An Exploration study into Good Governance and Equity Aspects of JKN Program in Cardiovascular Care Services in Central Java, Indonesia

https://doi.org/10.22146/jkki.68350

Suryani Yulianti(1), Edit Oktavia Manuama(2*), Tri Aktariyani(3), Tiara Marthias(4), Laksono Trisnantoro(5)

(1) Fakultas Kedokteran, Universitas Islam Sultan Agung
(2) Pusat Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran Kesehatan Masyarakat dan Keperawatan Universitas Gadjah Mada
(3) Direktorat Jenderal Pencegahan & Pengendalian Penyakit - Kementerian Kesehatan
(4) Pusat Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran Kesehatan Masyarakat dan Keperawatan Universitas Gadjah Mada
(5) Departemen Kebijakan dan Manajemen Kesehatan, Fakultas Kedokteran Kesehatan Masyarakat dan Keperawatan Universitas Gadjah Mada
(*) Corresponding Author

Abstract


To achieve equitable access of its citizen to health care, since 2014, the Government of Indonesia has implemented the national health insurance scheme, namely JKN. However, equal access to specialistic health care is still challenging. Using a convergent parallel mixed-method approach, and the utilization of cardiovascular services as an example, this study aims to evaluate the good governance and equity aspects of the JKN program in Central Java, a province in Indonesia which records a high poverty rate above the national rate. Based on IHME, Central Java has the highest proportion of mortality associated with cardiovascular diseases among the provinces in Indonesia. This study found that most of the districts in this province are struggling to achieve the 2019 JKN roadmap target in terms of JKN participation coverage.  Unequal distribution of health facilities and human resources is recorded affecting access to and utilization of cardiovascular care services. More contribution from the district and provincial government as well participation from private sectors (the employers) to fund the JKN program is essential to ensure the availability of specialistic care services in rural areas to narrow the gaps in cardiovascular care services.  


Keywords


cardiovascular care services, equity, utilization, JKN



References

WHO. 2015. Tracking Universal Health Coverage; First Global Monitoring Report. [Internet]. [Diakses pada 19 April 2021]. Tersedia pada: https://apps.who.int/iris/bitstream/handle/10665/174536/9789241564977_eng .pdf;jsessionid=122770F6AE49EED7974BE844FC4024B9?sequence=1 Mundiharno, and H. Thabrany. 2012. Peta Jalan Menuju JKN 2012 - 2019. [Internet]. [dikutip pada 12 April 2021]. Tersedia pada: http://djsn.go.id/storage/app/media/Peta%20Jalan%20Jaminan%20Kesehatan/ROADMAP_JKN_ EdisiRingkas_CDVersion.pdf Grubber, J. 2010. Health Care Reform Is a "Three-Legged Stool": The Cost o f Partially Repealing the Affordable Care Act. [Internet]. [dikutip 12 Mei 2021]. Tersedia pada: //www.americanproaress.ora /issues/healthcare/report/2010/08/Q5/8226/health-careis-a-three-leaaed-stool/ Pradiptyo, R., A. Winotomo., Y. H. Permana., K. Ash Shidiqi., R.M. Hilman., T.H. Partohap, (2014). Laporan Penelitian Menuju Jaminan Kesehatan Semesta Indonesia 2019. Makalah dalam Focused Group Discussion Manuju Jaminan Kesehatan Semesta tanggal 11 September 2014. Jakarta:Badan Kebijkan Fiskal BPS. 2021. Kemiskinan Provinsi Jawa Tengah September 2020, https://bappeda.purworejokab.go.id/badan-pusat-statistik-provinsi-jawa-tengah-rilis-kemiskinan-dan-tingkat-ketimpangan-pengeluaran-penduduk-jawa-tengah Badan Pusat Statistik. 2019. Statistik Kemiskinan dan Kesetaraan Indonesia. Jakarta: Badan Pusat Statistik Dinas Kesehatan Provinsi Jawa Tengah. Laporan Riskesdas Jawa Tengah 2018 [Internet]. [diakses pada 7 April 2021]. Tersedia pada: https://dinkesjatengprov.go.id/v2018/storage/2019/12/CETAK-LAPORAN-RISKESDAS-JATENG-2018-ACC-PIMRED.pdf Kementerian Kesehatan Republik Indonesia. Laporan Nasional Riset Kesehatan Dasar 2018 [Internet]. [Diakses pada 7 April 2021]. Tersedia pada: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf John W. Creswell, Creswell JW. Research Design qualitative, quantitative, and mixed methods approaches. Fourth. Knight V, editor. Research design Qualitative quantitative and mixed methods approaches. United States of America: SAGE; 2013. 342 p. DJSN. Sistem Monitoring dan Evaluasi Jaminan Kesehatan Nasional. [Internet]. [dikutip 1 Mei 2021]. Tersedia pada: http://sismonev.djsn.go.id/kepesertaan/ Dinas Kesehatan Provinsi Jawa Tengah. 2020. Buku Saku Kesehatan Tahun 2019. [Internet]. [dikutip 3 Mei 2021]. Tersedia pada: https://dinkesjatengprov.go.id/v2018/storage/2020/03/1_Buku-Saku-Kes-Th2019_FINAL.pdf The Institute for Health Metrics. 2017. Global Burden Disease. Washington. [Internet]. [dikutip pada 12 April 2021]. Tersedia pada: https://vizhub.healthdata.org/gbd-compare/#. Satriawan D., Joko Agus P., dan Rum Sri G., 2020. Cakupan Kesehatan UHC Pekerja Sektor Informal di Indonesia. [Internet]. [dikutip pada 7 Mei 2021]. Tersedia pada: https://ejournal2.undip.ac.id/index.php/tataloka/article/view/7523/0 Widodo Suryandono, 2011. Analisis dan Evaluasi Undang-Undang Nomor 40 Tahun 2004 tentang Sistem Jaminan Sosial Nasional. [Internet]. [dikutip pada 21 Mei 2021]. Tersedia pada: https://www.bphn.go.id/data/documents/ae-2011-5.pdf Shelvy Haria Roza, dkk. 2020. Capaian Sasaran Keadilan Sosial dalam Layanan Jantung bagi Peserta Jaminan Kesehatan Nasional di Kota Padang. [Internet]. [Dikutip 11 Mei 2021]. Tersedia pada: https://jurnal.ugm.ac.id/jkki/article/view/60656/30204 The World Health. Universal Health Coverage Study; Chapter 1; World Health Organization: Geneva, Switzerland, 2013; pp. 1–15. McKee, M.; Balabanova, D.; Basu, S.; Ricciardi, W.; Stuckler, D. 2013. Universal health coverage: A quest for all countries but under threat in some. [Internet]. [dikutip pada 19 Mei 2021]. Tersedia pada: https://www.valueinhealthjournal.com/article/S1098-3015(12)04152-6/fulltext Boerma, T., Eozenou, P., Evans, D., Evans, T., Kieny, M. P., & Wagstaff, A. 2014. Monitoring Progress towards Universal Health Coverage at Country and Global Levels. [Internet]. [dikutip 18 Mei 2021]. Tersedia pada: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001731 Trisnantoro, L. 2019. Kebijakan Pembiayaan Dan Fragmentasi Sistem Kesehatan. Yogyakarta. UGM Press. Low, S.; Tun, K.T.; Mhote, N.P. 2014. Human resources for health: Task shifting to promote basic health service delivery among internally displaced people in ethnic health program service areas in eastern Burma/Myanmar. [Internet]. [Dikutip pada 7 Juni 2021]. Tersedia pada: https://pubmed.ncbi.nlm.nih.gov/25280737/



DOI: https://doi.org/10.22146/jkki.68350

Article Metrics

Abstract views : 1261

Refbacks

  • There are currently no refbacks.


Copyright (c) 2021 Jurnal Kebijakan Kesehatan Indonesia : JKKI

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Jurnal Kebijakan Kesehatan Indonesia : JKKI [ISSN 2089 2624 (print); ISSN 2620 4703 (online)] is published by Center for Health Policy and Management (CHPM). This website is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Built on the Public Knowledge Project's OJS 2.4.8.1.
 Web Analytics View My Stats