The state-run Healthcare and Social Security Agency (BPJS Kesehatan) and the Indonesian Health Ministry has piloted a payment system with the Strategic Health Expenditure for Maternal and Child Health (BKS KIA) in 40 first-level health facilities (FKTP) in Serang, Banten.
“This scheme has been formulated since 2019 as a step to increase the effectiveness and efficiency of maternal and child health services,” the agency’s Director of Planning, Development, and Risk Management, Mahlil Ruby, said here, Monday.
He noted that the trial of the BKS KIA scheme began in September 2022 and continuing until August 2023, by involving support from the Banten Provincial Government, Serang City/District Government, FKTP, the United States Agency for International Development (USAID), and the World Bank.
Currently, 67 percent of antenatal care (ANC) is carried out in hospitals, while FKTP remains in the front line of health services, though it only serves 33 percent of ANC, Ruby stated.
However, the quality of ANC services does not meet the standards and is unable to identify high-risk pregnancies, leading to high referrals to hospitals, he noted.
“The percentage of ANC services in Indonesia that meet the new standard is only 2.7 percent. One of the reasons for the high number of deliveries by caesarean section is the low quantity and quality of ANC,” Ruby remarked.
Therefore, BPJS Kesehatan collaborated with the Health Ministry and USAID to develop the BKS KIA payment scheme to improve the efficiency of maternal and child health financing, while still paying attention to the quality of services, facilities, and infrastructure.
BPJS Kesehatan Director of Supervision, Examination, and Inter-Agency Relations Mundiharno said he hopes that BKS KIA can boost the quality, efficiency, and equity of health services for mothers and children.
He said that through the development of the BKS KIA payment system, participants could benefit from ultrasonography (USG) services at the FKTP, six ANC services, and deliveries assisted by one doctor and two midwives/nurses at FKTP.
“The benefits are not only for the participants, but also for FKTPs that support BKS KIA. There will be an increase in the rate according to the economic price of maternal and child health, for example for ANC services, childbirth, post-natal care (PNC), and family planning services. The provision of complete ANC and PNC services at FKTP will be monitored and evaluated closely,” Mundiharno added.
His party also developed the P-Care Application feature to simplify the process of verifying the billing of KIA claims and monitoring its implementation in the trial FKTP.
The Head of the Center for Health Financing and Decentralization Policy at the Health Ministry, Yuli Farianti, said that her party was ready to start a strategic spending system in maternal health services at the community health center (Puskesmas) and clinics.
She said that the compliance of health facilities in providing standardized maternal services would be monitored by the regional health service and BPJS Kesehatan.
“Strengthening quality assurance is one of the keys to succeeding in the BKS KIA system. Claims that have been paid will be verified with standardized services,” she added.
Farianti also said that the certainty of service quality would bring an impact on improving services for pregnant women and childbirth, which are part of the Minimum Service Standards (SPM) in the health sector that must be achieved by local governments.
Meanwhile, the head of the Serang District Health Service, Agus Sukmayadi, said his party was ready to support the trial of the BKS KIA system in four health centers and 11 private clinics in Serang District. He said he hoped that the program will also be able to reduce maternal and newborn mortality rates.
On the same occasion, the head of the Serang City Health Service, Ahmad Hasanuddin, said he is committed to support the smooth trial of BKS KIA in eight health centers and 17 private clinics in Serang City.
The USAID Indonesia Health Office Deputy Director, Daryl Martyris, also said that the initiative would help strengthen the quality of services in health facilities in Indonesia and improve the health of mothers and babies.
“USAID is happy to be able to support BPJS Kesehatan and the Ministry of Health in designing the BKS KIA trial activity in Serang District/City,” he noted.
Source: Antara News