The Effectiveness of the BPJS Program and Health Infrastructure which Affects the Infant Mortality Rate in Indonesia in 2023
DOI:
https://doi.org/10.65886/ijde.v1i3.55Keywords:
Exchange rate, Gini coefficient, Bound testing analysisAbstract
This study examines the effectiveness of the BPJS Kesehatan Program in reducing infant mortality in Indonesia, especially in the early neonatal period (0–18 days). Although the coverage of BPJS membership has expanded nationally, the AKB is still high and shows disparities between provinces, especially in areas with limited access to health services. Background Problems: The discrepancy between the high coverage of BPJS and the sub-optimal reduction in AKB, especially in disadvantaged areas, is a major issue. The availability of infrastructure and health workers is also still uneven. Contribution: This study simultaneously analyzes the relationship between BPJS membership, health infrastructure, and AKB, a relationship that has rarely been empirically discussed in previous studies. Research Gap: Most previous research has highlighted only one aspect, both social security and infrastructure. The study fills the gap by testing both in a single quantitative model. Research Methods: Multiple linear regression (OLS) was used with secondary data from 34 provinces, accompanied by classical assumption tests for model validation. Findings/Results: BPJS coverage has a negative and significant effect on AKB. The number of health facilities does not have a significant effect, indicating the importance of the quality of services and distribution of medical personnel. Conclusion: The BPJS program plays a role in reducing AKB, but needs to be strengthened through equitable distribution of infrastructure and region-based policies for more equitable and equitable results.
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Anindya, K., Lee, T., & Agus, S. (2020). Impact of Indonesia ’ s national health insurance scheme on inequality in access to maternal health services : A propensity score matched analysis. 10(1), 1–12. https://doi.org/10.7189/jogh.10.010429
Asyary, A. (2018). Indonesian Primary Care Through Universal Health Coverage Systems: a Feeling in Bones. Public Health of Indonesia, 4(3), 138–145. https://doi.org/10.36685/phi.v4i3.200
Aziz, N., Liu, T., & Yang, S. (2022). Causal relationship between health insurance and overall health status of children : Insights from Pakistan.
Azmi, F., Rahayu, B. Z., & Hidayatullah, D. (2024). ANALISIS EFEKTIVITAS PROGRAM ASURANSI KESEHATAN. 5, 13667–13677.
Delaneira, N. (2022). KOMUNIKASI ANTAR BUDAYA DI KALANGAN MAHASISWA (Studi tentang Komunikasi Antar Budaya di Kalangan Mahasiswa Etnis Sunda dan Mahasiswa Etnis ….
Development, H., Wayan, N., Sasmita, S., Widyantara, I. M. O., & Acwin, N. K. (2025). Optimizing National Health Insurance ( JKN ) Policy to Support Sustainable Optimizing National Health Insurance ( JKN ) Policy to Support Sustainable Health Development in Gianyar Regency , Bali , Indonesia. March. https://doi.org/10.59890/ijsr.v3i2.505
Dewanti, L. M. P., & Widyanthini, D. N. (2023). Faktor-Faktor Yang Memengaruhi Kejadian Bayi Berat Badan Lahir Rendah (Bblr) Di Kota Denpasar (Analisis Data Sekunder Menggunakan Uji Regresi Logistik). Archive of Community Health, 10(1), 114. https://doi.org/10.24843/ach.2023.v10.i01.p10
Erlangga, D. (2018). The impact evaluation of public healthinsurance in Indonesia on access tocare, financial protection, and healthstatus. September.
Erlangga, D., Ali, S., & Bloor, K. (2019). The impact of public health insurance on healthcare utilisation in Indonesia: evidence from panel data. International Journal of Public Health, 64(4), 603–613. https://doi.org/10.1007/s00038-019-01215-2
Ewi, Y., Hermawati, S., & Mahadewi, E. P. (2021). Analysis Of BPJS Based National Health Insurance Program Financing For Sectio Caesarea Birth In Indonesia. 132–137.
Fatimah, F. (2024). Pengaruh Komplikasi Kehamilan terhadap Kematian Neonatal Dini di Indonesia : Analisis Data Survei Demografi dan Kesehatan Pengaruh Komplikasi Kehamilan terhadap Kematian Neonatal Dini di Indonesia : Analisis Data Survei Demografi dan Kesehatan Indonesia (. 8(1). https://doi.org/10.7454/epidkes.v8i1.1105
Heywood, P. F., & Harahap, N. P. (2009). Human resources for health at the district level in Indonesia: The smoke and mirrors of decentralization. Human Resources for Health, 7, 1–16. https://doi.org/10.1186/1478-4491-7-6
Hodge, A., Firth, S., Marthias, T., & Jimenez-Soto, E. (2014). Location matters: Trends in inequalities in child mortality in Indonesia. Evidence from repeated cross-sectional surveys. PLoS ONE, 9(7). https://doi.org/10.1371/journal.pone.0103597
Husada, P. Y., & Yuniasih, A. F. (2022). Analisis Spasial Angka Kematian Neonatal di Pulau Jawa Tahun 2020. Seminar Nasional Official Statistics, 2022(1), 207–216. https://doi.org/10.34123/semnasoffstat.v2022i1.1273
Idaiani, S., Hendarwan, H., & Herawati, M. H. (2023). Disparities of Health Program Information Systems in Indonesia: A Cross-Sectional Indonesian Health Facility Research 2019. International Journal of Environmental Research and Public Health, 20(5). https://doi.org/10.3390/ijerph20054384
Islam, M. A., Butt, Z. A., & Sathi, N. J. (2022). Prevalence of Neonatal Mortality and its Associated Factors: A Meta-analysis of Demographic and Health Survey Data from 21 Developing Countries. Dr. Sulaiman Al Habib Medical Journal, 4(3), 145–152. https://doi.org/10.1007/s44229-022-00013-y
Khasanah, U., Id, F. E., Mishbahatul, E., Id, M. H., & Estiningtyas, Q. (2023). Healthcare-seeking behavior for children aged 0 – 59 months : Evidence from 2002 – 2017 Indonesia Demographic and Health Surveys. 1–17. https://doi.org/10.1371/journal.pone.0281543
Kosasih, D. M., Adam, S., Uchida, M., Yamazaki, C., & Koyama, H. (2022). Determinant factors behind changes in health ‑ seeking behaviour before and after implementation of universal health coverage in Indonesia. BMC Public Health. https://doi.org/10.1186/s12889-022-13142-8
Laksono, A. D., Wulandari, R. D., Rohmah, N., Rukmini, R., & Tumaji, T. (2023). Regional disparities in hospital utilisation in Indonesia: a cross-sectional analysis data from the 2018 Indonesian Basic Health Survey. BMJ Open, 13(1), e064532. https://doi.org/10.1136/bmjopen-2022-064532
Lengkong, G. T., Posangi, J., Studi, P., Kesehatan, I., Pascasarjana, P., Sam, U., Kesehatan, F., Universitas, M., & Ratulangi, S. (2020). 41 faktor – faktor yang berhubungan dengan kematian bayi di indonesia. 9(4), 41–47.
Muldoon, K. A., Galway, L. P., Nakajima, M., Kanters, S., Hogg, R. S., Bendavid, E., & Mills, E. J. (2011). Health system determinants of infant, child and maternal mortality: A cross-sectional study of UN member countries. Globalization and Health, 7, 1–10. https://doi.org/10.1186/1744-8603-7-42
Mulyanto, J., Kunst, A. E., & Kringos, D. S. (2020). The Contribution of Service Density and Proximity to Geographical Inequalities in Health Care Utilisation in Indonesia: A Nation-Wide Multilevel Analysis. Journal of Global Health, 10(2). https://doi.org/10.7189/jogh.10.020428
Nugraheni, W. P., Mubasyiroh, R., & Hartono, R. K. (2020). The influence of Jaminan Kesehatan Nasional (JKN) on the cost of delivery services in Indonesia. PLoS ONE, 15(7), 1–16. https://doi.org/10.1371/journal.pone.0235176
Nurcahyo, H., & Bachtiar, A. (2020). Analysis of the Problems of General Practitioners Distribution in Community Health Centers (Puskesmas) in Indonesia. 22(36), 354–360. https://doi.org/10.2991/ahsr.k.200215.068
Putri, B. S., & Kartika, L. (2017). Pengaruh Kualitas Pelayanan Bpjs Kesehatan Terhadap Kepuasan Pengguna Perspektif Dokter Rumah Sakit Hermina Bogor. Jurnal Riset Manajemen Dan Bisnis (JRMB) Fakultas Ekonomi UNIAT, 2(1), 1–12. https://doi.org/10.36226/jrmb.v2i1.24
Rahima, D., Anienda, M., & Fitria, T. (2024). Merdeka Implementation of Health Insurance System in Independent Practice Midwives ( Bpm ) in the Framework of Maternal and Child Health According to Law Number 40 Year 2004 Merdeka. 10(2), 25–37.
Rahmawati, Y., Prasetyo, J., & Wardani, R. (2023). Factors Related to Conservative Preterm Therapy on BPJS Claim Achievement in Waluyo Jati Hospital Probolinggo Regency. Asian Journal of Health Research, 2(3), 19–24. https://doi.org/10.55561/ajhr.v2i3.126
Ras, A., Genda, A., Sumilih, D. A., Rahim, H., Ramadhan, S., Hasanuddin, U., & Makassar, U. N. (2024). Tantangan dan peran pemerintah dalam meningkatkan pelayanan kesehatan di kabupaten takalar. 7(3), 1574–1585.
Romadhona, Y. S., & Siregar, K. N. (2018). Analisis Sebaran Tenaga Kesehatan Puskesmas di Indonesia berdasarkan Peraturan Menteri Kesehatan Nomor 75 Tahun 2014 tentang Puskesmas. Jurnal Kesehatan Manarang, 4(2), 114. https://doi.org/10.33490/jkm.v4i2.99
Scholz, S., Ngoli, B., & Flessa, S. (2015). Rapid assessment of infrastructure of primary health care facilities - A relevant instrument for health care systems management Organization, structure and delivery of healthcare. BMC Health Services Research, 15(1), 1–10. https://doi.org/10.1186/s12913-015-0838-8
Silalahi, V. A. J. M. (2024). Ten Year Evaluation of JKN: Strengthening Primary Health Care for National Resilience. Indonesian Journal of Economic & Management Sciences, 2(4), 651–670. https://doi.org/10.55927/ijems.v2i4.10761
Subramaniam, T., Loganathan, N., Yerushalmi, E., Devadason, E. S., & Majid, M. (2018). Determinants of Infant Mortality in Older ASEAN Economies. Social Indicators Research, 136(1), 397–415. https://doi.org/10.1007/s11205-016-1526-8
Sun, D., Ahn, H., Lievens, T., & Zeng, W. (2017). Evaluation of the performance of national health systems in 2004-2011: An analysis of 173 countries. PLoS ONE, 12(3), 1–13. https://doi.org/10.1371/journal.pone.0173346
Suparmi, Kusumawardani, N., Nambiar, D., Trihono, & Hosseinpoor, A. R. (2018). Subnational regional inequality in the public health development index in Indonesia. Global Health Action, 11(sup1). https://doi.org/10.1080/16549716.2018.1500133
Wenang, S., Schaefers, J., Afdal, A., Gufron, A., Geyer, S., Dewanto, I., & Haier, J. (2021). Availability and Accessibility of Primary Care for the Remote, Rural, and Poor Population of Indonesia. Frontiers in Public Health, 9(September), 1–11. https://doi.org/10.3389/fpubh.2021.721886
Wennemo, I. (1993). Infant mortality, public policy and inequality – a comparison of 18 industrialised countries 1950–85. Sociology of Health & Illness, 15(4), 429–446. https://doi.org/10.1111/j.1467-9566.1993.tb00354.x
Zylbersztejn, A., Gilbert, R., Hjern, A., & Hardelid, P. (2017). How can we make international comparisons of infant mortality in high income countries based on aggregate data more relevant to policy? BMC Pregnancy and Childbirth, 17(1), 1–7. https://doi.org/10.1186/s12884-017-1622-z
Anindya, K., Lee, T., & Agus, S. (2020). Impact of Indonesia ’ s national health insurance scheme on inequality in access to maternal health services : A propensity score matched analysis. 10(1), 1–12. https://doi.org/10.7189/jogh.10.010429
Asyary, A. (2018). Indonesian Primary Care Through Universal Health Coverage Systems: a Feeling in Bones. Public Health of Indonesia, 4(3), 138–145. https://doi.org/10.36685/phi.v4i3.200
Aziz, N., Liu, T., & Yang, S. (2022). Causal relationship between health insurance and overall health status of children : Insights from Pakistan.
Azmi, F., Rahayu, B. Z., & Hidayatullah, D. (2024). ANALISIS EFEKTIVITAS PROGRAM ASURANSI KESEHATAN. 5, 13667–13677.
Delaneira, N. (2022). KOMUNIKASI ANTAR BUDAYA DI KALANGAN MAHASISWA (Studi tentang Komunikasi Antar Budaya di Kalangan Mahasiswa Etnis Sunda dan Mahasiswa Etnis ….
Development, H., Wayan, N., Sasmita, S., Widyantara, I. M. O., & Acwin, N. K. (2025). Optimizing National Health Insurance ( JKN ) Policy to Support Sustainable Optimizing National Health Insurance ( JKN ) Policy to Support Sustainable Health Development in Gianyar Regency , Bali , Indonesia. March. https://doi.org/10.59890/ijsr.v3i2.505
Dewanti, L. M. P., & Widyanthini, D. N. (2023). Faktor-Faktor Yang Memengaruhi Kejadian Bayi Berat Badan Lahir Rendah (Bblr) Di Kota Denpasar (Analisis Data Sekunder Menggunakan Uji Regresi Logistik). Archive of Community Health, 10(1), 114. https://doi.org/10.24843/ach.2023.v10.i01.p10
Erlangga, D. (2018). The impact evaluation of public healthinsurance in Indonesia on access tocare, financial protection, and healthstatus. September.
Erlangga, D., Ali, S., & Bloor, K. (2019). The impact of public health insurance on healthcare utilisation in Indonesia: evidence from panel data. International Journal of Public Health, 64(4), 603–613. https://doi.org/10.1007/s00038-019-01215-2
Ewi, Y., Hermawati, S., & Mahadewi, E. P. (2021). Analysis Of BPJS Based National Health Insurance Program Financing For Sectio Caesarea Birth In Indonesia. 132–137.
Fatimah, F. (2024). Pengaruh Komplikasi Kehamilan terhadap Kematian Neonatal Dini di Indonesia : Analisis Data Survei Demografi dan Kesehatan Pengaruh Komplikasi Kehamilan terhadap Kematian Neonatal Dini di Indonesia : Analisis Data Survei Demografi dan Kesehatan Indonesia (. 8(1). https://doi.org/10.7454/epidkes.v8i1.1105
Heywood, P. F., & Harahap, N. P. (2009). Human resources for health at the district level in Indonesia: The smoke and mirrors of decentralization. Human Resources for Health, 7, 1–16. https://doi.org/10.1186/1478-4491-7-6
Hodge, A., Firth, S., Marthias, T., & Jimenez-Soto, E. (2014). Location matters: Trends in inequalities in child mortality in Indonesia. Evidence from repeated cross-sectional surveys. PLoS ONE, 9(7). https://doi.org/10.1371/journal.pone.0103597
Husada, P. Y., & Yuniasih, A. F. (2022). Analisis Spasial Angka Kematian Neonatal di Pulau Jawa Tahun 2020. Seminar Nasional Official Statistics, 2022(1), 207–216. https://doi.org/10.34123/semnasoffstat.v2022i1.1273
Idaiani, S., Hendarwan, H., & Herawati, M. H. (2023). Disparities of Health Program Information Systems in Indonesia: A Cross-Sectional Indonesian Health Facility Research 2019. International Journal of Environmental Research and Public Health, 20(5). https://doi.org/10.3390/ijerph20054384
Islam, M. A., Butt, Z. A., & Sathi, N. J. (2022). Prevalence of Neonatal Mortality and its Associated Factors: A Meta-analysis of Demographic and Health Survey Data from 21 Developing Countries. Dr. Sulaiman Al Habib Medical Journal, 4(3), 145–152. https://doi.org/10.1007/s44229-022-00013-y
Khasanah, U., Id, F. E., Mishbahatul, E., Id, M. H., & Estiningtyas, Q. (2023). Healthcare-seeking behavior for children aged 0 – 59 months : Evidence from 2002 – 2017 Indonesia Demographic and Health Surveys. 1–17. https://doi.org/10.1371/journal.pone.0281543
Kosasih, D. M., Adam, S., Uchida, M., Yamazaki, C., & Koyama, H. (2022). Determinant factors behind changes in health ‑ seeking behaviour before and after implementation of universal health coverage in Indonesia. BMC Public Health. https://doi.org/10.1186/s12889-022-13142-8
Laksono, A. D., Wulandari, R. D., Rohmah, N., Rukmini, R., & Tumaji, T. (2023). Regional disparities in hospital utilisation in Indonesia: a cross-sectional analysis data from the 2018 Indonesian Basic Health Survey. BMJ Open, 13(1), e064532. https://doi.org/10.1136/bmjopen-2022-064532
Lengkong, G. T., Posangi, J., Studi, P., Kesehatan, I., Pascasarjana, P., Sam, U., Kesehatan, F., Universitas, M., & Ratulangi, S. (2020). 41 faktor – faktor yang berhubungan dengan kematian bayi di indonesia. 9(4), 41–47.
Muldoon, K. A., Galway, L. P., Nakajima, M., Kanters, S., Hogg, R. S., Bendavid, E., & Mills, E. J. (2011). Health system determinants of infant, child and maternal mortality: A cross-sectional study of UN member countries. Globalization and Health, 7, 1–10. https://doi.org/10.1186/1744-8603-7-42
Mulyanto, J., Kunst, A. E., & Kringos, D. S. (2020). The Contribution of Service Density and Proximity to Geographical Inequalities in Health Care Utilisation in Indonesia: A Nation-Wide Multilevel Analysis. Journal of Global Health, 10(2). https://doi.org/10.7189/jogh.10.020428
Nugraheni, W. P., Mubasyiroh, R., & Hartono, R. K. (2020). The influence of Jaminan Kesehatan Nasional (JKN) on the cost of delivery services in Indonesia. PLoS ONE, 15(7), 1–16. https://doi.org/10.1371/journal.pone.0235176
Nurcahyo, H., & Bachtiar, A. (2020). Analysis of the Problems of General Practitioners Distribution in Community Health Centers (Puskesmas) in Indonesia. 22(36), 354–360. https://doi.org/10.2991/ahsr.k.200215.068
Putri, B. S., & Kartika, L. (2017). Pengaruh Kualitas Pelayanan Bpjs Kesehatan Terhadap Kepuasan Pengguna Perspektif Dokter Rumah Sakit Hermina Bogor. Jurnal Riset Manajemen Dan Bisnis (JRMB) Fakultas Ekonomi UNIAT, 2(1), 1–12. https://doi.org/10.36226/jrmb.v2i1.24
Rahima, D., Anienda, M., & Fitria, T. (2024). Merdeka Implementation of Health Insurance System in Independent Practice Midwives ( Bpm ) in the Framework of Maternal and Child Health According to Law Number 40 Year 2004 Merdeka. 10(2), 25–37.
Rahmawati, Y., Prasetyo, J., & Wardani, R. (2023). Factors Related to Conservative Preterm Therapy on BPJS Claim Achievement in Waluyo Jati Hospital Probolinggo Regency. Asian Journal of Health Research, 2(3), 19–24. https://doi.org/10.55561/ajhr.v2i3.126
Ras, A., Genda, A., Sumilih, D. A., Rahim, H., Ramadhan, S., Hasanuddin, U., & Makassar, U. N. (2024). Tantangan dan peran pemerintah dalam meningkatkan pelayanan kesehatan di kabupaten takalar. 7(3), 1574–1585.
Romadhona, Y. S., & Siregar, K. N. (2018). Analisis Sebaran Tenaga Kesehatan Puskesmas di Indonesia berdasarkan Peraturan Menteri Kesehatan Nomor 75 Tahun 2014 tentang Puskesmas. Jurnal Kesehatan Manarang, 4(2), 114. https://doi.org/10.33490/jkm.v4i2.99
Scholz, S., Ngoli, B., & Flessa, S. (2015). Rapid assessment of infrastructure of primary health care facilities - A relevant instrument for health care systems management Organization, structure and delivery of healthcare. BMC Health Services Research, 15(1), 1–10. https://doi.org/10.1186/s12913-015-0838-8
Silalahi, V. A. J. M. (2024). Ten Year Evaluation of JKN: Strengthening Primary Health Care for National Resilience. Indonesian Journal of Economic & Management Sciences, 2(4), 651–670. https://doi.org/10.55927/ijems.v2i4.10761
Subramaniam, T., Loganathan, N., Yerushalmi, E., Devadason, E. S., & Majid, M. (2018). Determinants of Infant Mortality in Older ASEAN Economies. Social Indicators Research, 136(1), 397–415. https://doi.org/10.1007/s11205-016-1526-8
Sun, D., Ahn, H., Lievens, T., & Zeng, W. (2017). Evaluation of the performance of national health systems in 2004-2011: An analysis of 173 countries. PLoS ONE, 12(3), 1–13. https://doi.org/10.1371/journal.pone.0173346
Suparmi, Kusumawardani, N., Nambiar, D., Trihono, & Hosseinpoor, A. R. (2018). Subnational regional inequality in the public health development index in Indonesia. Global Health Action, 11(sup1). https://doi.org/10.1080/16549716.2018.1500133
Wenang, S., Schaefers, J., Afdal, A., Gufron, A., Geyer, S., Dewanto, I., & Haier, J. (2021). Availability and Accessibility of Primary Care for the Remote, Rural, and Poor Population of Indonesia. Frontiers in Public Health, 9(September), 1–11. https://doi.org/10.3389/fpubh.2021.721886
Wennemo, I. (1993). Infant mortality, public policy and inequality – a comparison of 18 industrialised countries 1950–85. Sociology of Health & Illness, 15(4), 429–446. https://doi.org/10.1111/j.1467-9566.1993.tb00354.x
Zylbersztejn, A., Gilbert, R., Hjern, A., & Hardelid, P. (2017). How can we make international comparisons of infant mortality in high income countries based on aggregate data more relevant to policy? BMC Pregnancy and Childbirth, 17(1), 1–7. https://doi.org/10.1186/s12884-017-1622-z
Mulyanto, J., Kunst, A. E., & Kringos, D. S. (2020). The Contribution of Service Density and Proximity to Geographical Inequalities in Health Care Utilisation in Indonesia: A Nation-Wide Multilevel Analysis. Journal of Global Health, 10(2). https://doi.org/10.7189/jogh.10.020428
Nugraheni, W. P., Mubasyiroh, R., & Hartono, R. K. (2020). The influence of Jaminan Kesehatan Nasional (JKN) on the cost of delivery services in Indonesia. PLoS ONE, 15(7), 1–16. https://doi.org/10.1371/journal.pone.0235176
Nurcahyo, H., & Bachtiar, A. (2020). Analysis of the Problems of General Practitioners Distribution in Community Health Centers (Puskesmas) in Indonesia. 22(36), 354–360. https://doi.org/10.2991/ahsr.k.200215.068
Nuryati, Budi, S. C., & Rokhman, N. (2016). Kendala Pelaksanaan Program Jkn Terkait. Jurnal Manajemen Informasi Kesehatan Indonesia, 4(1), 15.
Romadhona, Y. S., & Siregar, K. N. (2018). Analisis Sebaran Tenaga Kesehatan Puskesmas di Indonesia berdasarkan Peraturan Menteri Kesehatan Nomor 75 Tahun 2014 tentang Puskesmas. Jurnal Kesehatan Manarang, 4(2), 114. https://doi.org/10.33490/jkm.v4i2.99
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