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Low awareness hinders women's reproductive health: Study
A four-year study from 2015 to 2018 by the Women’s Health Foundation (YKP) that surveyed reproductive health services in 15 regencies and municipalities has revealed that health facilities are grappling with changing policies and the discriminatory treatment of insurance holders
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span>A four-year study from 2015 to 2018 by the Women’s Health Foundation (YKP) that surveyed reproductive health services in 15 regencies and municipalities has revealed that health facilities are grappling with changing policies and the discriminatory treatment of insurance holders.
The study also indicated a lack of general knowledge about the health services covered by the National Health Insurance (JKN).
The YKP, along with the Network of Women Concerned About Health (JP2K), initiated the study over growing concerns about women’s reproductive health in Indonesia, with 305 maternal deaths per 100,000 live births as reported in the Health Ministry's 2015 Basic Health Survey (Riskesdas).
YKP chairwoman Herna Lestari said that women were generally satisfied with reproductive health services, but many issues still needed to be addressed because reproductive health remained a taboo subject in Indonesia.
The study primarily evaluated the reproductive health services covered by the JKN, which has been administered by the Health Care and Social Security Agency (BPJS Kesehatan) since January 2014.
According to the study, women with JKN coverage showed a tendency to delay seeking reproductive health services for a variety of reasons, with the main reasons being embarrassment, family or relatives influencing their decision, slow insurance processing at health centers and a general lack of knowledge of reproductive health services.
Poor awareness and social stigma were other causes of delayed medical checks that the respondents cited.
Delaying checkups meant that early signs of diseases like cervical cancer would go undetected and increase the incidence rate of diagnoses at later stages of the disease, said Herna.
“Because reproductive health is not considered a debilitating [health] condition, diseases could be ignored until it was too late," Herna told The Jakarta Post on Wednesday.
Apart from discrimination and unawareness, she said that inconsistent policies also hampered the provision of reproductive health services.
Herna added that one policy that troubled medical professionals was health coverage for babies, and whether the coverage applied to babies before or after birth. Such inconsistency in policy coverage led to various interpretations among health facilities.
The study highlighted other persistent issues, such as a lack of transparency over the types of reproductive health services covered by the JKN policy, minimal public education on health insurance and the different functions between the government and health centers.
Separately, Youna Ismartono, 61, a JKN cardholder in Jakarta who was once diagnosed with internal bleeding, received full coverage for her treatment at a BPJS-affiliated hospital.
"[The] treatment and the operation were all free and [fully] covered, but like at any hospital, you had to queue," Youna told the Post.
The YKP reported the findings of the study, which referred to quantitative data compiled from three annual surveys conducted in 2015-2017. The surveys involved a total of 10,960 randomly selected respondents comprising the general public (women aged 15 to 65 years), medical workers and administrative officials.
The 2015 survey was held across 15 regencies/municipalities — one regency or city represents a province — and involved in each regency or city involves 200 women. There were a total of 392 medical workers and administrative staff at 253 health centers also involved in the surveys.
The surveys in the succeeding two years also comprised a similar breakdown of respondents.
For its 2018 data, the study employed the Rapid Assessment Procedure to gather qualitative data through focus group discussions and in-depth interviews. (tru)
