Universal Health Coverage Achieves Equitable Maternal Healthcare Quality Among JKN Participants

Romhana Alifah; Asri Hidayat; Wantonoro

doi:10.24036/eksakta/vol27-iss04/711

EKSAKTA: Berkala Ilmiah Bidang MIPA

Open Access

Universal Health Coverage Achieves Equitable Maternal Healthcare Quality Among JKN Participants

Romhana Alifah ¹

, Asri Hidayat ¹

, Wantonoro ¹

¹ Master's Program in Midwifery, Faculty of Health Sciences, Universitas 'Aisyiyah Yogyakarta, Yogyakarta, Indonesia

Published 2026-08-07

Vol. 27 No. 04 (2026) PAGES 609-619

DOI 10.24036/eksakta/vol27-iss04/711

Views / Downloads 31 10

Download PDF

Abstract

Universal Health Coverage (UHC) aims to ensure equitable access to quality healthcare services regardless of socioeconomic status. Maternal healthcare quality is a key indicator of UHC implementation because it directly influences maternal and neonatal outcomes. Although Indonesia has expanded healthcare coverage through the National Health Insurance (JKN) program, evidence regarding equity in maternal healthcare quality between Penerima Bantuan Iuran (PBI) and non-PBI participants remains limited. This study aimed to analyze differences in maternal healthcare service quality between PBI and non-PBI JKN participants at RSUD Dr. H. Moh. Anwar Sumenep. A quantitative cross-sectional study was conducted among 94 respondents, consisting of 47 PBI and 47 non-PBI participants selected using a non-probability quota sampling technique. Data were collected using a SERVQUAL-based questionnaire and analyzed using the Mann–Whitney U test. Significant differences were found in responsiveness (p = 0.029) and assurance (p = 0.045). However, no significant differences were observed in tangible (p = 0.197), reliability (p = 0.154), empathy (p = 0.111), or overall service quality (p = 0.063). These findings suggest generally comparable maternal healthcare quality between financing categories, although improvements in responsiveness, communication, and service assurance remain necessary to support UHC objectives.

References

1

[1] World Health Organization, International Bank for Reconstruction and Development. Tracking Universal Health Coverage: 2021 Global Monitoring Report. First Glob. Monit. Rep. 2021.

2

[2] Pratiwi EP, Simanjuntak HTRF. Implementation of the Universal Health Coverage (UHC) Program by the Riau Provincial Health Office. QISTINA J Multidisiplin Indones. 2024;3(2):1056–1070.

3

[3] Dinas Kesehatan Provinsi Jawa Timur. Profil Kesehatan Provinsi Jawa Timur Tahun 2023. 2024.

4

[4] Kemenkes. PROFIL KESEHATAN INDONESIA 2023. 2024.

5

[5] Chou VB, Walker N, Kanyangarara M. Estimating the Global Impact of Poor Quality of Care on Maternal and Neonatal Outcomes in 81 Low- and Middle-Income Countries: A Modeling Study. Persson LÅ, editor. PLOS Med. 2019;16(12):e1002990.

6

[6] Andegiorgish AK, Andemariam M, Temesghen S, et al. Neonatal Mortality and Associated Factors in the Specialized Neonatal Care Unit Asmara, Eritrea. BMC Public Health. 2020;20(1):10.

7

[7] Annisa R, Winda S, Dwisaputro E, et al. Mengatasi Defisit Dana Jaminan Sosial Kesehatan Melalui Perbaikan Tata Kelola. Komisi Pemberantasan Korupsi. 2020;Vol. 6 No. 2 (2020): INTEGRITAS: Jurnal Antikorupsi.

8

[8] Langi S, Winarti E. Pengaruh Kualitas Pelayanan terhadap Kepuasan Pasien. J Ilmu Medis Indones. 2024;3(1):31–39.

9

[9] Sofiah, Hapsari SK, Sumardiyono. Pencegahan Kematian Ibu dan Anak melalui Pendekatan Strategi Komunikasi pada Program EMAS (Expanding Maternal and Neonatal Survival). J Ilmu Komun. 2016;14(3).

10

[10] Zhafarin BS, Ghifary H, Novianti PA, et al. Analisis Efektivitas Pelaksanaan UHC Dalam Meningkatkan Kualitas Layanan Kesehatan Di Indonesia. J Vent. 2023;1(1):01–09.

11

[11] Pratama EPPA, Annajah S, Adristi K, et al. Analisis Efektivitas Implementasi Kebijakan Universal Health Coverage di Indonesia Tinjauan Ketersediaan dan Kualitas Layanan Kesehatan: Literature Review. J Med Husada. 2023;3(1):51–62.

12

[12] Sugiyono. Metode penelitian pendidikan pendekatan kuantitatif, kualitatif dan R&D. Cetakan ke 9. Alfabeta; 2022.

13

[13] Wang X, Kattan MW. Cohort Studies: Design, Analysis, and Reporting. Chest. 2020;158(1):S72–S78.

14

[14] Prastica I. Pengaruh Mutu Pelayanan Terhadap Kepuasan Pasien Unit Rawat Jalan di Rumah Sakit Umum Daerah Kota Madiun [Tesis]. [Madiun]: STIKES Bhakti Husada Mulia; 2019.

15

[15] Pardede CS, Suryawati C, Wigati PA. Analisis Perbedaan Persepsi Pasien Peserta Bpjs Terhadap Penilaian Mutu Pelayanan Di Puskesmas Kedungmundu Kota Semarang Tahun 2016. J Kesehat Masy Vol 4 No 4 2016 JULIDO - 1014710jkmv4i413897 [Internet]. 2016;

16

[16] Melina ASW, Nawangsih UHE. Hubungan Penggunaan Jaminan Kesehatan Nasional Dengan Capaian Target Cakupan Layanan Ibu Hamil Di Puskesmas Banguntapan Ii Kabupaten Bantul Tahun 2016 [Tesis]. [Yogyakarta]: Universitas ’Aisyiyah Yogyakarta; 2016.

17

[17] Laksono AD, Wulandari RD, Matahari R. The Determinant of Health Insurance Ownership Among Pregnant Women in Indonesia. BMC Public Health. 2021;21(1):1538.

18

[18] Ruslinawati, Sukarlan, Hanan. Perbedaan Status Pekerjaan Ibu Hamil Dengan Frekuensi Kunjungan Antenatal Care (anc) Di Wilayah Kerja Puskesmas Pekauman Kota Banjarmasin Tahun 2016. J KEPERAWATAN SUAKA INSAN. 2016;1(2).

19

[19] Kondamaru K, Ibrahim DAF, Puspita A. Hubungan Pengetahuan dan Sikap Ibu Hamil dengan Kunjungan Antenatal Care (ANC) di Wilayah Kerja Puskesmas Bapinang. J Gen Health Pharm Sci Res. 2024;2(2):95–110.

20

[20] Loda JPR, Sinaga M, Sirait RW. The Factors Related to The Utilization of Antenatal Care Services in Oesapa Community Health Center. Lontar J Community Health. 2022;4(4).

21

[21] Fayola D, Zuraida R, Jausal AN, et al. Hubungan Tingkat Pendidikan Akhir Ibu terhadap Status Gizi Balita (BB/TB). J Penelit Perawat Prof. 2025;7(2).

22

[22] BPJS. Panduan Layanan Bagi Peserta Jaminan Kesehatan Nasional Kartu Indonesia Sehat (JKN-KIS). 2023.

23

[23] Saputri NS, Murniati S. Kajian Dampak Bantuan Iuran Program Jaminan Kesehatan terhadap Masyarakat Miskin dan Tidak Mampu. Jakarta: The SMERU Research Institute; 2023.

24

[24] Rummiati, Kusumo. Perbandingan Kualitas Pelayanan Pasien Bpjs Pbi Dan Non Pbi Di Rumah Sakit Daerah. 2019.

25

[25] Parasuraman AP, Zeithaml V, Berry L. SERVQUAL A Multiple-item Scale for Measuring Consumer Perceptions of Service Quality. J Retail. 1988;64:12–40.

26

[26] Setiono BA, Putra RNP. The Influence of Service Quality (Reliability, Responsiveness, Tangibles, Empathy and Assurance) on Student Satisfaction Port Management and Maritime Logistics Study Program Vocational Faculty of Shipping Hang Tuah University. J Apl PELAYARAN DAN KEPELABUHANAN. 2025;15(2):327–339.

27

[27] Magdalena M, Ainy A. Kepatuhan Membayar Iuran Peserta Jaminan Kesehatan Nasional (JKN) Non Penerima Bantuan Iuran (Non-PBI) di Wilayah Pulau Jawa. J Kebijak Kesehat Indones. 2024;13(2):56.

28

[28] Rohmah S, Desty RT, Arumsari W. Analisis Kualitas Layanan pada Aplikasi Mobile JKN dengan Tingkat Kepuasan Pengguna Mobile JKN BPJS Kesehatan di Kabupaten Demak. Indones J Health Community. 2024;5(1):25.

29

[29] Herlinawati, Lilis Banowati, Hilma Dessy Nurhasan. Determinan Pemanfaatan Pelayanan Kesehatan Oleh Peserta Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS). Health CARE J Kesehat. 2024;13(1):59–73.

30

[30] Nugraha M, Sumadi S. Pengaruh Kualitas Pelayanan dan Persepsi Harga terhadap Kepuasan Pasien di Rumah Sakit Type C Kabupaten Kebumen. J Ilm Ekon Glob Masa Kini. 2020;11(2):97–102.

31

[31] Budiharjo N, Saimi S, Menap M, et al. Perbedaan Tingkat Kepuasan antara Pasien Pengguna BPJS Kesehatan dengan KLU Sehat. J Keperawatan Silampari. 2022;5(2):689–697.

32

[32] Amalia R, Sabilu Y, Nirmala F. KUALITAS PELAYANAN KESEHATAN PASIEN JKN PENERIMA BANTUAN IURAN (PBI) DAN BUKAN PENERIMA BANTUAN IURAN (NON PBI) DI WILAYAH KERJA PUSKESMAS WATOPUTE KABUPATEN MUNA TAHUN 2019. Dep AKK FKM UHO [Internet]. 2020;Vol 1, No 2 (2020): JAKK (Jurnal Administrasi Kebijakan Kesehatan).

Universal Health Coverage Achieves Equitable Maternal Healthcare Quality Among JKN Participants

Abstract

References

How to Cite

Cite Article

Article Update