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Cathie Marsh Institute for Social Research

Asri Maharani

Research title

Essays on decentralisation, health providers performance and health outcomes in Indonesia

Abstract

The past two decades have seen many countries, including developing countries, decentralising their health system with the aim of improving the efficiency, quality and equity of healthcare services. However, the effects of this reform remain largely unknown.

This thesis analyses the consequences of decentralisation on health providers’ performance and health outcomes in Indonesia. Launched in 2001, health sector decentralisation in Indonesia is unique for several reasons.

Firstly, it combines two forms of decentralisation in the same period, allowing this study to examine the consequences of more than one form of decentralisation in a country.

Secondly, it takes place in a large number of districts (514 districts), allowing this study to investigate the consequences on a large number of district in a country.

Finally, it was executed together with another health reform, such as the launch of universal coverage, which emphasise the need of success decentralisation.

This thesis uses both primary and secondary data. The primary data is obtained from 54 public hospitals in East Java province, while the source of secondary data are Indonesia’s national socio-economic survey (Susenas) 1992-2012, Indonesian Family Life Survey 1993-2007, Podes village census and government financial data.

Several methods, including linear and non-linear multilevel models, multilevel structural equation models, random effects and fixed effects models and cost calculation using step down method, are used in this work.

Papers

  • Maharani, Asri, Femina, Devi, and Tampubolon, Gindo. "Decentralisation in Indonesia: lessons from cost recovery rate of district hospitals." Health Policy and Planning (2014). eScholarID:225087. DOI:10.1093/heapol/czu049
  • Maharani, Asri, and Tampubolon, Gindo. "Has decentralisation affected child immunisation status in Indonesia?" Global Health Action (2014). eScholarID:230292. DOI:10.3402/gha.v7.24913
  • Maharani, Asri, and Tampubolon, Gindo. "Unmet need for cardiovascular care in Indonesia." PLoS ONE (2014). eScholarID:230293. DOI:10.1371/journal.pone.0105831

Papers under review

  • Maharani, Asri, and Tampubolon, Gindo. “Reviewing the role of health sector decentralisation: The case of childhood immunisation status in Indonesia”. Social Science & Medicine.
  • Maharani, Asri, and Tampubolon, Gindo. “The double-edge sword of corporatisation in hospital sector: Evidence from Indonesia”. Journal of Health Economics.

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