Anom Dwi Prakoso
Masters Program in Public Health, Universitas Sebelas Maret

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Application of Health Belief Model on Factors Affecting Participation in the National Health Insurance Scheme among Informal Sector Workers in Kudus, Central Java Anom Dwi Prakoso; Endang Sutisna Sulaeman; Arief Suryono
Journal of Health Policy and Management Vol. 5 No. 1 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

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Abstract

Background: Universal Health Coverage is the mandate of the Pancasila and 1945 Constitution. UHC's target on January 1st, 2019 is that all Indonesians are covered by the National Health In­su­ran­ce (JKN). Meanwhile, the participation of informal workers as of May 1, 2019 only reached 57%. The cross subsidy system is not optimal and the budget deficit will continue to be experienced because the­re are still many citizens who have not joined JKN. This study aimed to analyze the de­ter­mi­nants of the participation of informal workers in the national health insurance program in Kudus using the Health Belief Model.Subjects and Method: This was case control study,conducted in 5 sub-districts in Kudus Re­gen­cy, Cen­tral Java from September to October 2019. Total of 200 informal workers were selected by pur­posive sampling, it were devided into two groups including 100 in case group and a 100 in con­trol group. The dependent variable was the participation of informal workers in the JKN program. The independent variables were perception of vulnerability, perception of seriousness, perspective of be­nefits, family support, self-efficacy, and social environment. The data collection was per­for­med using a questionnaire and data analysis with logistic regression using stata 13.Results: The participation of informal workers in the JKN program increased with knowledge of ≥Senior high school (b = 5.09; 95% CI = 0.32 to 9.87; p = 0.036), high perception of vulnerability (b = 3.01; 95% CI = 0.26 to 5.75; p = 0.031), high perceived seriousness (b= 5.38; 95% CI = 2.14 to 8.61; p= 0.001), high perceived benefit (b= 3.86; 95% CI= 0.39 to 7.34; p= 0.029), strong family support (b= 7.26; 95% CI= 2.69 to 11.82; p= 0.002), strong self-efficacy (b = 3.98; 95% CI = 0.98 to 6.98; p= 0.009) and a supportive social environment (b = 4.51; 95% CI= 1.61 to 7.40; p= 0.002).Conclusion:Knowledge, perception of vulnerability, perception of seriousness, perceived use­ful­ness, family support and social environment influence the participation of informal workers in the JKN program.Keywords: universal health coverage, national health insurance, health belief modelCorrespondence: Anom Dwi Prakoso, Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: anomdwiprakoso@gmail.com. Mobile: +62­895363­054­393.Journal of Health Policy and Management (2020), 5(1): 61-73https://doi.org/10.26911/thejhpm.2020.05.01.06