IDEAS home Printed from https://ideas.repec.org/a/ucp/ecdecc/doi10.1086-698312.html
   My bibliography  Save this article

Effects of Decentralized Health-Care Financing on Maternal Care in Indonesia

Author

Listed:
  • Renate Hartwig
  • Robert Sparrow
  • Sri Budiyati
  • Athia Yumna
  • Nila Warda
  • Asep Suryahadi
  • Arjun S. Bedi

Abstract

We exploit variation in the design of subnational health-care financing initiatives in Indonesian districts to assess the effects of these local schemes on maternal care from 2004 to 2010. The analysis is based on a district pseudopanel, combining data from a unique survey among District Health Offices with the Indonesian Demographic and Health Surveys, the national socioeconomic household surveys, and the village census. Our results show that these district schemes contribute to an increase in antenatal care visits and the probability of receiving basic recommended antenatal care services for households that are not targeted by the national health insurance programs. We observe a decrease in home births. However, there is no effect on professional assistance at birth. We also observe variation in scheme design across districts as well as constraints to the effectiveness of local schemes. Including antenatal and delivery services explicitly in benefits packages and contracting local rather than national health-care providers increases the effects on maternal care. Increasing population coverage reduces effectiveness, delineating limitations to local funding and risk pooling. Furthermore, we do not find any effects for districts outside Java and Bali, where access to basic health care remains a key policy concern.

Suggested Citation

  • Renate Hartwig & Robert Sparrow & Sri Budiyati & Athia Yumna & Nila Warda & Asep Suryahadi & Arjun S. Bedi, 2019. "Effects of Decentralized Health-Care Financing on Maternal Care in Indonesia," Economic Development and Cultural Change, University of Chicago Press, vol. 67(3), pages 659-686.
  • Handle: RePEc:ucp:ecdecc:doi:10.1086/698312
    DOI: 10.1086/698312
    as

    Download full text from publisher

    File URL: http://dx.doi.org/10.1086/698312
    Download Restriction: Access to the online full text or PDF requires a subscription.

    File URL: http://dx.doi.org/10.1086/698312
    Download Restriction: Access to the online full text or PDF requires a subscription.

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Long, Qian & Klemetti, Reija & Wang, Yang & Tao, Fangbiao & Yan, Hong & Hemminki, Elina, 2012. "High caesarean section rate in rural China: Is it related to health insurance (New Co-operative Medical Scheme)?," Social Science & Medicine, Elsevier, vol. 75(4), pages 733-737.
    2. Galiani, Sebastian & Gertler, Paul & Schargrodsky, Ernesto, 2008. "School decentralization: Helping the good get better, but leaving the poor behind," Journal of Public Economics, Elsevier, vol. 92(10-11), pages 2106-2120, October.
    3. Faguet, Jean-Paul, 2004. "Does decentralization increase government responsiveness to local needs?: Evidence from Bolivia," Journal of Public Economics, Elsevier, vol. 88(3-4), pages 867-893, March.
    4. Horrace, William C. & Oaxaca, Ronald L., 2006. "Results on the bias and inconsistency of ordinary least squares for the linear probability model," Economics Letters, Elsevier, vol. 90(3), pages 321-327, March.
    5. Powell-Jackson, Timothy & Hanson, Kara, 2012. "Financial incentives for maternal health: Impact of a national programme in Nepal," Journal of Health Economics, Elsevier, vol. 31(1), pages 271-284.
    6. Joseph Mensah & Joseph R. Oppong & Christoph M. Schmidt, 2010. "Ghana's national health insurance scheme in the context of the health MDGs: an empirical evaluation using propensity score matching," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 95-106, September.
    Full references (including those not matched with items on IDEAS)

    More about this item

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ucp:ecdecc:doi:10.1086/698312. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Journals Division). General contact details of provider: https://www.journals.uchicago.edu/EDCC .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.