Public funding for community-based skilled delivery care in Indonesia: to what extent are the poor benefiting?

The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care
Tim EnsorAmila Megraini

Abstract

Since the early 1990s, the Government of Indonesia has addressed high maternal mortality by attempting to ensure skilled attendance at delivery through access to trained village midwifery services in every village. Yet access to skilled services at delivery continues to prove problematic, with low levels of skilled attendance and high mortality. Making use of a funding flow analysis and population-based survey in two districts, we investigate to what extent funding allocated for maternal services enables access to skilled services by rich and poor households. The results suggest that, although resources reach remote poor areas, the poor obtain unequal access to skilled delivery services. Because rural midwives must earn a significant fraction of their income from private fees this acts to deter women from seeking their help. A new system of targeting poor women utilising the existing state insurance company (ASKES) is an important step in helping to reduce these barriers, but may not be sufficiently generous to protect all those that are considered vulnerable.

References

Dec 14, 2007·Tropical Medicine & International Health : TM & IH·Endang AchadiCarine Ronsmans

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Citations

Nov 22, 2008·Health Policy and Planning·Tim EnsorPurwa Sucahya
Nov 10, 2011·International Journal for Equity in Health·Budi UtomoFita R Utami
Apr 15, 2008·Lancet·Anuraj ShankarFasli Jalal
Jan 23, 2016·Health Research Policy and Systems·Zubia MumtazAfshan Bhatti
Dec 11, 2014·BJOG : an International Journal of Obstetrics and Gynaecology·M MaruthappuT Zeltner
Mar 23, 2019·The International Journal of Health Planning and Management·Trisya RakmawatiJerico Franciscus Pardosi
Oct 16, 2014·BJOG : an International Journal of Obstetrics and Gynaecology·Z MumtazS Salway

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