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Effects of decentralized health care financing on maternal care in Indonesia

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Listed:
  • Hartwig, R.
  • Sparrow, R.A.
  • Budiyati, S.
  • Yumna, A.
  • Warda, N.
  • Suryahadi, A.
  • Bedi, A.S.

Abstract

We exploit variation in the design of sub-national 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 pseudo-panel, 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, and a decrease in home births, especially for households that fall outside the target group of the national health insurance programs. The variation in scheme design is a source of impact heterogeneity. Including antenatal and delivery services explicitly in benefit packages and contracting local rather than national health care providers increases the positive effects on maternal care.

Suggested Citation

  • Hartwig, R. & Sparrow, R.A. & Budiyati, S. & Yumna, A. & Warda, N. & Suryahadi, A. & Bedi, A.S., 2015. "Effects of decentralized health care financing on maternal care in Indonesia," ISS Working Papers - General Series 607, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
  • Handle: RePEc:ems:euriss:77964
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    References listed on IDEAS

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    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.
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    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.
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    Keywords

    health care financing; decentralization; maternal health care; Indonesia;

    JEL classification:

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

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