Impact of National Health Insurance to Neonatal Survival at Indonesia

Abstract

We assessed the effect of Indonesia’s national health insurance programme (Jaminan Kesehatan Nasional (JKN)) on effective coverage for maternal and child health across geographical regions and population groups. We used four waves of the Indonesia Demographic and Health Survey from 2017, The population in this study is the total number of children born to the 2017 IDHS survey respondents in Indonesia 18.029.  JKN introduction was associated with variables are statistically related to neonatal survival, namely ANC, parity, multiple births, maternal occupation, maternal education, paternal education, age at delivery and wealth index because they have HR values ​​above 1 and p-values ​​<0.05. We did not find any significant level increase in ANC service contact or caesarean section. Interestingly, increases in ANC service contact and crude coverage, and safe delivery crude coverage were larger among the poorest compared with the most affluent. No statistically significant associations were found between JKN introduction and neonatal and infant mortality (p>0.05) in the first 3 years following implementation. Expansion of social health insurance led to substantial improvements in quality of care for maternal health services but not in child mortality. Concerted efforts are required to equitably improve service quality and child mortality across the population in Indonesia.