Equity of health financing in Indonesia: A 5-year financing incidence analysis (2015-2019).

Cheng, Q; Asante, A; Susilo, D; Satrya, A; Man, N; Fattah, RA; Haemmerli, M; Kosen, S; Novitasari, D; Puteri, GC; Adawiyah, E; Hayen, A; Gilson, L; Mills, A; Tangcharoensathien, V; Jan, S; Thabrany, H; Wiseman, V

Equity of health financing in Indonesia: A 5-year financing incidence analysis (2015-2019).

Cheng, Q Asante, A Susilo, D Satrya, A Man, N Fattah, RA Haemmerli, M Kosen, S Novitasari, D Puteri, GC Adawiyah, E Hayen, A

Gilson, L Mills, A Tangcharoensathien, V Jan, S Thabrany, H Wiseman, V

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Publisher:: ELSEVIER
Publication Type:: Journal Article
Citation:: The Lancet Regional Health - Western Pacific, 2022, 21, pp. 1-12
Issue Date:: 2022-04

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Field	Value	Language
dc.contributor.author	Cheng, Q
dc.contributor.author	Asante, A
dc.contributor.author	Susilo, D
dc.contributor.author	Satrya, A
dc.contributor.author	Man, N
dc.contributor.author	Fattah, RA
dc.contributor.author	Haemmerli, M
dc.contributor.author	Kosen, S
dc.contributor.author	Novitasari, D
dc.contributor.author	Puteri, GC
dc.contributor.author	Adawiyah, E
dc.contributor.author	Hayen, A https://orcid.org/0000-0003-4046-8030
dc.contributor.author	Gilson, L
dc.contributor.author	Mills, A
dc.contributor.author	Tangcharoensathien, V
dc.contributor.author	Jan, S
dc.contributor.author	Thabrany, H
dc.contributor.author	Wiseman, V
dc.date.accessioned	2022-10-11T04:19:09Z
dc.date.available	2022-10-11T04:19:09Z
dc.date.issued	2022-04
dc.identifier.citation	The Lancet Regional Health - Western Pacific, 2022, 21, pp. 1-12
dc.identifier.issn	2666-6065
dc.identifier.issn	2666-6065
dc.identifier.uri	http://hdl.handle.net/10453/162464
dc.description.abstract	BACKGROUND: In 2014, Indonesia launched a single payer national health insurance scheme with the aim of covering the entire population by 2024. The objective of this paper is to assess the equity with which contributions to the health financing system were distributed in Indonesia over 2015 - 2019. METHODS: This study is a secondary analysis of nationally representative data from the National Socioeconomic Survey of Indonesia (2015 - 2019). The relative progressivity of each health financing source and overall health financing was determined using a summary score, the Kakwani index. FINDINGS: Around a third of health financing was sourced from out-of-pocket (OOP) payments each year, with direct taxes, indirect taxes and social health insurance (SHI) each taking up 15 - 20%. Direct taxes and OOP payments were progressive sources of health financing, and indirect tax payments regressive, for all of 2015 - 2019. SHI contributions were regressive except in 2017 and 2018. The overall health financing system was progressive from 2015 to 2018, but this declined year by year and became mildly regressive in 2019. INTERPRETATION: The declining progressivity of the overall health financing system between 2015 - 2019 suggests that Indonesia still has a way to go in developing a fair and equitable health financing system that ensures the poor are financially protected. FUNDING: This study is supported through the Health Systems Research Initiative in the UK, and is jointly funded by the Department of International Development, the Economic and Social Research Council, the Medical Research Council and the Wellcome Trust.
dc.format	Electronic-eCollection
dc.language	eng
dc.publisher	ELSEVIER
dc.relation.ispartof	The Lancet Regional Health - Western Pacific
dc.relation.isbasedon	10.1016/j.lanwpc.2022.100400
dc.rights	info:eu-repo/semantics/openAccess
dc.title	Equity of health financing in Indonesia: A 5-year financing incidence analysis (2015-2019).
dc.type	Journal Article
utslib.citation.volume	21
utslib.location.activity	England
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2022-10-11T04:18:43Z
pubs.publication-status	Published
pubs.volume	21

Abstract:

BACKGROUND: In 2014, Indonesia launched a single payer national health insurance scheme with the aim of covering the entire population by 2024. The objective of this paper is to assess the equity with which contributions to the health financing system were distributed in Indonesia over 2015 - 2019. METHODS: This study is a secondary analysis of nationally representative data from the National Socioeconomic Survey of Indonesia (2015 - 2019). The relative progressivity of each health financing source and overall health financing was determined using a summary score, the Kakwani index. FINDINGS: Around a third of health financing was sourced from out-of-pocket (OOP) payments each year, with direct taxes, indirect taxes and social health insurance (SHI) each taking up 15 - 20%. Direct taxes and OOP payments were progressive sources of health financing, and indirect tax payments regressive, for all of 2015 - 2019. SHI contributions were regressive except in 2017 and 2018. The overall health financing system was progressive from 2015 to 2018, but this declined year by year and became mildly regressive in 2019. INTERPRETATION: The declining progressivity of the overall health financing system between 2015 - 2019 suggests that Indonesia still has a way to go in developing a fair and equitable health financing system that ensures the poor are financially protected. FUNDING: This study is supported through the Health Systems Research Initiative in the UK, and is jointly funded by the Department of International Development, the Economic and Social Research Council, the Medical Research Council and the Wellcome Trust.

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http://hdl.handle.net/10453/162464