The effect of health insurance and socioeconomic status on women's choice in birth attendant and place of delivery across regions in Indonesia: a multinomial logit analysis

被引：1

作者：

Lee, John Tayu ^{[1
,2
,3
]}

McPake, Barbara ^{[1
]}

Putri, Likke Prawidya ^{[4
]}

Anindya, Kanya ^{[5
]}

Puspandari, Diah Ayu ^{[4
]}

Marthias, Tiara ^{[1
,4
]}

机构：

[1] Univ Melbourne, Nossal Inst Global Hlth, Melbourne Sch Populat & Global Hlth, Melbourne, Vic, Australia

[2] Imperial Coll London, Dept Primary Care & Publ Hlth, London, England

[3] Australian Natl Univ, Coll Hlth & Med, Canberra, Australia

[4] Gadjah Mada Univ, Fac Med Publ Hlth & Nursing, Dept Hlth Policy & Management, DI Yogyakarta, Yogyakarta, Di Yogyakarta, Indonesia

[5] Univ Gothenburg, Inst Med, Sahlgrenska Acad, Sch Publ Hlth & Community Med, Gothenburg, Sweden

来源：

BMJ GLOBAL HEALTH | 2023年 / 8卷 / 01期

关键词：

Health insurance; Public Health; Maternal health; Health policy; CARE; DETERMINANTS; SANITATION; MORTALITY; PROVIDER; MIDWIFE; DOCTORS; WATER;

D O I：

10.1136/bmjgh-2021-007758

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

BackgroundEvidence suggests that women gave birth in diverse types of health facilities and were assisted by various types of health providers. This study examines how these choices are influenced by the Indonesia national health insurance programme (Jaminan Kesehatan Nasional (JKN)), which aimed to provide equitable access to health services, including maternal health. MethodsUsing multinomial logit regression models, we examined patterns and determinants of women's choice for childbirth, focusing on health insurance coverage, geographical location and socioeconomic disparities. We used the 2018 nationally representative household survey dataset consisting of 41 460 women (15-49 years) with a recent live birth. ResultsJKN coverage was associated with increased use of higher-level health providers and facilities and reduced the likelihood of deliveries at primary health facilities and attendance by midwives/nurses. Women with JKN coverage were 13.1% and 17.0% (p<0.05) more likely to be attended by OBGYN/general practitioner (GP) and to deliver at hospitals, respectively, compared with uninsured women. We found notable synergistic effects of insurance status, place of residence and economic status on women's choice of type of birth attendant and place of delivery. Insured women living in Java-Bali and in the richest wealth quintile were 6.4 times more likely to be attended by OBGYN/GP and 4.2 times more likely to deliver at a hospital compared with those without health insurance, living in Eastern Indonesia, and in the poorest income quantile. ConclusionThere are large variations in the choice of birth attendant and place of delivery by population groups in Indonesia. Evaluation of health systems reform initiatives, including the JKN programme and the primary healthcare strengthening, is essential to determine their impact on disparities in maternal health services.

引用

页数：13

共 2 条

[1] Traditional Birth Attendant reorientation and Motherpacks incentive's effect on health facility delivery uptake in Narok County, Kenya: An impact analysis
Kitui, John Emmanuel
Dutton, Vaughan
Bester, Dirk
Ndirangu, Rachel
Wangai, Susan
Ngugi, Stephen
BMC PREGNANCY AND CHILDBIRTH, 2017, 17
[2] Traditional Birth Attendant reorientation and Motherpacks incentive’s effect on health facility delivery uptake in Narok County, Kenya: An impact analysis
John Emmanuel Kitui
Vaughan Dutton
Dirk Bester
Rachel Ndirangu
Susan Wangai
Stephen Ngugi
BMC Pregnancy and Childbirth, 17

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