Effects of decentralized health care financing on maternal care in Indonesia

Type Journal Article - ISS Working Paper Series
Title Effects of decentralized health care financing on maternal care in Indonesia
Author(s)
Volume 607
Issue 607
Publication (Day/Month/Year) 2015
Page numbers 1-42
URL http://www.renatehartwig.com/media/WorkingPaper_RenateHartwig_Indonesia.pdf
Abstract
— We exploit variation in the design of sub-national health care
financing initiatives in Indonesian districts to assess the effects of these local
schemes on maternal care from 2004 to 2010. The analysis is based on a district
pseudo-panel, combining data from a unique survey among District Health
Offices with the Indonesian Demographic and Health Surveys, the national socioeconomic
household surveys, and the village census. Our results show that
these district schemes contribute to an increase in antenatal care visits and
the probability of receiving basic recommended antenatal care services, and
a decrease in home births, especially for households that fall outside the target
group of the national health insurance programs. The variation in scheme
design is a source of impact heterogeneity. Including antenatal and delivery services
explicitly in benefit packages and contracting local rather than national
health care providers increases the positive effects on maternal care.

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