Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities

Abstract Background For many low and middle-income countries poor quality health care is now responsible for a greater number of deaths than insufficient access to care. This has in turn raised concerns around the distribution of quality of care in LMICs: do the poor have access to lower quality hea...

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Autores principales:	Manon Haemmerli, Timothy Powell-Jackson, Catherine Goodman, Hasbullah Thabrany, Virginia Wiseman
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Inequalities Quality of care Universal health coverage Health insurance Indonesia Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/37a50be75044476f993a3de82eeeb808
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spelling	oai:doaj.org-article:37a50be75044476f993a3de82eeeb8082021-11-08T10:44:17ZPoor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities10.1186/s12939-021-01577-11475-9276https://doaj.org/article/37a50be75044476f993a3de82eeeb8082021-11-01T00:00:00Zhttps://doi.org/10.1186/s12939-021-01577-1https://doaj.org/toc/1475-9276Abstract Background For many low and middle-income countries poor quality health care is now responsible for a greater number of deaths than insufficient access to care. This has in turn raised concerns around the distribution of quality of care in LMICs: do the poor have access to lower quality health care compared to the rich? The aim of this study is to investigate the extent of inequalities in the availability of quality health services across the Indonesian health system with a particular focus on differences between care delivered in the public and private sectors. Methods Using the Indonesian Family Life Survey (wave 5, 2015), 15,877 households in 312 communities were linked with a representative sample of both public and private health facilities available in the same communities. Quality of health facilities was assessed using both a facility service readiness score and a knowledge score constructed using clinical vignettes. Ordinary least squares regression models were used to investigate the determinants of quality in public and private health facilities. Results In both sectors, inequalities in both quality scores existed between major islands. In public facilities, inequalities in readiness scores persisted between rural and urban areas, and to a lesser extent between rich and poor communities. Conclusion In order to reach the ambitious stated goal of reaching Universal Health Coverage in Indonesia, priority should be given to redressing current inequalities in the quality of care.Manon HaemmerliTimothy Powell-JacksonCatherine GoodmanHasbullah ThabranyVirginia WisemanBMCarticleInequalitiesQuality of careUniversal health coverageHealth insuranceIndonesiaPublic aspects of medicineRA1-1270ENInternational Journal for Equity in Health, Vol 20, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Inequalities Quality of care Universal health coverage Health insurance Indonesia Public aspects of medicine RA1-1270
spellingShingle	Inequalities Quality of care Universal health coverage Health insurance Indonesia Public aspects of medicine RA1-1270 Manon Haemmerli Timothy Powell-Jackson Catherine Goodman Hasbullah Thabrany Virginia Wiseman Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities
description	Abstract Background For many low and middle-income countries poor quality health care is now responsible for a greater number of deaths than insufficient access to care. This has in turn raised concerns around the distribution of quality of care in LMICs: do the poor have access to lower quality health care compared to the rich? The aim of this study is to investigate the extent of inequalities in the availability of quality health services across the Indonesian health system with a particular focus on differences between care delivered in the public and private sectors. Methods Using the Indonesian Family Life Survey (wave 5, 2015), 15,877 households in 312 communities were linked with a representative sample of both public and private health facilities available in the same communities. Quality of health facilities was assessed using both a facility service readiness score and a knowledge score constructed using clinical vignettes. Ordinary least squares regression models were used to investigate the determinants of quality in public and private health facilities. Results In both sectors, inequalities in both quality scores existed between major islands. In public facilities, inequalities in readiness scores persisted between rural and urban areas, and to a lesser extent between rich and poor communities. Conclusion In order to reach the ambitious stated goal of reaching Universal Health Coverage in Indonesia, priority should be given to redressing current inequalities in the quality of care.
format	article
author	Manon Haemmerli Timothy Powell-Jackson Catherine Goodman Hasbullah Thabrany Virginia Wiseman
author_facet	Manon Haemmerli Timothy Powell-Jackson Catherine Goodman Hasbullah Thabrany Virginia Wiseman
author_sort	Manon Haemmerli
title	Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities
title_short	Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities
title_full	Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities
title_fullStr	Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities
title_full_unstemmed	Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities
title_sort	poor quality for the poor? a study of inequalities in service readiness and provider knowledge in indonesian primary health care facilities
publisher	BMC
publishDate	2021
url	https://doaj.org/article/37a50be75044476f993a3de82eeeb808
work_keys_str_mv	AT manonhaemmerli poorqualityforthepoorastudyofinequalitiesinservicereadinessandproviderknowledgeinindonesianprimaryhealthcarefacilities AT timothypowelljackson poorqualityforthepoorastudyofinequalitiesinservicereadinessandproviderknowledgeinindonesianprimaryhealthcarefacilities AT catherinegoodman poorqualityforthepoorastudyofinequalitiesinservicereadinessandproviderknowledgeinindonesianprimaryhealthcarefacilities AT hasbullahthabrany poorqualityforthepoorastudyofinequalitiesinservicereadinessandproviderknowledgeinindonesianprimaryhealthcarefacilities AT virginiawiseman poorqualityforthepoorastudyofinequalitiesinservicereadinessandproviderknowledgeinindonesianprimaryhealthcarefacilities
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Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities

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