Reducing Maternal and Neonatal Mortality in Indonesia

Reducing Maternal and Neonatal Mortality in Indonesia

Author: Indonesian Academy of Sciences

Publisher: National Academies Press

Published: 2013-12-26

Total Pages: 202

ISBN-13: 0309290791

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The Republic of Indonesia, home to over 240 million people, is the world's fourth most populous nation. Ethnically, culturally, and economically diverse, the Indonesian people are broadly dispersed across an archipelago of more than 13,000 islands. Rapid urbanization has given rise to one megacity (Jakarta) and to 10 other major metropolitan areas. And yet about half of Indonesians make their homes in rural areas of the country. Indonesia, a signatory to the United Nations Millennium Declaration, has committed to achieving the Millennium Development Goals (MDGs). However, recent estimates suggest that Indonesia will not achieve by the target date of 2015 MDG 4 - reduction by two-thirds of the 1990 under - 5 infant mortality rate (number of children under age 5 who die per 1,000 live births) - and MDG 5 - reduction by three-quarters of the 1990 maternal mortality ratio (number of maternal deaths within 28 days of childbirth in a given year per 100,000 live births). Although much has been achieved, complex and indeed difficult challenges will have to be overcome before maternal and infant mortality are brought into the MDG-prescribed range. Reducing Maternal and Neonatal Mortality in Indonesia is a joint study by the U.S. National Academy of Sciences and the Indonesian Academy of Sciences that evaluates the quality and consistency of the existing data on maternal and neonatal mortality; devises a strategy to achieve the Millennium Development Goals related to maternal mortality, fetal mortality (stillbirths), and neonatal mortality; and identifies the highest priority interventions and proposes steps toward development of an effective implementation plan. According to the UN Human Development Index (HDI), in 2012 Indonesia ranked 121st out of 185 countries in human development. However, over the last 20 years the rate of improvement in Indonesia\'s HDI ranking has exceeded the world average. This progress may be attributable in part to the fact that Indonesia has put considerable effort into meeting the MDGs. This report is intended to be a contribution toward achieving the Millennium Development Goals.


Health Financing in Indonesia

Health Financing in Indonesia

Author:

Publisher: World Bank Publications

Published: 2009-01-01

Total Pages: 202

ISBN-13: 0821380079

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In 2004 the Indonesian government made a commitment to provide its entire population with health insurance coverage through a mandatory public health insurance scheme. It has moved boldly already provides coverage to an estimated 76.4 million poor and near poor, funded through the public budget. Nevertheless, over half the population still lacks health insurance coverage, and the full fiscal impacts of the government's program for the poor have not been fully assessed or felt. In addition, significant deficiencies in the efficiency and equity of the current health system, unless addressed will exacerbate cost pressures and could preclude the effective implementation of universal coverage (Ue and the desired result of improvements in population health outcomes and financial protection. For Indonesia to achieve UC, systems' performance must be improved and key policy choices with respect to the configuration of the health financing system must be made. Indonesia's health system performs well with respect to some health outcomes and financial protection, but there is potential for significant improvement. High-level political decisions are necessary on key elements of the health financing reform package. The key transitional questions to get there include: [ the benefits that can be afforded and their impacts on health outcomes and financial protection; [ how the more than 50 percent of those currently without coverage will be insured; [ how to pay medical care providers to assure access, efficiency, and quality; [ developing a streamlined and efficient administrative structure; [ how to address the current supply constraints to assure availability of promised services; [ how to raise revenues to finance the system, including the program for the poor as well as currently uninsured groups that may require government subsidization such as the more than 60 million informal sector workers, the 85 percent of workers in firms of less than five employees, and the 70 percent of the population living in rural areas.


Health Systems Financing

Health Systems Financing

Author: World Health Organization

Publisher: World Health Organization

Published: 2010

Total Pages: 132

ISBN-13: 9241564024

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"This World Health Report was produced under the overall direction of Carissa Etienne ... and Anarfi Asamoa Baah ... The principal writers were David B. Evans ... [et al] -- t.p. verso.


Fiscal Sustainability of Health Systems Bridging Health and Finance Perspectives

Fiscal Sustainability of Health Systems Bridging Health and Finance Perspectives

Author: OECD

Publisher: OECD Publishing

Published: 2015-09-24

Total Pages: 264

ISBN-13: 9264233385

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The health systems we enjoy today, and expected medical advances in the future, will be difficult to finance from public resources without major reforms. Public health spending in OECD countries has grown rapidly over most of the last half century. These spending increases have contributed to ...


Financing Health Services in Developing Countries

Financing Health Services in Developing Countries

Author: John S. Akin

Publisher: World Bank Publications

Published: 1987-01-01

Total Pages: 104

ISBN-13: 9780821309001

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This report discusses several different approaches that support reforming health care services in developing countries. For some time now, health care services have been supported by government funds. As demands for improving health care services continue to increase additional demands will be placed on governments to respond. This, however, will not be easy. Slow economic growth and record budget deficits in the 1980's have forced reductions in public spending. Alternative approaches to finance health care services are needed. Such possible changes could involve: decentralization of federal government involvement; the promotion of nongovernment involvement; the imposition of user fees; and, establishing health insurance. Finally, the role of the Bank in pursuing new financing strategies is discussed.


New Insights Into the Provision of Health Services in Indonesia

New Insights Into the Provision of Health Services in Indonesia

Author:

Publisher: World Bank Publications

Published: 2010-01-01

Total Pages: 161

ISBN-13: 0821382993

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Over the past decade, Indonesia has implemented significant health sector reforms that include decentralizing responsibilities for service delivery, designing incentives for health providers, increasing the supply of midwives in remote areas, and analyzing demographic and epidemiological transitions causing changes in the patterns of disease prevalence. Financial protection against catastrophic expenditures has improved substantially, and legislation has been enacted to improve the quality of physician training and patient care.Despite the progress, substantial challenges remain and include comparatively low resources for the health sector, limitations in the supply of providers at the primary and hospital levels, inefficient payment systems, shortcomings in the quality of maternal and child and adult care, lack of oversight and effective licensing in an expanding private health sector, and ineffective planning for and recruitment and retention of health workers.Given the slow pace in improving health outcomes and limited evidence linking health performance and the health workforce, the need to make more information available about past experiences to inform future policy changes is pressing. Few studies have been undertaken to measure the actual impact of the reforms and the remaining challenges. 'New Insights into the Provision of Health Services in Indonesia: A Health Workforce Study' begins the process, providing real time evidence-based inputs to facilitate the Government of Indonesia's comprehensive health sector review. The authors' analysis of panel data from households and health providers will assist the government's assessment of the impact of past health work force policies and its consideration of policy changes.


Analyzing Health Equity Using Household Survey Data

Analyzing Health Equity Using Household Survey Data

Author: Adam Wagstaff

Publisher: World Bank Publications

Published: 2007-11-02

Total Pages: 234

ISBN-13: 0821369342

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Have gaps in health outcomes between the poor and better off grown? Are they larger in one country than another? Are health sector subsidies more equally distributed in some countries than others? Are health care payments more progressive in one health care financing system than another? What are catastrophic payments and how can they be measured? How far do health care payments impoverish households? Answering questions such as these requires quantitative analysis. This in turn depends on a clear understanding of how to measure key variables in the analysis, such as health outcomes, health expenditures, need, and living standards. It also requires set quantitative methods for measuring inequality and inequity, progressivity, catastrophic expenditures, poverty impact, and so on. This book provides an overview of the key issues that arise in the measurement of health variables and living standards, outlines and explains essential tools and methods for distributional analysis, and, using worked examples, shows how these tools and methods can be applied in the health sector. The book seeks to provide the reader with both a solid grasp of the principles underpinning distributional analysis, while at the same time offering hands-on guidance on how to move from principles to practice.


The Impact of Health Insurance in Low- and Middle-Income Countries

The Impact of Health Insurance in Low- and Middle-Income Countries

Author: Maria-Luisa Escobar

Publisher: Rowman & Littlefield

Published: 2011-01-01

Total Pages: 239

ISBN-13: 0815705611

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Over the past twenty years, many low- and middle-income countries have experimented with health insurance options. While their plans have varied widely in scale and ambition, their goals are the same: to make health services more affordable through the use of public subsidies while also moving care providers partially or fully into competitive markets. Colombia embarked in 1993 on a fifteen-year effort to cover its entire population with insurance, in combination with greater freedom to choose among providers. A decade later Mexico followed suit with a program tailored to its federal system. Several African nations have introduced new programs in the past decade, and many are testing options for reform. For the past twenty years, Eastern Europe has been shifting from government-run care to insurance-based competitive systems, and both China and India have experimental programs to expand coverage. These nations are betting that insurance-based health care financing can increase the accessibility of services, increase providers' productivity, and change the population's health care use patterns, mirroring the development of health systems in most OECD countries. Until now, however, we have known little about the actual effects of these dramatic policy changes. Understanding the impact of health insurance–based care is key to the public policy debate of whether to extend insurance to low-income populations—and if so, how to do it—or to serve them through other means. Using recent household data, this book presents evidence of the impact of insurance programs in China, Colombia, Costa Rica, Ghana, Indonesia, Namibia, and Peru. The contributors also discuss potential design improvements that could increase impact. They provide innovative insights on improving the evaluation of health insurance reforms and on building a robust knowledge base to guide policy as other countries tackle the health insurance challenge.


Health Equity and Financial Protection

Health Equity and Financial Protection

Author:

Publisher: World Bank Publications

Published: 2011-01-01

Total Pages: 139

ISBN-13: 0821387960

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Two key policy goals in the health sector are equity and financial protection. New methods, data and powerful computers have led to a surge of interest in quantitative analysis that permits monitoring progress toward these objectives, and comparisons across countries. ADePT is a new computer program that streamlines and automates such work, ensuring that results are genuinely comparable and allowing them to be produced with a minimum of programming skills. This book provides a step-by-step guide to the use of ADePT for quantitative analysis of equity and financial protection in the health sect


What's In, What's Out

What's In, What's Out

Author: Amanda Glassman

Publisher: Brookings Institution Press

Published: 2017-10-10

Total Pages: 449

ISBN-13: 1944691057

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Vaccinate children against deadly pneumococcal disease, or pay for cardiac patients to undergo lifesaving surgery? Cover the costs of dialysis for kidney patients, or channel the money toward preventing the conditions that lead to renal failure in the first place? Policymakers dealing with the realities of limited health care budgets face tough decisions like these regularly. And for many individuals, their personal health care choices are equally stark: paying for medical treatment could push them into poverty. Many low- and middle-income countries now aspire to universal health coverage, where governments ensure that all people have access to the quality health services they need without risk of impoverishment. But for universal health coverage to become reality, the health services offered must be consistent with the funds available—and this implies tough everyday choices for policymakers that could be the difference between life and death for those affected by any given condition or disease. The situation is particularly acute in low- and middle income countries where public spending on health is on the rise but still extremely low, and where demand for expanded services is growing rapidly. What’s In, What’s Out: Designing Benefits for Universal Health Coverage argues that the creation of an explicit health benefits plan—a defined list of services that are and are not available—is an essential element in creating a sustainable system of universal health coverage. With contributions from leading health economists and policy experts, the book considers the many dimensions of governance, institutions, methods, political economy, and ethics that are needed to decide what’s in and what’s out in a way that is fair, evidence-based, and sustainable over time.