Marginal Benefit Incidence of Public Health Spending: Evidence from Indonesian Sub-National Data

Abstract

The Institute of Social Studies is Europe's longest-established centre of higher education and research in development studies. On 1 July 2009, it became a University Institute of the Erasmus University Rotterdam (EUR). Postgraduate teaching programmes range from six-week diploma courses to the PhD programme. Research at ISS is fundamental in the sense of laying a scientific basis for the formulation of appropriate development policies. The academic work of ISS is disseminated in the form of books, journal articles, teaching texts, monographs and working papers. The Working Paper series provides a forum for work in progress which seeks to elicit comments and generate discussion. The series includes academic research by staff, PhD participants and visiting fellows, and award-winning research papers by graduate students.

District‐level impacts of health system decentralization in Indonesia: A systematic review

“…Budget constraints, ineffective public spending, and sub‐optimal public insurance coverage were identified as health financing issues at the district level. After decentralization, increased fiscal independence at the district level was recognized in the majority of districts across Indonesia . The increase allowed DHO to manage their spending and prioritize according to their local health needs.…”

Does Decentralization Improve Health System Performance and Outcomes in Low‐ and Middle‐Income Countries? A Systematic Review of Evidence From Quantitative Studies

“…Although Akin, Hutchinson, and Strumpf did not find significant effect of the fiscal autonomy on health spending in Uganda, they found that as the districts progressed further into the decentralization process, they allocated less money for public goods and primary health care. A study by Kruse, Pradhan, and Sparrow found that each additional 1% increase in local revenue was associated with a 0.88% increase in total public health spending . This finding suggests that an increase in local revenue does not translate into an equal rate of increase in public health spending.…”

“…Table reports the characteristics of the articles selected for review. Sixteen different studies were identified, with the earliest one published in 2003 and the most recent one published in 2016 . The selected studies were situated in Latin America ( n = 8), Asia ( n = 5), Africa ( n = 2), and multiple countries ( n = 1).…”

“…In terms of the effects of decentralization on health system inputs, 2 of the 3 studies showed adverse effects of decentralization, and 1 study did not find significant effects of decentralization on corruption . The impact of decentralization on health system performance was investigated in 7 studies and showed mixed findings . Two studies showed beneficial effects, 3 studies showed mixed results, 1 study showed harmful effects, and 1 study showed no significant effects …”

The Missing Link: Explaining the Political Mobilisation of Islam in Indonesia

“…Nevertheless, there are indications that the new scheme has been a qualified success, with analyses showing it has been the poor who have benefited most (Kruse et al, 2009). It has been well targeted: one study shows that 80% of those covered by Jamkesmas come from the poorest 50% of the population (Sparrow et al, 2010: 10).…”