Restricted accessResearch articleFirst published online 2015-4
Utilization of the Local Government Health Insurance Scheme (JKA) for Maternal Health Services Among Women Living in Underdeveloped Areas of Aceh Province,Indonesia
Aceh province of Indonesia created its own health coverage scheme called Jaminan Kesehatan Aceh (JKA) to cover Aceh’s populations who were not registered under insurance for the poor (Jamkesmas). This study aims to compare the utilization rate of maternal health care (MHC) services and contraceptive prevalence rate (CPR) before JKA, during the transition period, and after JKA had been established. A cross-sectional household survey was conducted from June 2011 to July 2012. Utilization of MHC services and CPR during the 3 periods was assessed using a questionnaire. The Mantel-Haenszel χ2 test was used to examine the association between period and coverage. Generalized estimating equations (GEEs) were used to examine utilization and type of service, period of service, and type of scheme. Coverage of utilization of skilled birth attendants significantly improved among the JKA holders (odds ratio = 1.84; 95% confidence interval = 1.18-2.89). JKA, thus, has shown its positive impact.
Ministry of National Development Planning (Bappenas). Achievement of MDGs Indonesia. Jakarta, Indonesia: Bappenas; 2010.
2.
LozanoRWangHForemanKJ. Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. Lancet. 2011;378:1139-1165.
3.
AcuinCSKhorGLLiabsuetrakulT. Maternal, neonatal, and child health in southeast Asia: towards greater regional collaboration. Lancet. 2011;377:516-525.
4.
World Health Organization. Mother and Child Health; Indonesia Health Profile. Geneva, Switzerland: WHO; 2010.
5.
Ministry of National Development Planning Agency. Achievement of Millenium Development Goals. Jakarta, Indonesia: National Development Planning Agency; 2007.
6.
World Health Organization. Accelerating Progress Towards Achieving MDG-4 and -5 in South East Asia. Ahmedabad, India: WHO; 2008.
7.
Health Department of Republic Indonesia. Basic Health Research (Riskesdas). Jakarta, Indonesia: Health Department of Republic Indonesia; 2007.
8.
Ministry of Health. Long Term Strategic Planning Department of Health Republic of Indonesia 2010-2015. Jakarta, Indonesia: Ministry of Health; 2010.
9.
Indonesia Bureau of Statistics. Profile of Aceh Province. Jakarta, Indonesia: Indonesia Bureau of Statistics; 2007.
10.
World Health Organization. Moving Toward Universal Health Coverage Indonesia. Geneva, Switzerland: WHO; 2008.
11.
Aceh Development Planning Agency (Bappeda). Human Development Approach to Strategic Planning in Aceh. Aceh, Indonesia: Bappeda, Aceh Province; 2009.
12.
Health Department of Aceh Province. Guidelines for the Implementation of Health Insurance Aceh. Aceh, Indonesia: Health Department of Aceh Province; 2010.
13.
Health Department of Aceh Province. Implementation of Aceh Universal Health Coverage (JKA). Aceh, Indonesia: Health Department of Aceh Province; 2010.
14.
World Health Organization. Monitoring of the Achievement of the Health-Related Millennium Development Goals: Report by the Secretariat. Geneva, Switzerland: WHO; 2009.
15.
The National Bureau of Asian Research. Universal Health Coverage: Discussion Highlights From a 2010 Pacific Health Summit Workshop. Seattle, WA: National Bureau of Asian Research; 2010.
16.
GavinNIAdamsEKManningWG. The impact of welfare reform on insurance coverage before pregnancy and the timing of prenatal care initiation. Health Serv Res. 2006;42:1564-1588.
17.
LuCChinBLewandowskiJL. Towards universal health coverage: an evaluation of Rwanda Mutuelles in its first eight years. PLoS One. 2012;7(6):e39282.
Ministry of Health Republic of Indonesia. Indonesia Health Profile 2010. Jakarta, Indonesia: Ministry of Health, Republic of Indonesia; 2011.
20.
Ministry of Health. The Technical Guidelines of Minimum Standards of Health Services for Every District/City. Jakarta, Indonesia: Ministry of Health, Republic of Indonesia; 2011.
21.
Ministry of Health. Strategic Planning of Health. Jakarta, Indonesia: Ministry of Health, Republic of Indonesia; 2010.
World Health Organization. World Health Statistics 2012. Geneva, Switzerland: WHO; 2012. Report No WA. 2012;900.
24.
Directorate of Population, Women Empowerment and Protection of Children Agency. Family Planning Evaluation in Poor Society. Jakarta, Indonesia: Directorate of Population, Women Empowerment and Protection of Children Agency, Indonesia; 2010.
25.
Soekirno. Analysis of the Data Population and Family Planning Programs. Jakarta, Indonesia: National Family Planning Coordinating Board, Indonesia; 2009.
26.
MurawskiLChurchRL. Improving accessibility to rural health services: the maximal covering network improvement problem. Socio-Econ Plan Sci. 2009;43:102-110.
