Enrolment of informal sector workers in the National Health Insurance System in Indonesia: A qualitative study

One of the main challenges facing the expansion of universal health coverage (UHC) in developing countries like Indonesia is the high prevalence of those working in the informal sector who must voluntarily register in the National Health Insurance System (NHIS). This condition hinders some from bein...

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Main Authors: Teguh Dartanto, Wahyu Pramono, Alvin Ulido Lumbanraja, Chairina Hanum Siregar, Hamdan Bintara, Nia Kurnia Sholihah, Usman
Format: Article
Language:English
Published: Elsevier 2020-11-01
Series:Heliyon
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405844020321599
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spelling doaj-22beda47c1684ea69dcf1e152da6be6a2020-12-09T06:24:47ZengElsevierHeliyon2405-84402020-11-01611e05316Enrolment of informal sector workers in the National Health Insurance System in Indonesia: A qualitative studyTeguh Dartanto0Wahyu Pramono1Alvin Ulido Lumbanraja2Chairina Hanum Siregar3Hamdan Bintara4Nia Kurnia Sholihah5 Usman6Research Cluster on Poverty, Social Protection and Development Economics, Department of Economics, Faculty of Economics and Business, Universitas Indonesia, Campus UI Depok, Depok, 16424, Indonesia; Institute for Economic and Social Research, Faculty of Economics and Business, Universitas Indonesia, Campus UI Salemba, Jakarta, 10430, Indonesia; Corresponding author.Institute for Economic and Social Research, Faculty of Economics and Business, Universitas Indonesia, Campus UI Salemba, Jakarta, 10430, IndonesiaInstitute for Economic and Social Research, Faculty of Economics and Business, Universitas Indonesia, Campus UI Salemba, Jakarta, 10430, IndonesiaInstitute for Economic and Social Research, Faculty of Economics and Business, Universitas Indonesia, Campus UI Salemba, Jakarta, 10430, IndonesiaInstitute for Economic and Social Research, Faculty of Economics and Business, Universitas Indonesia, Campus UI Salemba, Jakarta, 10430, IndonesiaInstitute for Economic and Social Research, Faculty of Economics and Business, Universitas Indonesia, Campus UI Salemba, Jakarta, 10430, IndonesiaPT Sarana Multi Infrastruktur (Persero), Sahid Sudirman Center 47-48th floor, Jakarta, 10220, IndonesiaOne of the main challenges facing the expansion of universal health coverage (UHC) in developing countries like Indonesia is the high prevalence of those working in the informal sector who must voluntarily register in the National Health Insurance System (NHIS). This condition hinders some from being covered by the NHIS. Following Bourdieu's concepts of field, capital and habitus, this research aims to analyse some aspects that influence the decision of informal sector workers to join the NHIS in Indonesia. We conducted qualitative methods, including in-depth interviews of 29 informants and Focus Group Discussion (FGD) in the three selected regions of Deli Serdang (North Sumatera), Pandeglang (Banten) and Kupang (East Nusa Tenggara). Using thematic content analysis and several triangulation processes, this study found that three main factors influence the decisions of those working in the informal sector to join the NHIS: health conditions, family and peers, and existing knowledge and experience. The stories provided by the informants regarding their decision-making processes in joining NHIS also reveal the necessary and sufficient conditions that enable informal sector workers to join the NHIS, which are individual-specific and which may differ between people, depending on individual characteristics, regional socioeconomic and demographic characteristics and belief systems. These three factors are all necessary conditions to support the joining of informal sector workers into the NHIS. This study suggests that one possible route for expanding the UHC coverage of informal sector workers is through maximising the word-of-mouth effect by engaging local or influential leaders.http://www.sciencedirect.com/science/article/pii/S2405844020321599Social scienceHealth sciencesNational health insurance systemUniversal health coverageInformal sectorExpanding coverage
collection DOAJ
language English
format Article
sources DOAJ
author Teguh Dartanto
Wahyu Pramono
Alvin Ulido Lumbanraja
Chairina Hanum Siregar
Hamdan Bintara
Nia Kurnia Sholihah
Usman
spellingShingle Teguh Dartanto
Wahyu Pramono
Alvin Ulido Lumbanraja
Chairina Hanum Siregar
Hamdan Bintara
Nia Kurnia Sholihah
Usman
Enrolment of informal sector workers in the National Health Insurance System in Indonesia: A qualitative study
Heliyon
Social science
Health sciences
National health insurance system
Universal health coverage
Informal sector
Expanding coverage
author_facet Teguh Dartanto
Wahyu Pramono
Alvin Ulido Lumbanraja
Chairina Hanum Siregar
Hamdan Bintara
Nia Kurnia Sholihah
Usman
author_sort Teguh Dartanto
title Enrolment of informal sector workers in the National Health Insurance System in Indonesia: A qualitative study
title_short Enrolment of informal sector workers in the National Health Insurance System in Indonesia: A qualitative study
title_full Enrolment of informal sector workers in the National Health Insurance System in Indonesia: A qualitative study
title_fullStr Enrolment of informal sector workers in the National Health Insurance System in Indonesia: A qualitative study
title_full_unstemmed Enrolment of informal sector workers in the National Health Insurance System in Indonesia: A qualitative study
title_sort enrolment of informal sector workers in the national health insurance system in indonesia: a qualitative study
publisher Elsevier
series Heliyon
issn 2405-8440
publishDate 2020-11-01
description One of the main challenges facing the expansion of universal health coverage (UHC) in developing countries like Indonesia is the high prevalence of those working in the informal sector who must voluntarily register in the National Health Insurance System (NHIS). This condition hinders some from being covered by the NHIS. Following Bourdieu's concepts of field, capital and habitus, this research aims to analyse some aspects that influence the decision of informal sector workers to join the NHIS in Indonesia. We conducted qualitative methods, including in-depth interviews of 29 informants and Focus Group Discussion (FGD) in the three selected regions of Deli Serdang (North Sumatera), Pandeglang (Banten) and Kupang (East Nusa Tenggara). Using thematic content analysis and several triangulation processes, this study found that three main factors influence the decisions of those working in the informal sector to join the NHIS: health conditions, family and peers, and existing knowledge and experience. The stories provided by the informants regarding their decision-making processes in joining NHIS also reveal the necessary and sufficient conditions that enable informal sector workers to join the NHIS, which are individual-specific and which may differ between people, depending on individual characteristics, regional socioeconomic and demographic characteristics and belief systems. These three factors are all necessary conditions to support the joining of informal sector workers into the NHIS. This study suggests that one possible route for expanding the UHC coverage of informal sector workers is through maximising the word-of-mouth effect by engaging local or influential leaders.
topic Social science
Health sciences
National health insurance system
Universal health coverage
Informal sector
Expanding coverage
url http://www.sciencedirect.com/science/article/pii/S2405844020321599
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