Evaluasi kebijakan berobat gratis di kabupaten Tanjung Jabung Timur propinsi Jambi

Date

2013

Journal Title

Journal ISSN

Volume Title

Publisher

Pusat Kebijakan dan Manajemen Kesehatan, Universitas Gadjah Mada, Yogyakarta, ID

Abstract

Background: In the decentralized era, local government has wider authority to decide policies relevant with local needs. For this reason the Regent of Tanjung Jabung Timur District in 2005 issued a decree on free medication at the health center and secondary health center. However there are problems with the sources and allocation of budget to support the decree. Besides, there is also a problem with target of the program funded by the government. Therefore there should be an evaluation to find out facts for future improvement. Objective: The study aimed to identify mechanisms of funding, relevance of target and efficiency of the policy. Method: This was an explanatory case study which used quantitative and qualitative approaches. Analysis units of the study were local government, health center and secondary health center; and the subject were members of local parliament, head of health office, head of local planning council, head of health centers, staff of health centers/secondary health centers and the community. The size of samples to measure target relevance was determined using stratified sampling; qualitative method was determined using purposive sampling. Data were obtained through questionnaire, in-depth interview and document checklist. Data were analyzed qualitatively and quantitatively in proportion. Result: Local government of Tanjung Jabung Timur allocated budget in the form of operational fund of health centers, drug allocation and incentives. The realization of budget was delayed so that health centers used alternative financial resources, i.e. budget of health insurance for poor community. Operational fund did not give much support for free medication when there was no clear cut distinction between users of health insurance for poor communities and free medication. This caused overlap in budgeting which might end in inefficiency. The authority did not do monitoring and supervision appropriately. Users of free medication were mostly non poor communities. Poor communities utilized free medication at secondary health centers more frequently than at health centers. Conclusion: The local government of Tanjung Jabung Timur District had not implemented good health insurance principles in health financing to support free medication policies. There was misallocation of funding because more non – poor communities used the service. This increased the potential of inefficiency in government budget utilization.

Description

Keywords

INDONESIA--JAMBI, HEALTH INSURANCE, RIGHT TO HEALTH, LOCAL GOVERNMENT, FINANCIAL ADMINISTRATION, FEES AND CHARGES, HEALTH FINANCING, SOCIAL DETERMINANTS OF HEALTH, CIRCUMCISION OF CHILDREN AND WOMEN, ACCESS TO HEALTH SERVICES

Citation

Hendriyanto, Hendrartini, J., & Juanita (2013). Evaluasi kebijakan berobat gratis di kabupaten Tanjung Jabung Timur propinsi Jambi. Jurnal Kebijakan Kesehatan Indonesia, 2(2): 71-76.

DOI