All the united nations, including Indonesia, have committed to achieving universal health coverage (UHC), as part of the sustainable development goals by 2030. The UHC exists in a country when all society could receive the quality healthcare services they need without suffering financial hardship. At the beginning of 2014, Indonesia launched new national health insurance, Jaminan Kesehatan Nasional-Kartu Indonesia Sehat (JKN-KIS) and officially announced its plan to achieve UHC by 2020. This thesis aims to evaluate the progress of the JKN-KIS towards UHC. Three key challenges i.e, medicines management, health financing system, and the epidemiological situation are discussed in this thesis. Regarding medicine management, the government of Indonesia introduces several new medicine policies to support JKN-KIS. However, these policies have not been fully utilized for achieving UHC because of a lack of harmonization, a lack of evidence-based, and so on could be found more detailed in this thesis. In terms of the health financing system, this thesis identified that the target for reducing out of pocket payment schemes below 20% may be reached by 2024. In the meantime, the target for achieving government schemes 4% of GDP still remains challenging. As regards to the epidemiological situation, an aging population lead to non-communicable disease, especially cardiovascular disease as the largest financial burden on the JKN-KIS program. Our thesis identified that smoking is the existing risk factor that indeed could be intervened. Finally, the conclusion of this thesis is that JKN-KIS is the cornerstone for Indonesia to achieve UHC. However, improving efficiency and raising financial resources for health are the necessity to address the three key challenges.
|Kwalificatie||Doctor of Philosophy|
|Datum van toekenning||13-mei-2020|
|Plaats van publicatie||[Groningen]|
|Status||Published - 2020|