Universal Maternal Health Coverage? Assessing the Readiness of Public Health Facilities to Provide Maternal Health Care in Indonesia
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World Bank, Jakarta
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Over the period 2011-2013, Indonesia
had universal maternal health coverage for its population.
Facility-based deliveries, however, remain relatively low:
only about 63 percent of all deliveries occurred at a health
facility in Indonesia. Recent progress notwithstanding, and
despite the relatively high utilization rates for most key
maternal health services, the level of maternal mortality
remains high in Indonesia, especially in provinces such as
West Papua, North Maluku, Papua, Gorontalo, West Sulawesi,
Maluku, and South Kalimantan. This policy paper assesses the
supply-side readiness of Indonesia s public health
facilities in providing key maternal health services such as
antenatal care (ANC) as well as basic and comprehensive
emergency obstetric care. The focus in the paper is on
assessing to what extent Indonesia's universal maternal
health coverage is real. Ensuring the supply-side readiness
of Indonesia's health system, incorporating lessons
from the past experiences of implementing universal maternal
health coverage under the different social health insurance
programs, will be one key factor in ensuring that
implementation of universal health coverage (UHC) results in
improvements in health outcomes, including for maternal
health. The policy paper is structured as follows: the
section maternal health in Indonesia provides background on
maternal health in Indonesia and on intended reforms to
attain UHC by 2019. Assessing universal maternal health
coverage in Indonesia provides information on maternal
health benefits under existing social health insurance
programs. Public facility supply-side service readiness for
maternal health outlines the supply-side implications of
maternal health coverage using national guidelines as well
as the World Health Organization's (WHO's) service
availability and readiness assessment (SARA) framework,
focusing specifically on ANC as well as basic and emergency
obstetric care services and presents an assessment of
service readiness using facility-level data. The report
concludes with policy implications in the final section,
policy implications and conclusions.
Palabras clave
ABORTION, ACCESS TO FAMILY PLANNING, ACCESS TO FAMILY PLANNING SERVICES, ADOLESCENT, ADOLESCENT PREGNANCIES, ADOLESCENT WOMEN, ANEMIA, ANTENATAL CARE, ANTIBIOTICS, BIRTH ATTENDANT, BIRTH ATTENDANTS, BLEEDING, BLOOD TESTS, BLOOD TRANSFUSION, BODY WEIGHT, BULLETIN, CAESAREAN SECTIONS, CHILDBEARING, CHILDBIRTH, CIRCULATORY SYSTEM, CITIES, CLINICS, COLD CHAIN, COMMUNICABLE DISEASES, COMPETENCIES, COMPLICATIONS, COMPLICATIONS DURING PREGNANCY, CONTRACEPTION, DELIVERY CARE, DIABETES, DIABETES MELLITUS, DIAGNOSIS, DIAGNOSTIC TESTS, DIAGNOSTICS, DISABILITY, DISASTERS, DISEASE, DOCTORS, DRUGS, EARLY CHILDBEARING, EARLY DETECTION, ECLAMPSIA, ECONOMIC STATUS, EMERGENCY OBSTETRIC CARE, EMERGENCY OBSTETRIC SERVICES, ESSENTIAL DRUGS, ESSENTIAL HEALTH SERVICES, ESSENTIAL MEDICINES, FAMILY MEMBERS, FAMILY PLANNING, FAMILY PLANNING SERVICES, FERTILITY, FERTILITY RATES, FIRST CHILD, FOLIC ACID, GLUCOSE, GOVERNMENT HEALTH SERVICES, GOVERNMENT INITIATIVES, HEALTH CARE, HEALTH CARE PROVIDERS, HEALTH CARE SERVICES, HEALTH CENTERS, HEALTH COSTS, HEALTH EXPENDITURE, HEALTH FACILITIES, HEALTH FACILITY, HEALTH INDICATORS, HEALTH INTERVENTIONS, HEALTH OUTCOMES, HEALTH POSTS, HEALTH PROVIDERS, HEALTH RESEARCH, HEALTH SERVICE, HEALTH SERVICE UTILIZATION, HEALTH SERVICES, HEALTH SYSTEM, HEALTH SYSTEM STRENGTHENING, HEALTH SYSTEMS, HEALTH WORKERS, HEALTH WORKFORCE, HEMORRHAGE, HIGH BLOOD PRESSURE, HIGH FERTILITY, HIGH-RISK, HIGH-RISK PREGNANCIES, HOSPITAL, HOSPITAL BEDS, HOSPITALS, HUMAN RESOURCES, HYPERTENSIVE DISORDERS, IMMUNIZATIONS, IMPLANTS, INCOME, INFECTION, INFECTIONS, INPATIENT CARE, INSTITUTIONALIZATION, INSURANCE SCHEMES, INTERNATIONAL COOPERATION, IRON, IUD, LEGAL STATUS, LIVE BIRTH, LIVE BIRTHS, LOCAL GOVERNMENTS, LOW BIRTH WEIGHT, MALARIA, MANAGEMENT OF PREGNANCY, MATERNAL DEATH, MATERNAL DEATHS, MATERNAL HEALTH, MATERNAL HEALTH CARE, MATERNAL HEALTH INTERVENTIONS, MATERNAL HEALTH OUTCOMES, MATERNAL HEALTH SERVICES, MATERNAL MORTALITY, MATERNAL MORTALITY RATE, MATERNAL MORTALITY RATES, MATERNAL MORTALITY RATIO, MATERNAL MORTALITY RATIOS, MATERNITY CARE, MEDICAL DOCTOR, MEDICAL EQUIPMENT, MEDICINE, MEDICINES, MIDWIFE, MIDWIFERY, MIDWIVES, MILLENNIUM DEVELOPMENT GOAL, MINISTRY OF HEALTH, MISCARRIAGE, MORTALITY, MOTHER, MULTIPLE PREGNANCIES, MUSCLES, NATIONAL HEALTH, NATIONAL HEALTH INSURANCE, NATIONAL POLICY, NATIONAL PRIORITIES, NATIONAL PRIORITY, NCD, NEONATAL CARE, NEONATAL TETANUS, NEWBORN, NEWBORN HEALTH, NORMAL DELIVERIES, NURSE, NURSES, NUTRITION, OBSTETRIC CARE, OBSTETRIC COMPLICATIONS, OBSTETRIC EMERGENCIES, OXYGEN, PATIENTS, POLICY IMPLICATIONS, POOR HEALTH, POPULATION SIZE, POSTNATAL CARE, PREGNANCY, PREGNANT WOMAN, PREGNANT WOMEN, PRESIDENTIAL DECREE, PRIMARY CARE, PRIMARY EDUCATION, PRIVATE CLINICS, PRIVATE PROVIDERS, PROGRESS, PROVIDER PAYMENT, PROVISION OF CARE, PROVISION OF MATERNAL HEALTH SERVICES, PUBLIC HEALTH, PUBLIC HEALTH INTERVENTIONS, PUBLIC HOSPITALS, PUERPERAL SEPSIS, QUALITY OF HEALTH, QUALITY OF HEALTH CARE, REDUCING MATERNAL MORTALITY, REFERRAL SYSTEM, REFERRAL SYSTEMS, RESPIRATORY DISEASES, RESPIRATORY SYSTEM, RIGHT TO HEALTH CARE, RISK FACTORS, RISK OF COMPLICATIONS, ROOMS, RURAL AREAS, RURAL RESIDENCE, SANITATION, SANITATION FACILITIES, SCREENING, SERVICE DELIVERY, SERVICE PROVISION, SERVICE UTILIZATION, SKILLED ATTENDANCE, SKILLED ATTENDANT, SKILLED ATTENDANTS, SKILLED BIRTH ATTENDANCE, SKILLED BIRTH ATTENDANTS, SOCIAL HEALTH INSURANCE, SOCIAL INSTITUTIONS, SOCIAL SERVICES, SOCIALIZATION, STERILIZATION, TETANUS, TRADITIONAL BIRTH ATTENDANTS, TRANSPORTATION, TRAUMA, TREATMENT, TUBERCULOSIS, UNFPA, UNIVERSAL AVAILABILITY, UNIVERSAL RIGHT, URBAN AREAS, URBAN CENTERS, URINE SAMPLE, URINE TEST, USER FEES, VACCINATION, VACCINE, VACCINES, VAGINAL DELIVERY, VICTIMS, WOMAN, WORKERS, WORKFORCE, WORLD HEALTH ORGANIZATION