The effect of social health insurance on maternal healthcare services utilization in Indonesia

This study examines the effect of a social health insurance program on maternal health care services utilization in Indonesia. Despite being avoidable the maternal death rate in Indonesia remains high due to underutilization of health care services. For the majority of women healthcare is unaffordable even when medical services are within reach. In the year 2005 the Indonesian government introduced a free social health insurance scheme (ASKESKIN) with the intention of removing the financial barrier that hindered accessibility and thus utilization of healthcare services amongst the poor. To quantify the effect the study departs from the traditional regression based approach and instead employs propensity score matching to reduce the selection bias due to non random targeting of insurance recipients. The results indicate that insurance uptake significantly increases utilization of public healthcare facilities for antenatal check up, use of the Pill, reduces utilization of midwives for birth delivery, and reduces delivery care expenditure. The program appears to have benefitted women from urban settings and women from the older age cohort. The results are robust to the use of different matching methods.