Determinants of National Health Insurance Membership among Indonesian Women with Live Births

Authors

  • Lely Khulafa'ur Rosidah Akademi Kebidanan Dharma Husada Kediri
  • Rahma Novita Asdary Akbid Dharma Husada Kediri
  • Siti Komariyah Akbid Dharma Husada Kediri
  • Widya Kusumawati Akbid Dharma Husada Kediri

DOI:

https://doi.org/10.35890/jkdh.v12i1.267

Keywords:

Health Insurance membership, maternal healthcare

Abstract

According to WHO statistics, the maternal mortality rate (MMR) in developed countries is estimated at 12/100,000 live births, while in Low and Middle-income countries (LMICs) is 239/100,000 live births. Whilst 99% of all maternal deaths were estimated to occur in LMICs, even though the causes of death can be prevented with the right policies considering that one of the goals of the Sustainable Development Goals is to reduce MMR. Access to the maternal health care (MHC) is the main technique to reduce maternal morbidity and mortality. The study evaluated the factors that influence Indonesia’s national health insurance ownership, Jaminan Kesehatan Nasional (JKN), among women who utilize MHC in Indonesia.

Methods: We used data from the 2017 Indonesia Demographic and Health Survey (IDHS) on women with live births (n=5429) in 2016-2017. We conducted analyses at the national level using descriptive statistics and logistic regression through RStudio software

Results: Out of 5717 samples, 61.4% were insured by JKN and 38.6% were uninsured. Women in white-collar employment were 2.37 times (95%s CI = 1.77-2.59) more likely to be insured by JKN, and those living in urban areas had a 1.39 (95% CI = 1.18-1.44) higher chance of being enrolled in JKN.

Conclusion: The study concluded that employment status and place of residence were significant determinants of health insurance ownership in Indonesia.

Downloads

Download data is not yet available.

References

[1] World Health Organization and The World Bank, “Tracking Universal Health Coverage: 2017 Global Monitoring Report,” Switzerland, 2017. doi: 10.1596/978-92-4-151355-5.
[2] United Nations Development Programme, “Sustainable Development Goals,” 2021. https://www.undp.org/content/undp/en/home/sustainable-development-goals.html
[3] Ministry of Health Republic of Indonesia, “Health Insurance for All Indonesians: Jaminan Kesehatan Nasional (JKN),” 2014. https://www.searo.who.int/indonesia/documents/health-insurance-for-all-indonesians-jaminan-kesehatan-nasional-jkn/en/
[4] R. Agustina et al., “Universal Health Coverage in Indonesia: Concept, Progress, and Challenges,” Lancet, vol. 393, no. 10166, pp. 75–102, 2019, doi: 10.1016/S0140-6736(18)31647-7.
[5] L. Teplitskaya and A. Dutta, “Has Indonesia’s national health insurance scheme improved access to maternal and newborn health services,” Washington, DC Heal. Policy Plus, vol. 2017, no. 2017, 2018.
[6] J. Y. S. Ng, R. V. Ramadani, D. Hendrawan, D. T. Duc, and P. H. T. Kiet, “National Health Insurance Databases in Indonesia, Vietnam and the Philippines,” PharmacoEconomics - Open, vol. 3, no. 4, pp. 517–526, 2019, doi: 10.1007/s41669-019-0127-2.
[7] W. P. Nugraheni, R. Mubasyiroh, and R. K. Hartono, “The influence of Jaminan Kesehatan Nasional (JKN) on the cost of delivery services in Indonesia,” PLoS One, vol. 15, no. 7, p. e0235176, Jul. 2020, [Online]. Available: https://doi.org/10.1371/journal.pone.0235176
[8] Y. Mahendradhata et al., The Republic of Indonesia health system review, vol. 7, no. 1. New Delhi PP - New Delhi: WHO Regional Office for South-East Asia, 2017. [Online]. Available: https://apps.who.int/iris/handle/10665/254716
[9] N. A. Sanogo and S. Yaya, “Wealth Status, Health Insurance, and Maternal Health Care Utilization in Africa: Evidence from Gabon,” Biomed Res. Int., vol. 2020, p. 4036830, 2020, doi: 10.1155/2020/4036830.
[10] N. P. and F. P. B.- BKKBN/Indonesia, K. K.-K.-M. of Health/Indonesia, and I. C. F. International, “Indonesia Demographic and Health Survey 2012.” BPS, BKKBN, Kemenkes, and ICF International, Jakarta, Indonesia, 2013. [Online]. Available: http://dhsprogram.com/pubs/pdf/FR275/FR275.pdf
[11] National Population and Family Planning Board, Statistical Indonesia, Ministry of Health, and ICF, “Indonesia Demographic and Health Survey 2017,” BKKBN, BPS, Kemenkes, and ICF, Jakarta, Indonesia, 2018. [Online]. Available: http://dhsprogram.com/pubs/pdf/FR342/FR342.pdf
[12] R. Fauzi et al., “Factors affecting optimal antenatal care utilization in Indonesia: implications for policies and practices.,” J. Public Health Policy, vol. 42, no. 4, pp. 559–573, Dec. 2021, doi: 10.1057/s41271-021-00307-9.
[13] C. L. Cesar and G. J. Walker, “Diversity in provision and utilization of maternal and child health care in an urban area of Brazil.,” Ann. Trop. Paediatr., vol. 6, no. 3, pp. 167–174, Sep. 1986, doi: 10.1080/02724936.1986.11748432.
[14] D. Romero, W. Chavkin, P. H. Wise, L. A. Smith, and P. R. Wood, “Welfare to work? Impact of maternal health on employment.,” Am. J. Public Health, vol. 92, no. 9, pp. 1462–1468, Sep. 2002, doi: 10.2105/ajph.92.9.1462.
[15] C. M. E. Reynolds, L. E. McMahon, E. G. O’Malley, O. O’Brien, S. R. Sheehan, and M. J. Turner, “Maternal employment and pregnancy outcomes in a large European maternity hospital.,” Eur. J. Obstet. Gynecol. Reprod. Biol., vol. 250, pp. 86–92, Jul. 2020, doi: 10.1016/j.ejogrb.2020.04.005.
[16] L. Shao, Y. Wang, X. Wang, L. Ji, and R. Huang, “Factors associated with health insurance ownership among women of reproductive age: A multicountry study in sub-Saharan Africa.,” PLoS One, vol. 17, no. 4, p. e0264377, 2022, doi: 10.1371/journal.pone.0264377.
[17] J. F. Figueroa, M. Tosin-Oni, J. Phelan, E. J. Orav, and A. M. Epstein, “Changes in Employment Status and Access to Care During COVID-19 Pandemic Among Low-Income Adults in 4 Southern States.,” J. Gen. Intern. Med., vol. 37, no. 11, pp. 2795–2802, Aug. 2022, doi: 10.1007/s11606-022-07547-9.
[18] Z. Changkun, G. Bishwajit, L. Ji, and S. Tang, “Sociodemographic correlates of cervix, breast and oral cancer screening among Indian women,” PLoS One, vol. 17, no. 5, p. e0265881, May 2022, doi: 10.1371/journal.pone.0265881.

Downloads

Published

2023-06-21

How to Cite

Lely Khulafa’ur Rosidah, Asdary, R. N. ., Siti Komariyah, & Widya Kusumawati. (2023). Determinants of National Health Insurance Membership among Indonesian Women with Live Births. JURNAL KEBIDANAN, 12(1), 39–46. https://doi.org/10.35890/jkdh.v12i1.267