Evaluation of the Implementation of the Indonesia Social Insurance Model of Health Care

  • . Rosyidah

    Student thesis: Doctoral ThesisDoctor of Philosophy


    This thesis aims to critically evaluate the Government of Indonesia’s implementation of its Universal Health Coverage (UHC) to assist Indonesia’s policymakers and other key stakeholders (the Board of National Security Council/DJSN), BPJS Kesehatan, Ministry of Health, Ministry of Social Welfare and Ministry of Finance) as they consider how best to develop a sustainable UHC system. UHC is based on a public policy that seeks to provide a country or region’s whole population with both health protection and health services that it requires without the financial burden that would otherwise negatively impact upon individuals, families, and the wider society (WHO cited Reeves et al., 2017). Currently, Indonesia’s implementation of its UHC is struggling as it transitions from multiple health insurance systems into a single, collective insurance scheme that covers all of Indonesia’s 270 million populations (Britnell, 2015). Previous researchers have carried out studies of other nations’ social health insurance (for example, Bradenkamp et al., 2015; Rolindrawan, 2015; Ekawati et al., 2017). However, unlike this study, these did not apply a mixed-methods approach. Instead, they used either a qualitative or quantitative method for data collection and analysis.

    This thesis employs a mixed-methods approach, informed by the Context, Input, Process and Product (CIPP) evaluation model. The research was undertaken between May 2019 and May 2021. Quantitative data was accessed via official data sets, whilst qualitative interviews and focus group discussions were conducted with key stakeholders in Jakarta and Yogyakarta from July to September 2019.

    The thesis concludes that Indonesia’s UHC implementation needs greater synchronisation between its key stakeholders, not least the Ministry of Health, the DJSN, BPJS Kesehatan and the Ministry of Social Welfare. This suggests that the Indonesia UHC system needs further improvements in order to ensure effective benefits and outcomes for the Indonesia people. These necessary improvements include the supply of sufficient human resources (health and other professions) as well as sufficient procurement and supply of medical equipment and drugs. Other necessary improvements include the timely payment by BPJS Kesehatan of claims to hospitals and other healthcare providers, improvements to the referral system; adequate provision and distribution of health care providers to ensure that all UHC members (including those living in remote areas) are covered, and improvements to the online referral system (including ensuring that healthcare providers provide accurate data on usage and provision (including hospital occupancy and room availability rates).
    Date of Award2022
    Original languageEnglish
    Awarding Institution
    • Coventry University
    SupervisorGuy Daly (Supervisor) & Gurnam Singh (Supervisor)

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