Studies in other countries indicated some facilitators for PLHIV in accessing health care, such as availability of health insurance, the caring and acceptance from health care providers and availability of health and social workers (25, 39). A study by Wisaksana et.al., found that out-of-pocket health expenditure in Merauke is relatively low as compared to other cities such as Jakarta and Jogjakarta because of the availability of a public-sector owned health insurance in Indonesia (28). However, there is limited information on the facilitators for the PLHIV in accessing health care in the country.
National Health Insurance in Indonesia
Indonesia has gone through health-financing reforms and introduced its National Health Insurance (NHI) scheme under the name of Jaminan Kesehatan Nasional (JKN) in 2014, under Law 40/2004 on the National Social Security System, and managed by the NHI agency, Badan Penyelenggara Jaminan Sosial (BPJS) (42). The NHI is aimed at achieving universal health coverage (UHC) in Indonesia by 2019 (10, 43)as one of the key areas in the Sustainable Development Goals (SDG) (44).
Prior to the National Health Insurance, formal sector employees were covered by social health insurance with payroll tax as the source of financing (10, 41). The decentralization policy in 1999 resulted in the implementation of different public sector insurance schemes at provincial and district levels, leading to variations in funding mechanisms as well as disparities in health care access within regions (10, 41). However, coverage for insurance services were still lower than anticipated as only half of the targeted Indonesian population was covered by 2009 (41).
The goals of NHI inclu...
... middle of paper ...
...of the PLHIV, lack of baseline information necessitated this preliminary qualitative study. Similar approach was used effectively in studies by Steven and Li, on experiences of PLHIV in United States of America (USA) and China, respectively (21, 23).
In as much as the focus group discussion (FGD) would be relevant in this study considering that very little information is known about the topic, the need to explore for multiple themes, the validity of group expression on the topic and the possibility of developing further studies, the concern about the confidentiality of the PLHIV from various background such as MSM, IDU and commercial sex workers who may also have sensitive information prompted only in-depth interviews (54, 55, 57). It is imperative therefore that a follow up study should be conducted using focus group discussion in addressing the emerging themes.
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