Achieving Universal Health Coverage with an Unenforceable Mandate: Evidence from the Government of Indonesia's JKN Mandiri Program

2015 ◽  
Author(s):  
Benjamin Olken ◽  
Rachmat Samudra ◽  
Masyhur Hilmy ◽  
Lina Marliani ◽  
Arianna Ornaghi ◽  
...  
Keyword(s):  
Universal Health Coverage ◽  
Health Coverage ◽  
The Government ◽  
Universal Health

scholarly journals Unique health identifiers for universal health coverage

2019 ◽  
Vol 38 (S1) ◽  
Author(s):  
Samuel Mills ◽  
Jane Kim Lee ◽  
Bahie Mary Rassekh ◽  
Martina Zorko Kodelja ◽  
Green Bae ◽  
...  
Keyword(s):  
Universal Health Coverage ◽  
Identity Management ◽  
Health Coverage ◽  
Vital Event ◽  
Identification Number ◽  
Civil Registration ◽  
Advantages And Disadvantages ◽  
Number Systems ◽  
The Government ◽  
Universal Health

Abstract Identifying everyone residing in a country, especially the poor, is an indispensable part of pursuing universal health coverage (UHC). Having information on an individuals’ financial protection is also imperative for measuring the progress of UHC. This paper examines different ways of instituting a system of unique health identifiers that can lead toward achieving UHC, particularly in relation to utilizing universal civil registration and national unique identification number systems. Civil registration is a fundamental function of the government that establishes a legal identity for individuals and enables them to access essential public services. National unique identification numbers assigned at birth registration can further link their vital event information with data collected in different sectors, including in finance and health. Some countries use the national unique identification number as the unique health identifier, such as is done in South Korea and Thailand. In other countries, a unique health identifier is created in addition to the national unique identification number, but the two numbers are linked; Slovenia offers an example of this arrangement. The advantages and disadvantages of the system types are discussed in the paper. In either approach, linking the health system with the civil registration and national identity management systems contributed to advancing effective and efficient UHC programs in those countries.

scholarly journals Gambaran Out of Pocket pada Awal Era JKN di Indonesia

2018 ◽  
pp. 141-146
Author(s):  
Ingan Tarigan ◽  
Taty Suryati
Keyword(s):  
Health Insurance ◽  
Universal Health Coverage ◽  
Health Expenditures ◽  
Health Care Expenditures ◽  
Financial Protection ◽  
Health Coverage ◽  
Medical Expenses ◽  
The Poor ◽  
The Government ◽  
Universal Health

Abstrak Pogram Jaminan Kesehatan Nasional (JKN) salah satunya bertujuan memberikan perlindungan finansial khususnya biaya katastropik terhadap semua peserta. Penerima manfaat JKN berhak mendapatkan berbagai layanan sebagai bagian dari paket manfaat dasar tanpa mengeluarkan biaya pelayanan, dan diharapkan Out of Pocket (OOP) akan lebih rendah dibandingkan dengan mereka yang tidak memiliki asuransi kesehatan. Tujuan penulisan akan membandingkan total pengeluaran untuk kesehatan dari peserta jaminan kesehatan dengan yang tidak memiliki jaminan kesehatan pada awal era JKN. Dalam analisis ini, pengukuran pengeluaran perawatan kesehatan hanya mencakup biaya pengobatan langsung, seperti biaya konsultasi, pemakaian kamar di rumah sakit dan obat-obatan. Analisis dengan menggunakan data Susenas 2014 terdiri dari 274.673 individu dan 71.051 rumah tangga di 33 provinsi di Indonesia. Hasil penelitian menunjukkan bahwa pada awal era JKN ada sedikit perbedaan OOP pada penduduk miskin dibandingkan dengan penduduk dimana proteksi finansial terhadap penduduk miskin untuk pengeluaran kesehatan masih rendah.Kepemilikan jaminan kesehatan memberikan proteksi finansial akibat pengeluaran biaya kesehatan, khususnya pengeluaran biaya katastropik dibandingkan dengan yang tidak memiliki jaminan kesehatan. Kepesertaan penduduk miskin ditargetkan tahun 2019 sudah terpenuhi sehingga target pemerintah tentang Universal Health Coverage (UHC) perlindungan finansial pada penduduk miskin dan hampir miskin semakin tinggi atau OOP semakin mendekati nol. Kata kunci: OOP, Pembiayaan, Asuransi Kesehatan Abstract One of the main objectives of the JKN program is to provide financial protection, especially catastrophic costs to all members. JKN beneficiaries are entitled to various services as part of the basic benefit package without incurring service costs, and it is expected that Out of Pocket (OOP) will be lower than those who do not have health insurance. The purpose of writing will be to compare the total health expenditures of health insurance participants or beneficiaries and those without health insurance. In this analysis, the measurement of health care expenditures only includes direct medical expenses, such as consultation fees, hospital room usage and medication. Using Susenas data 2014 consists of 274,673 individuals and 71,051 households in 33 provinces in Indonesia. At the beginning of the JKN implementation, there was little difference of out of pocket in the poorest population compared to the richest population. This shows that financial protection to the poor for health expenditures are still low. The ownership of health insurance tends to provide financial protection due to health expenditures, especially catastrophic expenses compared to those without health insurance. In the Year of 2019 where the government targeted to Universal Health Coverage (UHC) expected protection financial on the poor and near poor is getting higher or out of pocket or getting closer up to zero. Keywords: OOP, Financial Protection, Health Insurance

scholarly journals Government plans in the 2016 and 2021 Peruvian presidential elections: A natural language processing analysis of the health chapters

2021 ◽  
Vol 6 ◽  
pp. 177
Author(s):  
Rodrigo M. Carrillo-Larco ◽  
Manuel Castillo-Cara ◽  
Jesús Lovón-Melgarejo
Keyword(s):  
Natural Language Processing ◽  
Natural Language ◽  
Language Processing ◽  
Universal Health Coverage ◽  
Presidential Elections ◽  
Clinical Medicine ◽  
Health Coverage ◽  
Keywords And Phrases ◽  
The Government ◽  
Universal Health

Background: While clinical medicine has exploded, electronic health records for Natural Language Processing (NLP) analyses, public health, and health policy research have not yet adopted these algorithms. We aimed to dissect the health chapters of the government plans of the 2016 and 2021 Peruvian presidential elections, and to compare different NLP algorithms. Methods: From the government plans (18 in 2016; 19 in 2021) we extracted each sentence from the health chapters. We used five NLP algorithms to extract keywords and phrases from each plan: Term Frequency–Inverse Document Frequency (TF-IDF), Latent Dirichlet Allocation (LDA), TextRank, Keywords Bidirectional Encoder Representations from Transformers (KeyBERT), and Rapid Automatic Keywords Extraction (Rake). Results: In 2016 we analysed 630 sentences, whereas in 2021 there were 1,685 sentences. The TF-IDF algorithm showed that in 2016, 22 terms appeared with a frequency of 0.05 or greater, while in 2021 27 terms met this criterion. The LDA algorithm defined two groups. The first included terms related to things the population would receive (e.g., ’insurance’), while the second included terms about the health system (e.g., ’capacity’). In 2021, most of the government plans belonged to the second group. The TextRank analysis provided keywords showing that ’universal health coverage’ appeared frequently in 2016, while in 2021 keywords about the COVID-19 pandemic were often found. The KeyBERT algorithm provided keywords based on the context of the text. These keywords identified some underlying characteristics of the political party (e.g., political spectrum such as left-wing). The Rake algorithm delivered phrases, in which we found ’universal health coverage’ in 2016 and 2021. Conclusion: The NLP analysis could be used to inform on the underlying priorities in each government plan. NLP analysis could also be included in research of health policies and politics during general elections and provide informative summaries for the general population.

scholarly journals In search of universal health coverage – highlighting the accessibility of health care to students with disabilities in Ghana: a qualitative study

2020 ◽  
Author(s):  
Eric Abodey ◽  
Irene Vanderpuye ◽  
Isaac Mensah ◽  
Eric Badu
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Students With Disabilities ◽  
Universal Health Coverage ◽  
Access To Health Care ◽  
Health Workers ◽  
Policy Formulation ◽  
Health Coverage ◽  
The Government ◽  
Universal Health

Abstract Background: Accessibility of health care to students with disabilities is a global concern. This is no less important in Ghana, however, to date, no study has been undertaken regarding access to health care to students with disabilities. This study, therefore, aims to explore the accessibility of health care to students with disabilities, in the quest of achieving universal health coverage in Ghana. Methods: Qualitative methods, involving in-depth interviews were employed to collect data from 54 participants (29 students with disabilities, 17 health workers and 8 school mothers), selected through purposive sampling. Thematic analysis was used to analyze the data. Results : The study identified three themes – accessibility, adequacy, and affordability. The study findings highlighted that universal health coverage for students with disabilities has not been achieved due to barriers in accessing health care. The barriers faced by students with disabilities were unfriendly physical environments, structures, equipment, limited support services and poor health insurance policy to finance health care. Conclusion : The study concludes that the government should prioritize disability-related issues in health policy formulation, implementation and monitoring. The current provisions and requirements in the disability act should be prioritized, enforced and monitored to ensure adequate inclusion of disability issues in health services. Further, the current exemption policy under the National Health Insurance Scheme should be revised to adequately address the needs of people with disabilities.

scholarly journals The role of occupational health services in the universal health coverage era in Indonesia

2019 ◽  
Vol 38 (1) ◽  
pp. 1
Author(s):  
Muchtaruddin Mansyur
Keyword(s):  
Social Security ◽  
Universal Health Coverage ◽  
Social Health Insurance ◽  
Pension Benefit ◽  
Occupational Health Services ◽  
Health Coverage ◽  
The Social ◽  
National Organizations ◽  
The Government ◽  
Universal Health

<p>In accordance to Act No 24 Year 2011 on The Social Security Administrating Body, the Indonesian National Social Security program is managed by  two national organizations, namely: Social Security Administering Body for Health (<em>Badan Penyelenggara Jaminan Sosial Kesehatan = BPJS Kesehatan</em>) and Social Security Administering Body for Labor (<em>Badan Penyelenggara Jaminan Sosial Ketenagakerjaan = BPJS Ketenagakerjaan</em>). The former is responsible for providing health coverage for all Indonesians through the National Social Health Insurance Scheme known as the Jaminan Kesehatan Nasional/JKN. The latter is  responsible for  providing the worker's social security consisting of Provident Fund Benefit, Accident Benefit, Pension Benefit, and Death Benefit.<sup>1</sup></p>The Indonesian government has been continuously improving the health service program towards better national universal health coverage and has set the 2019 functional achievement target of 95% of the population enrolled in the program. To ensure that this target of  the program will be achieved,  the government pays the premium of <em>BPJS Kesehatan</em> of the poor and near poor.<sup>2</sup>

scholarly journals In search of universal health coverage – highlighting the accessibility of health services for students with disabilities in Ghana: a qualitative study

2019 ◽  
Author(s):  
Eric Abodey ◽  
Irene Vanderpuye ◽  
Isaac Mensah ◽  
Eric Badu
Keyword(s):  
Health Services ◽  
Students With Disabilities ◽  
Universal Health Coverage ◽  
Health Workers ◽  
Policy Formulation ◽  
Health Coverage ◽  
Access To Health Services ◽  
Accessibility Of Health Services ◽  
The Government ◽  
Universal Health

Abstract Background: Accessibility to health services for students with disabilities is a global concern. This is no less important in Ghana, however, to date, no study has been undertaken regarding access to health services for students with disabilities. This study, therefore, aims to explore the accessibility of health services for students with disabilities, in the quest of achieving universal health coverage in Ghana. Methods: Qualitative methods, involving in-depth interviews were employed to collect data from 54 participants (29 students with disabilities, 17 health workers and 8 school mothers), selected through purposive sampling. Thematic analysis was used to analyze the data. Results : The study identified three themes – accessibility, adequacy, and affordability. The study findings highlighted that universal health coverage for students with disabilities has not been achieved due to barriers in accessing health services. The barriers faced by students with disabilities are unfriendly physical environments, structures, equipment, limited support services and poor health insurance policy to finance health services. Conclusion : The study concludes that the government should prioritize disability-related issues in health policy formulation, implementation and monitoring. The current provisions and requirements in the disability act should be prioritized, enforced and monitored to ensure adequate inclusion of disability issues in health services. Further, the current exemption policy under the NHIS scheme should be revised to adequately address the needs of people with disabilities.

scholarly journals Universal Health Coverage- A Case Study of Indian Healthcare System during COVID-19 Pandemic

2021 ◽  
pp. 1-6
Author(s):  
Rashika Nandwani
Keyword(s):  
Healthcare System ◽  
Health Systems ◽  
Universal Health Coverage ◽  
Building Blocks ◽  
Health Systems Strengthening ◽  
World Health ◽  
Health Coverage ◽  
The World ◽  
The Government ◽  
Universal Health

Aim: The main purpose of this paper is to look at the Indian healthcare system during the COVID-19 pandemic and how COVID-19 acts as barrier and also presents some opportunities towards the road of Universal Health Coverage (UHC). Background: COVID-19 has exposed the vulnerability of health systems across the world and India is no exception. The World Health Organization (WHO) has kept the definition of UHC very flexible and has left on the country which is implementing it as to how much of the population and which services should be included in the scheme.  Discussion: India already has a unique flagship program Ayushman Bharat where it is trying to cover her most vulnerable population against catastrophic expenditure of health. This paper further investigates the progress of India towards UHC and how COVID-19 is acting as an impediment for India to progress towards it. On the other hand, it also poses some opportunities which had not been explored in the past. Health Systems Strengthening is the path towards the achievement of UHC and due to COVID-19, India has touched upon all the six building blocks which are needed to strengthen our system towards the achievement of UHC. Recommendations and Conclusion: It recommends that Indian system should be more proactive than reactive; it also suggests following a systems-based approach and to not target the problem in silos. It also suggests increasing the government funding as well as establishment of proper public health cadre. To conclude, this paper also suggests that the government should include outpatient expenses into their scheme, and they should also concentrate towards building adequate infrastructure in order to face future pandemics like COVID-19.

scholarly journals ‘Connecting the dots’ for generating a momentum for Universal Health Coverage in Bangladesh: findings from a cross-sectional descriptive study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e024509
Author(s):  
Syed Masud Ahmed ◽  
Lal B Rawal ◽  
Nahitun Naher ◽  
Tarek Hossain
Keyword(s):  
Health Systems ◽  
Universal Health Coverage ◽  
Descriptive Study ◽  
Early Years ◽  
Health Coverage ◽  
Cross Sectional ◽  
Low Resource ◽  
Entry Points ◽  
The Government ◽  
Universal Health

ObjectiveThis study was conducted to explore how and whether, the strategic grants made by the Rockefeller Foundation (RF) in different sectors of health systems in the inception phase were able to ‘connect the dots’ for ‘generating a momentum for Universal Health Coverage (UHC)’ in the country.DesignCross-sectional descriptive study, using document review and qualitative methods.SettingBangladesh, 17 UHC-related projects funded by the RF Transforming Health Systems (THS) initiative during 2010–2013.DataAvailable reports of the completed and on-going UHC projects, policy documents of the government relevant to UHC, key-informant interviews and feedback from grant recipients and relevant stakeholders in the policy and practice.Outcome measuresKey policy initiatives undertaken for implementing UHC activities by the government post grants disbursement.ResultsThe RF THS grants simultaneously targeted and connected the academia, the public and non-profit development sectors and news media for awareness-building and advocacy on UHC, develop relevant policies and capacity for implementation including evidence generation. This strategy helped relevant stakeholders to come together to discuss and debate the core concepts, scopes and modalities of UHC in an attempt to reach a consensus. Additionally, experiences gained from implementation of the pilot projects helped in identifying possible entry points for initiating UHC activities in a low resource setting like Bangladesh.ConclusionsDuring early years of UHC-related activities in Bangladesh, strategic investments of the RF THS initiative played a catalytic role in sensitising and mobilising different constituencies for concerted activities and undertaking necessary first steps. Learnings from this strategy may be of help to countries under similar conditions of ‘low resource, apparent commitment, but poor governance,’ on their journey towards UHC.

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