Public funding for community-based skilled delivery care in Indonesia

Tim Ensor, Mardiati Nadjib, Zahid Quayyum, Amila Megraini

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Since the early 1990s, the Government of Indonesia has addressed high maternal mortality by attempting to ensure skilled attendance at delivery through access to trained village midwifery services in every village. Yet access to skilled services at delivery continues to prove problematic, with low levels of skilled attendance and high mortality. Making use of a funding flow analysis and population-based survey in two districts, we investigate to what extent funding allocated for maternal services enables access to skilled services by rich and poor households. The results suggests that, although resources reach remote poor areas, the poor obtain unequal access to skilled delivery services. Because rural midwives must earn a significant fraction of their inccome from private fees this acts to deter women from seeking their help. A new system of targeting poor women utilising the existing state insurance company (ASKES) is an important step in helping to reduce these barriers, but may not be sufficiently generous to protect all those that are considered vulnerable.

Original languageEnglish
Pages (from-to)385-392
Number of pages8
JournalEuropean Journal of Health Economics
Volume9
Issue number4
DOIs
Publication statusPublished - 2008

Keywords

  • targetting
  • maternal health
  • benefits incidence
  • equity

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