Aiming for a gender-transformative UHC agenda in Indonesia

Abstract

At the 2019 High-Level Meeting on Universal Health Coverage (UHC), women’s groups and their allies successfully lobbied for the recognition of gender equity and comprehensive sexual and reproductive health and rights (SRHR) as critical to UHC. Conservative opposition, however, remains, and realization of the then-approved political declaration will require their continued engagement to hold governments accountable and foster transformative reforms. This article, focusing on Indonesia’s national health insurance or JKN, provides an illustration of possible interventions to advance a women’s health and rights perspective in UHC in the context of existing barriers and opportunities for change. In particular, it presents women’s groups’ efforts, in part undertaken under the Australia-Indonesia Partnership for Gender Equality and Women’s Empowerment or MAMPU before the COVID-19 pandemic, to promote women’s participation in the national insurance scheme and improve its coverage of SRHR. Based on observational data, research findings and literature review, the article shows that these initiatives have contributed to the uptake of the scheme among disadvantaged women and brought significant gender biases to the attention of policy makers. However, much more will need to be done for the scheme to cover SRHR in a comprehensive and inclusive manner and recognize gender-responsiveness as a key element in improving women's health in Indonesia.

Keywords:

• Gender
• SRHR
• Indonesia
• UHC
• development

Acknowledgment

The author reports her association to the MAMPU program as strategic adviser (see also Note 1). She was, however, not involved in the daily execution of the program.

Useful comments were provided by Kate Shanahan, Ann Lockney and Steward Norup, The author is also thankful to the anonymous reviewers and the editor for their valuable inputs.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 The author has been a strategic adviser (consultant) to the program since its inception and until its closing. She also provided technical advice in several program evaluations and research projects whose findings are presented in this article (see also Acknowledgment at end of article).

2 For private sector employees, the employer is responsible for 4 percent and the employee is responsible for 1 percent while the split, for public sector employees is 3 and 2 percent respectively.

3 https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locations=ID

4 See further information on Mampu website https://www.mampu.or.id/en/ and on the DFAT website at https://www.dfat.gov.au/geo/indonesia/development-assistance/Pages/inclusive-society-in-indonesia

5 Including the author.

Additional information

Notes on contributors

Rosalia Sciortino

Dr Rosalia Sciortino Sumaryono is Associate Professor at the Institute for Population and Social Research, Mahidol University, Visiting Professor at the Master in International Development Studies (MAIDS), Chulalongkorn University, and Director SEA Junction (seajunction.org). Most recently, she was IDRC Regional Director for Southeast and East Asia (2010–2014), Senior Adviser to AusAID in Indonesia (2009-2010), and Regional Director for Southeast Asia of the Rockefeller Foundation (2000– 2007). She also served as program officer at the Indonesia and Philippines offices of the Ford Foundation (1993–2000). She received her doctoral degree cum laude from the Vrije Universiteit in Amsterdam and has published widely on development issues in Southeast Asia. In November 2017, she received a medal by the Vietnamese Association of Social Sciences for her contribution to social sciences in Vietnam.