Creating Equity? A Process Evaluation of Jamkesus Disabilitas , A Disability-Focused Health Financing Scheme in Yogyakarta, Indonesia
Discuss this preprint
Start a discussion What are Sciety discussions?Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Background
This study aims to explore the initiation and implementation of Jamkesus Disabilitas , a health financing scheme for people with disabilities in Yogyakarta Province, using the UK Medical Research Council (MRC) Process Evaluation for Complex Intervention.
Methods
We interviewed 19 people with disabilities with different types of impairment as beneficiaries, 3 people from Organisations for People with Disabilities (OPDs), 4 government officials, and 4 health providers, either in person, online, or by phone. Interviews were conducted by LA, and took place in Yogyakarta Province in July-September 2024. Data were analysed using a thematic analysis approach using NVivo 15 software.
Findings
Jamkesus Disabilitas has improved access to assistive technology (AT) and demonstrated inclusive care through its “one-stop service”. It also highlights the importance of consistent leadership in disability-inclusive health systems. However, challenges persist, including uneven AT quality, low coverage, limited availability, and inadequate data for evaluation and planning persisted. Moreover, the absence of inclusive features in the regular service means the scheme has not fully closed the equity gap in healthcare access for people with disabilities.
Conclusion
Jamkesus Disabilitas has expanded access to AT overlooked by the national health insurance (JKN). However, implementation should prioritise AT quality standards, financial and operational sustainability, and stronger data systems. Broader systemic reforms are also needed to embed disability inclusive practices in regular healthcare service delivery.
