Can a National Health Insurance Policy Increase Modern Contraceptive Use? A Cross-Sectional Study of the Indonesian Government Performance and Accountability Survey (GPAS) 2019

Abstract

Universal health insurance is widely believed to be a key strategy for improving health services. However, few studies have examined whether it increases the use of modern contraceptives. The purpose of the present research is to determine whether the policy of incorporating family planning services into the national health insurance policy in Indonesia ( Jaminan Kesehatan Nasional [JKN], implemented in 2016) has led to an increase in the use of modern contraceptives. The data were obtained from the 2019 Government Performance and Accountability Survey (GPAS; T otal = 46,220 married women aged 15–49 years). The findings show that women who are covered by the health insurance scheme for non-poor families (JKN non-PBI) are 19.12 times more likely to use modern contraceptives than women who are uninsured. Women who are covered by health insurance scheme for poor families (JKN PBI) are 17.04 times more likely to use modern contraceptives than those who are uninsured. These results are robust against predisposing, enabling and need factors associated with modern contraceptive uptake (i.e., education, family economic status, religion, knowledge of modern contraception, age at time of first marriage, perception of the ideal number of children, number of children born alive, and area of residence). The findings suggest that the government should expand health insurance benefits in order to increase the uptake of modern contraceptives, particularly among disadvantaged group within communities.