The impact of national health insurance on the access of maternal care service for women in Indonesia

Abstract

Background and purpose: The government of Indonesia has established national health insurance or Jaminan Kesehatan Nasional (JKN) since 2014 to meet the basic needs of appropriate public health, including women. However, maternal mortality rate in Indonesia is recorded to be higher than peers and decreases slowly. This paper aims to elaborate the impact of the national health insurance on the access to maternal care and services for women in Indonesia.Methods: This paper employs a secondary data analysis by using Indonesian National Socio-Economic Survey (SUSENAS) 2017 and applies propensity score matching methods. Within the sample, a treatment group is a group of women who are registered in the JKN, including the PBI and non-PBI participants, while the control group is a group of women who are not registered in the JKN, women who have other insurances and those who do not have any insurance. The total sample of the treatment group is 18,886 and the control group is 19,559 participants. There are two outcome variables in the analysis which reflect the access of health care and health services, which are child-birth service facility (CBSF) and Birth Attendant (BA), respectively.Results: The result shows that women who are the member of the JKN have greater probability in accessing formal health care and services during the maternity process. They tend to deliver babies in hospital and get helped by medical personnel. Moreover, by comparing the impact of the JKN in the rural and urban areas, the result shows that the probability of women in rural area to access health care and services is higher than women in cities.Conclusion: Based on these results, we can conclude that the JKN has improved the access for health care as well as medical services for maternity, in both rural and urban areas. However, the JKN program improvements are still needed, particularly in ameliorating the quality of JKN program, as well as expanding the number of participants to achieve a higher impact.