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Evaluating equity in health systems financing in Indonesia – a mixed methods study

Principal Supervisor: Associate Professor Virginia Wiseman (London School of Hygiene & Tropical Medicine)

Co-Supervisor: Associate Professor Josephine Borghi (London School of Hygiene & Tropical Medicine)

Co-Supervisor: Dr Ourania Dimakou (SOAS University of London)

Project description

Concerns about the poor and most vulnerable not getting adequate access to quality health care are widespread in low and middle-income countries (LMICs) and have led to an intense advocacy for universal health coverage (UHC). In recent years Indonesia has embarked on a program to achieve UHC through a JKN national health insurance program. The country has made steady progress but there is however mounting evidence of areas where the JKN is underperforming. It is currently estimated that 90 million (40% of the population) remain uncovered, most of these working in the informal sector. JKN members also continue to incur high out-of-pocket (OOP) health expenditures. Over the next 3 years, the government will be increasing its efforts to scale up the JKN and reach its UHC target of 2019. Using the tool of benefit incidence analysis (BIA), this project will measure the extent to which current UHC reforms in Indonesia are benefiting the poor. The research will also advance BIA methodology - which typically focuses on the utilisation of services by different socioeconomic groups (SEGs) - by taking into account the quality of services received; thereby providing a more precise measure of benefit/subsidy distribution.

Specific objectives include:

  1. Conduct a literature review of theories and tools for measuring quality of health care in LMICs.
  2. Extend BIA methodology by designing a quality of care index to adjust the distribution of public subsidy for health across SEGs.
  3. Measure the Indonesian health care system’s equity at two time points using the weighted BIA methodology.
  4. Compare the incidence of catastrophic and impoverishing health expenditure at two time points.
  5. Analyse the outcomes of Objectives 1-4 and provide recommendations for decision-makers.

Subject areas/ keywords

Health financing, equity, Indonesia, benefit incidence analysis, quality of care

Candidate requirements

MSc training in health economics, public health (with health economics courses), or closely related field.

The studentship is open to applicants who would be assessed to have UK/EU fee status.

Further information

Further information about PhDs at LSHTM is available here.

The successful student will be registered at: The London School of Hygiene & Tropical Medicine

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How to apply

Instructions for applicants

LSHTM uses an online application system

Please contact for queries related to the submission of the application.

Please use the standard LSHTM application system to apply for this studentship and state clearly under the funding section that you are applying for this particular studentship. Since you are applying for an existing project you do not need to include a research proposal, so please instead upload a document which states that you are applying for this studentship.

The closing date for applications is: 1st March 2018