Study of implementing the local regulation of community health insurance scheme (Jamkesda) West Sumatra Sakato towards SJSN and BPJS law in 2013

Background: Local health insurance (Jamkesda) is an effort made by the Government of West Sumatra province to improve the accessibility of health services for the poor or near poor who are not accommodated in the quota of public health insurance (Jamkesmas). Jamkesda was implemented at the start of 2007 until in 2011 using Governor Regulation West Sumatera Number 40 and Number 41 in 2007. After running for five years, there are still many problems in the implementation. Later in 2011, the provincial parliament of West Sumatera exercised its rights of initiative and enacted Local Legislation Number 10 year 2011 regarding the implementation of the Health Insurance West Sumatra Sakato. Afterwards, the implementation of Jamkesda West Sumatera Sakato refers to these regulations. The purpose of this study is to evaluate the implementation of the new regulation of the Jamkesda West Sumatera Sakato in 2013. Methods : This study is a descriptive analysis with a qualitative using case study. Data collection is done at the Provincial Health Office / District Health Office / City selected, PT Health Insurance, regional planning agency (Bappeda), and health provider. Qualitative data were collected through in-depth interviews, and secondary data were collected through document review. Result: The results of the study shows that implementation of health insurance on West Sumatra Sakato still had not been optimal, namely how the selection of the participants; a low premium that is Rp.6.000/month/member by sharing funding between provincial and district budgets / City budgets; the benefits are not yet comprehensive enough; health providers is still limited in the region of West Sumatra province and only in public facilities; health workers has not been evenly distributed; the team is still not functioning well; the monitoring and evaluation at every level Administrative as well as socialization of Jamkesda are not optimal; and the existing policy has not referred to higher level policy. Conclusion: Implementation of Jamkesda West Sumatra Sakato does not go according to the existing policy. Among others, the selection of membership, quality of health care,low premiums, health facilities are limited, health workers have not been evenly distributed, and the monitoring and evaluation team has not been established as per the guidelines. Suggestion: There is a need to evaluate Jamkesda West Sumatera Sakato policy so that the policies are not contradicting. There is a need to form a Monev Team for Jamkesda so that all parties have a sense of shared responsibility