Insights into Urban Informal Workers in Indonesia: Health Insurance Enrollment, Adverse Selection Issue and Access to Health Care Aji Budi1,*, Intiasari Arih Diyaning1, Masfiah Siti1 1School of Public Health, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto, Indonesia *Corresponding Author: Budi Aji, School of Public Health, Jenderal Soedirman University, Jl. Dr. Suparno, Purwokerto, Central Java, Indonesia, 53123, Email: budi.aji57@gmail.com
Online published on 20 March, 2019. Abstract Background The present study identified health insurance market penetration among urban informal workers with its challenges and their health seeking behavior. This study had been carried out in the district of Banyumas, Central Java, Indonesia. Method A multi-methods design by mixing both qualitative and quantitative studies had been applied. Results The present study identified the enrollment of urban informal workers in health insurance program was less than 3%. Challenges in expanding health insurance enrollment among urban informal workers were related to adverse selection, the need for specific premium collection, irregularity of income, and higher rate of failure to pay premium. In fact, urban informal workers who had been enrolled in national health insurance program had benefited accessing health care services compared to those who live in rural areas. The logistic regression results proved that informal workers who live in urban areas were statistically significant in hospital admissions. Conclusion Policy makers and marketers of health insurance policies should recognize a specific approach and intervention for extending enrollment to urban informal workers. Empowerment of social capital and networks among urban informal workers could be modified to support the effort of universal health insurance enrollment and enhance access to quality health services of such workers. Top Keywords Informal workers, urban area, health insurance, adverse selection, access to health. Top |