Does National Health Protection Cover the Vulnerable Groups in Indonesia? A Case Study of Waste Pickers in Surabaya.

Asia Pac J Public Health

School of Social Sciences, Faculty of Arts, Monash University, Melbourne, VIC, Australia.

Published: November 2023

AI Article Synopsis

  • The National Health Protection (NHP) in Indonesia aims to provide social health insurance for the poor, including waste pickers who particularly need affordable healthcare.
  • A study involving surveys, interviews, and focus group discussions found that 20% of waste pickers were not enrolled in the NHP due to various barriers like discrimination and high premiums.
  • While enrolled waste pickers were generally satisfied with their care, they noted issues such as long wait times and disparities in service quality, highlighting ongoing vulnerabilities despite the NHP.

Article Abstract

The National Health Protection (NHP) of Indonesia is a pro-poor social health insurance as the government pays the monthly premium for the poor. A waste picker is classified as an urban poor group needing affordable or free access to health care. This study explores the extent to which the NHP protects the health of waste pickers and provides them with quality health care. For this mixed-method study, 342 waste pickers completed the survey, 40 engaged in interviews, and 15 participated in Natural Group Discussions. The study found that 20% of waste pickers were not enrolled in NHP due to issues such as incorrect validation of poverty, discrimination, illegal fees, nepotism, unaffordable premiums, and lack of interest in purchasing the health plan. Among those who were enrolled, waste pickers expressed satisfaction with the health care they received and the behavior of the staff. However, they did criticize certain aspects such as waiting times, service gaps between full-paying and subsidized patients, suspicion of the quality of medicines, complicated medical administration procedures, and inflexibility of the capitation system. The study concludes that despite the NHP, poor groups remain vulnerable to accessing free health care.

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Source
http://dx.doi.org/10.1177/10105395231199559DOI Listing

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