THE IMPACT OF IMPLEMENTATION OF THE NATIONAL HEALTH INSURANCE PROGRAM TO DECREASE MATERNAL MORTALITY IN BOGOR

Abstract

The National Health Insurance Program (JKN) had passed the two-year implementation since January 1, 2014 implemented by the Government as the mandate of Law No. 40 of 2004 on National Social Security System (Navigation) and Law No. 24 of 2011 on Social Security Agency (BPJS). The national health system had been changeddue to the implementation of JKN, especially in the sub-system financing and health efforts. Before the implementation of JKN, there are some health insurance programs available for the community that can be accessed by all people without exception, yet now can only be enjoyed by the participants of JKN only. One program that terminated since the enactment of JKN is universal labor insurance program (Jampersal). This study aimed to evaluate the impact of the implementation of JKN for the quality of delivery service based on geography and socioeconomic conditions. This research has been conducted in the city of Bogor (urban) to represent different geographical characteristics, due in 2015 conducted in Bogor District (rural). Research in Bogor regency in 2015 showed that a decline in the number of women who undergo childbirth using JKN financing compared with Jampersal financing. The research design is a case study with a mixed-method approach, a combination of qualitative and quantitative. The quantitative data in the form of secondary data from the analysis of documents before and after the implementation of JKN. Qualitative data is the result of observation and interviews about the condition before and after the implementation of JKN. The scope of the study is limited to the Department of Health, Health Center, Hospital, Private Hospital Health BPJS partners, and society (pregnant women and mothers with children under five). The research variables include the scope of services, benefits packages and membership status. The results showed a decrease in maternal mortality in the city of Bogor is not merely influenced by the financing of labor, but also by the public awareness of the importance of compliance with health efforts JKN seen from the amount of participation is increasing. Besides, it also supported among others by the EMAS program funded by the budget, Opat sauyunan (the good cooperation between health workers, cadres, family and community).