Utilization of Service Delivery Insurance (Jampersal) for Maternal and Child Health Services in 12 Districts/Cities: Eliminate the Socio-cultural Obstacle on Safe Delivery

Handayani, Lestari • Suharmiati, Suharmiati • Kurniawan, Aan • Nuraini, Syarifah • Rahanto, Sugeng 2 more
Journal article Buletin Penelitian Sistem Kesehatan • October 2013 Indonesia

Abstract

Background: The Government launched Jampersal as one of efforts to suppress the number of Maternal and Infant Mortality Ratio (MMR & IMR) as well as a booster to achieve the MDGs by 2015. Delivery assistance seek are influencedby many factors including a socio-cultural factor. This research aimed to provide a study on the socio-cultural role inimproving the utilization of Service Delivery Insurance (Jampersal). Methods: Data about Jampersal was collected throughin-depth interviews, focus group discussion to community leaders, traditional birth attendants, midwives and head of thehealth center. In addition, as a supporting data, a quantitative survey to mothers who gave birth in the last year was alsoconducted. The research was located in 6 province in Indonesia. Each covered one health center in a rural area and one in a urban area. Results: The result of this research showed a strong evidence that rituals or traditions were still mostlyconducted. So the role of traditional birth attendants were still needed. Lack of transportation was to be the main obstacleto acces health facilities. Mean while, social interaction in rural area and a well-developed infrastructure in urban areawere important to enable the accessibility to access health facilities. Midwives were well-accepted by the people who hada good knowledge on health despite having less formal education both in rural or urban area. Labor financing by utilizingJampersal are good but not maximized or tend to be low in certain urban areas. Conclusions: People prefered to chosemidwives as birth attendants financed by Jampersal although some delivered at home. TBAs are still needed for maternal and baby care as well as to assist the implementation of rituals. Midwife-TBAs partnerships already on the right track butthe labor financing by Jampersal only support health care practitioner. Recommendation: Jampersal also support social and cultural-related financing, such as honorarium for TBAs who are in partner to midwives; transportation cost and alsoMCH health education and community outreach to involve TBAs and community leaders.

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Journal

Buletin Penelitian Sistem Kesehatan

Buletin Penelitian Sistem Kesehatan (Bulletin of Health Systems Research) is an open access, peer... see more