A Secondary Analysis of the 2012 to 2016 National Socio-Economic Survey of Indonesia

2019 ◽  
Vol 32 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Siti Khadijah Nasution ◽  
Yodi Mahendradhata ◽  
Laksono Trisnantoro
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Economic Status ◽  
National Level ◽  
Secondary Analysis ◽  
Geographical Location ◽  
Skilled Birth Attendants ◽  
Birth Attendants ◽  
Economic Survey

The Indonesian government has been implementing the National Health Insurance ( Jaminan Kesehatan Nasional [JKN]) policy since 2014. This study aimed to evaluate JKN based on equity indicators, especially in skilled birth attendants (SBAs) use. The data were obtained from National Socio-Economic Survey of Indonesia during 2012 to 2016. To analyze the data, χ2 and logistic regression tests were applied. The respondents were married mothers from 15 to 49 years who had delivered a baby. Deliveries by SBAs increased at the national level, but this achievement showed significant variation according to geographical location. The coverage of deliveries by SBAs in the eastern areas of Indonesia was still much lower than those in the western areas. All factors determining SBAs utilization (health insurance ownership, education, household economic status, and geography factor) indicated the positive correlation ( P < .05). The inequity of SBA use in differences in geographical location and socioeconomic status continues to occur after the implementation of JKN.

scholarly journals PERBEDAAN TARIF ASUHAN KEHAMILAN DAN PERSALINAN ANTARA PESERTA BPJS KESEHATAN DAN NON-BPJS KESEHATAN

2020 ◽  
Vol 13 (1) ◽  
pp. 73-83
Author(s):  
Astri Nurdiana ◽  
Ella Nurlailasari
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
Antenatal Care ◽  
National Health Insurance ◽  
Rural Areas ◽  
Urban Areas ◽  
Midwifery Care ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Urban And Rural Areas

Enforcement of national health insurance organized through Badan Penyelenggara Jaminan Kesehatan  experiences various polemics, one of which relates to financing for midwifery care listed in Permenkes No. 52 of 2016 concerning health service fare standards in the health insurance program, whether the standard tariff can cover the needs of services provided by midwives in rural or urban areas or not. The result found that there is no difference in antenatal care tariff between urban and rural areas (p>0.05), while there are differences in antenatal care tariff between urban tariff and UHC tariff standard (p<0.05), additionally there are significant different between both normal and childbirth with emergency condition tariff of UHC and urban and rural areas tariff (p< 0.05)

scholarly journals Green and Blue Space Availability and Self-Rated Health among Seniors in China: Evidence from a National Survey

2021 ◽  
Vol 18 (2) ◽  
pp. 545
Author(s):  
Chensong Lin ◽  
Longfeng Wu
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Empirical Studies ◽  
National Level ◽  
The Elderly ◽  
Coverage Ratio ◽  
Self Rated Health ◽  
Health Promoting ◽  
Major River ◽  
Urban And Rural Areas

Many empirical studies have shown evidence of multiple health benefits provided by green and blue spaces. Despite the importance of these spaces, investigations are scarce in details for blue spaces rather than green. Moreover, most research has focused on developed regions. A limited number of studies on blue spaces can be found in China with a focus on the city level. Outcomes have been mixed due to varying research scales, methodologies, and definitions. This study relies on a national-level social survey to explore how the self-rated health (SRH) of senior individuals is associated with local green and blue space availability in urban and rural areas. Results indicate that the coverage ratio of overall green spaces and waterbodies around a resident’s home have marginal effects on SRH status in both urban and rural areas. In urban areas, living close to a park can is marginally beneficial for older people’s health. Regarding different types of blue spaces, the presence of a major river (within 0.3–0.5 km) or coastline (within 1 km and 1–5 km) in the vicinity of home negatively affects SRH among the elderly in urban areas. Close proximity to lakes and other types of waterbodies with a water surface larger than 6.25 ha did not significantly influence SRH. These findings not only evaluate general health impacts of green/blue space development on senior populations across the county but inform decision makers concerning the health-promoting qualities and features of different green/blue spaces to better accommodate an aging population in the era of urbanization.

Influence of community satisfaction with individual happiness: comparative study in semi-urban and rural areas of Tikapur, Nepal

2017 ◽  
Vol 25 (3) ◽  
pp. 22-32 ◽  
Author(s):  
Myung-Bae Park ◽  
Chun-Bae Kim ◽  
Chhabi Ranabhat ◽  
Chang-Soo Kim ◽  
Sei-Jin Chang ◽  
...  
Keyword(s):  
Rural Areas ◽  
Physical Environment ◽  
Urban Areas ◽  
Positive Relationship ◽  
National Level ◽  
Medical Services ◽  
Community Satisfaction ◽  
Critical Factors ◽  
Urban And Rural Areas

Happiness is a subjective indicator of overall living conditions and quality of life. Recently, community- and national-level investigations connecting happiness and community satisfaction were conducted. This study investigated the effects of community satisfaction on happiness in Nepal. A factor analysis was employed to examine 24 items that are used to measure community satisfaction, and a multiple regression analysis was conducted to investigate the effects of these factors on happiness. In semi-urban areas, sanitation showed a positive relationship with happiness. In rural areas, edu-medical services were negatively related to happiness, while agriculture was positively related. Gender and perceived health were closely associated with happiness in rural areas. Both happiness and satisfaction are subjective concepts, and are perceived differently depending on the socio-physical environment and personal needs. Sanitation, agriculture (food) and edu-medical services were critical factors that affected happiness; however, the results of this study cannot be generalized to high-income countries.

Evaluating the Impact and Effectiveness of Community-Based Health Insurance Policy Among Informal Sector in Lagos State Using Donabedian Model

2021 ◽  
Vol 5 (2) ◽  
pp. 65-80
Author(s):  
Afeez Kolawole Shittu ◽  
Kikelomo Aboyowa Mbada ◽  
Temitayo Isaac Odeyemi
Keyword(s):  
Health Insurance ◽  
Informal Sector ◽  
Urban Areas ◽  
National Level ◽  
Community Based ◽  
Community Based Health Insurance ◽  
Healthcare Needs ◽  
Lagos State ◽  
Donabedian Model ◽  
The Impact

The study used the Donabedian model (process, structure, and outcome) to evaluate the impact and effectiveness of the Community Based Health Insurance Scheme (CBHIS) among informal sector population in rural and semi-urban areas of Lagos State, and the respondents were drawn among the market men and women, motorist, among others. Three hundred and eighty-four (384) respondents were sampled based on the research advisor's sampling size. Lagos State is stratified along with its three senatorial districts and a local government each is purposively selected based on the full implementation of CBHIS. Data were analysed using descriptive and interferential statistics and the result revealed that 55% of respondents attested to the effectiveness of CBHIS in drastically reducing the cost of medical services and enhancing equal accessibility for healthcare needs. On the other hand, the implementation of CBHIS has no significant impact on healthcare service delivery due to the unfriendly attitude of healthcare providers towards the beneficiaries. The study concluded by providing information on the outcomes of CBHIS implementation at the sub-national level of government in Nigeria and suggest ways of improvement.

scholarly journals Did expansion of health insurance coverage reduce horizontal inequity in healthcare finance? A decomposition analysis for China

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025184
Author(s):  
Zhonghua Wang ◽  
Xue Zhou ◽  
Yukuan Gao ◽  
Mingsheng Chen ◽  
Andrew J Palmer ◽  
...  
Keyword(s):  
Health Insurance ◽  
Rural Areas ◽  
Urban Areas ◽  
Decomposition Analysis ◽  
Healthcare Financing ◽  
Horizontal Inequity ◽  
Financing System ◽  
Percentage Points ◽  
Out Of Pocket Payments ◽  
Healthcare Finance

Objectives‘Horizontal inequity’ in healthcare finance occurs when people with equal income contribute unequally to healthcare payments. Prior research is lacking on horizontal inequity in China. Accordingly, this study set out to examine horizontal inequity in the Chinese healthcare financing system in 2002 and 2007 through two rounds of national household health surveys.DesignTwo rounds of cross-sectional study.SettingHeilongjiang Province, China.ParticipantsAdopting a multistage stratified random sampling, 3841 households with 11 572 individuals in 2003 and 5530 households with 15 817 individuals in 2008 were selected.MethodsThe decomposition method of Aronsonet alwas used in the present study to measure the redistributive effects and horizontal inequity in healthcare finance.FindingsOver the period 2002–2007, the absolute value of horizontal inequity in total healthcare payments decreased from 93.85 percentage points to 35.50 percentage points in urban areas, and from 113.19 percentage points to 37.12 percentage points in rural areas. For public health insurance, it increased from 17.84 percentage points to 28.02 percentage points in urban areas, and decreased from 127.93 percentage points to 0.36 percentage points in rural areas. Horizontal inequity in out-of-pocket payments decreased from 79.92 percentage points to 24.83 percentage points in urban areas, and from 127.71 percentage points to 53.10 percentage points in rural areas.ConclusionsOur results show that horizontal inequity in total healthcare financing decreased over the period 2002–2007 in China. In addition, out-of-pocket payments contributed most to the extent of horizontal inequity, which were reduced both in urban and rural areas over the period 2002–2007.

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