Improving maternal and newborn health services through strategic purchasing

09 May 2023

In October 2022, the Strategic Health Purchasing Pilot for Maternal and Newborn Health Services (“the pilot”) launched in Serang District of Indonesia. The pilot is a collaborative effort from the Ministry of Health and Indonesia’s Health Insurance Agency (BPJSK) to improve the way that maternal and newborn health services are paid for under the country’s national health insurance program (JKN). It comes in response to challenges with unpredictable service quality and financial strain on JKN. The innovative design of the pilot seeks to strengthen the benefits package, contracting arrangements, provider payment mechanism, and monitoring of maternal and newborn health services. Ultimately, this will reduce spending inefficiencies and promote better health outcomes for pregnant people and their children.

USAID’s Health Financing Activity (HFA)led by ThinkWell and implemented with Center for Health Economics and Policy Studies at the University of Indonesia, the Center for Health Policy and Management at Gadjah Mada University, and Results for Development (R4D)is providing technical support to the Ministry of Health and BPJSK. HFA’s collaborative and locally led approach has been instrumental to the success this initiative has seen so far. The pilot fosters active engagement and coordination among policymakers, purchasing agencies, and providers to effectively monitor and support maternal and newborn health service deliveryan achievement that has been lauded widely by those participating in this initiative. Portions of the pilot design are also already being adopted at the national level, and the pilot is now being expanded to include more facilities in the implementation region.

The pilot is ongoing and closely evaluated through implementation research. In a blog posted by ThinkWell’s partner, R4D, HFA experts share three main lessons from the process which they believe led to the successful launch the pilot and has set it up for a lasting impact:

  1. Co-creation with local stakeholders has grounded the design in local realities and was fundamental to promoting local ownership of this pilot.
  2. Collaboration and established partnership protocols among national and subnational health agencies built a strong foundation for scale-up.
  3. Placing local voices in the lead improves pilot performance and leaves a lasting impact.