REACHING THE POOREST –

WHAT ROLE FOR CASH TRANSFERS

TO ATTAINING UHC

ANDI ZA DULUNG

GENERAL DIRECTOR OF SOCIAL PROTECTION

AND SECURITY

MINISTRY OF SOCIAL AFFAIRS

Area: 5.193.250 km2. The sixth widest

country after Canada, USA , China,

Brazil, Australia

More than 13.000 islands

Population: more than 240 millions, the

four highest in the world after China,

India and USA

INDONESIA Data of Poverty

2013

SOCIAL PROTECTION INITIATIVES

1 A significant

number of the Poor

2 From commodity

subsidy to

household subsidy

3 Unconditional Cash

Transfer (UCT)

transformed to CCT

(Conditional Cash

Transfer) in 2007 ,

health insurance,

scholarship, and

rice for the poor.

4 Large poverty

dimension in

Indonesia

1. CCT & CCT Nutrition for

the poorest

2. Scholarship for the poor

3. Supplemental food for

school children program

4. Subsidized rice

5. For disabled

6. Children with adversity

7. Neglected old ages

8. Indigenous community

9. National Program on

Community

Empowerment (PNPM),

& PNPM Generation +

Nutrition)

10.Credit Facility to SMEs

1.Pension

2.Old age

security

3.“HEALTH”

4.Work Injury

5.Death

Social

Assistance

Social Insurance

NATIONA

L SOCIAL

INSURAN

CE

SYSTEM

(SJSN) -

UHC

Backgrounds

PKH (Family Hope Program) is a national priority program in

Indonesia.

The objective is to reduce poverty through improvement of life

quality in the field of health and education as well as to give ability

to the family to improve their consumption expense/economy.

PKH design elements:

1 PKH is a social protection program providing conditional cash

transfers (CCT) for the poorest families.

2 PKH is expected to change poorest families behavior in health

and education covering medical check up for women with

pregnancy/post natal/children under five and sending the

children to school.

3 PKH works on the principle that health is a human right and long

term investment which is expected to cut the link of poverty tothe next generation.

387,947 620,848

726,376 774,293 1,052,201

1,454,655

2,400,000

3,200,000

2007 2008 2009 2010 2011 2012 2013 2014

507

767 923 929

1280 1540

3600

5200

2007 2008 2009 2010 2011 2012 2013 2014

Budget Allocation(Billion IDR)

by Target/Household

PKH EXPANSION

COMPOSITION OF MEMBER PARTICIPATION FOR PKH FAMILY

Source : Center UPPKH , 2011

Positive Impact for Health

1. Number of women with pregnancy/post natal visitin g health facility improved 7 – 9 percentage points;

2. Number of children under five measured is improve d around 15-22 percentage points;

3. Delivery helped by medical person improved 5 percentage points;

4. Delivery helped by trained health personal improv ed 6 percentage points;

5. Impact of PKH is stronger in the regions with bet ter health service :

6. Impact in urban area is better than in rural. 7. Improvement of health facilities (Puskesmas, Pust u,

Pusling, Posyandu, dll)

collected from TNP2K 2011

PKH Health Impacts…PKH Health Impacts (% of baseline value)

-0,05

0,05

0,15

0,25

0,35

0,45

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Direct PKH Beneficiaries

Non-beneficiaries in PKHareas

1. Pre-natal visits

2. Pre-natal visits ≥ 4

3. Delivery at facility

4. Post-natal visits

5. Post-natal visits ≥ 2

6. Weighings ≥ 1 (1-3 yrs)

7. Weighings ≥ 1 (0-5 yrs

8. Public health facility outpatient visits

9. Public health facility outpatient visits (all HH members)

10. Private health facility outpatient visits (all HH members)

11. Body Weight

12. Diarrhea 13. Treated Diarrhea.

14. Fever

Program and Public Expenditure Review The World Bank , 2011

How did PKH contribute to improved health and

access to health service?

PKH contributed to the increased use of Posyandu in rural areas in NTT

because there were a more significant number of PKH recipients and

facilitators threatened to cut of PKH funding to recipients if they did not

routinely attend Posyand

Source: SMERU Research Report

Which design issues of the programs support these impacts?

The involvement of actors that influenced the utilization of MCH services including village officials, midwives, posyandu staff, PKH facilitators, and religious leaders

Source: SMERU Research Report

What are future challenges in this field (i. e. how to better

coordinate health sector and social protection/cash transfers)?

1 Increase the availability of MCH services so that this is adequate and easily

accessible by all communities.

2 Increase the number of MCH professionals and personals as well as improve

the incentive for them.

3 Improve rural infrastructure including buildings, roads, bridges, electricity, and

clean water.

4 Renew the awareness raising efforts of PKH to village officials, service

providers and recipient and non-recipient households. Midwives and Posyandu

cadres should also be involved in the monitoring of program beneficiaries.

5 Improve the relationship between facilitators and beneficiaries by defining

facilitator’s regions, not only on the number of beneficiaries, but also taking

into account the geographical area and number of villages beneficiaries.

6 Ensuring transparency in the targeting of beneficiaries and renewing

awareness raising efforts amongst program recipients and non-recipients.

7 Source: SMERU Research Report

EFFORT OF PROGRAM IMPROVEMENT AND SYNCHRONIZATION

SYNCHRONIZATION OF SUPPORTED

PROGRAM BETWEEN PKH,

KUBE AND ASKESOS

IMPROVEMENT OF BETTER

PKH ACHIEVEMENT AND

SUSTAIN

CONDUCTING FAMILY

DEVELOPMENT

SESSION

RE-CERTIFICATION

THANK YOU…..