Can a National Health Insurance Policy Increase Modern Contraceptive Use? A Cross-Sectional Study of the Indonesian Government Performance and Accountability Survey (GPAS) 2019
Can a National Health Insurance Policy Increase Modern Contraceptive Use? A Cross-Sectional Study of the Indonesian Government Performance and Accountability Survey (GPAS) 2019
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DOI：
10.1177/21582440231160665
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发表时间：
2023-01
期刊：
影响因子：
2
通讯作者：
S. Sujarwoto;Mario Ekoriano;Edy Purwoko;A. Titisari;Aditya Rahmadhony;Diah Puspita Sari
中科院分区：
文献类型：
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作者：
S. Sujarwoto;Mario Ekoriano;Edy Purwoko;A. Titisari;Aditya Rahmadhony;Diah Puspita Sari
普遍认为，全民医疗保险是改善医疗服务的关键战略。然而，很少有研究研究它是否会增加现代避孕药具的使用。本研究的目的是确定将计划生育服务纳入印度尼西亚国家健康保险政策的政策(Jaminan Kesehatan Nasional[JKN]，2016年实施)是否导致现代避孕药具的使用增加。数据来自2019年政府绩效和问责调查(GPA；总计=46,220名15-49岁的已婚妇女)。研究结果显示，被纳入非贫困家庭健康保险计划(JKN non-PBI)的妇女使用现代避孕药具的可能性是未参保妇女的19.12倍。参加贫困家庭健康保险计划(JKN PBI)的妇女使用现代避孕药具的可能性是未参保妇女的17.04倍。这些结果对于与采用现代避孕药具有关的诱因、使能因素和需要因素(即教育、家庭经济状况、宗教、现代避孕知识、初婚年龄、对理想子女数量的看法、活着出生的子女数量和居住地区)是强有力的。研究结果表明，政府应该扩大医疗保险福利，以增加现代避孕药具的接受，特别是在社区内的弱势群体中。
Universal health insurance is widely believed to be a key strategy for improving health services. However, few studies have examined whether it increases the use of modern contraceptives. The purpose of the present research is to determine whether the policy of incorporating family planning services into the national health insurance policy in Indonesia (Jaminan Kesehatan Nasional [JKN], implemented in 2016) has led to an increase in the use of modern contraceptives. The data were obtained from the 2019 Government Performance and Accountability Survey (GPAS; Total = 46,220 married women aged 15–49 years). The findings show that women who are covered by the health insurance scheme for non-poor families (JKN non-PBI) are 19.12 times more likely to use modern contraceptives than women who are uninsured. Women who are covered by health insurance scheme for poor families (JKN PBI) are 17.04 times more likely to use modern contraceptives than those who are uninsured. These results are robust against predisposing, enabling and need factors associated with modern contraceptive uptake (i.e., education, family economic status, religion, knowledge of modern contraception, age at time of first marriage, perception of the ideal number of children, number of children born alive, and area of residence). The findings suggest that the government should expand health insurance benefits in order to increase the uptake of modern contraceptives, particularly among disadvantaged group within communities.