Mitigating gaps in Indonesia’s social health insurance: Strategies for fulfilling the right to health for disabled persons

Abstract

This study aims to identify gaps in Indonesia’s national social health insurance scheme (Jaminan Kesehatan Nasional or JKN) in meeting the right to health for disabled persons in the country and to propose strategies to mitigate the gaps. This study employed descriptive qualitative methodologies. A questionnaire survey and structured interviews were undertaken from the period of October to December 2021, with a purposive sample of 317 disabled persons at their working age. Data collection also included on-site observations to sample of healthcare providers in six provinces and focused group discussions with key stakeholders. This study found that JKN is the primary source of hope for disabled persons. Nevertheless, approximately ten percent of disabled persons have been omitted from the scheme. Moreover, respondents of the survey expressed notably lower satisfaction level compared to the national average. Meanwhile, 25% of them also reported that JKN did not cover certain disability-specific benefits. The findings suggest that the national social health insurance scheme is not well prepared to offer disability-inclusive services. Thereby, policymakers should implement various interventions to improve the admission processes for disabled persons and to develop a system to identify disabled members based on their specific disabilities. Additionally, stipulating standards for disability-friendly minimum services for healthcare providers and incorporating the standards into the credentialing systems, providing regular training on disability-friendly services for healthcare personnel, also enhancing benefits coverage for disabled members in the Indonesian Case Base Groups (INA-CBGs) are the necessary strategies to mitigate the gaps.