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"Studi ini memiliki dua tujuan utama. Tujuan penelitian pertama adalah mengevaluasi pencapaian keadilan pelayanan Kesehatan di Indonesia dan mengkaji dimensi geografis ketimpangan menggunakan ukuran ketimpangan yang dapat didekomposisi secara sempurna yaitu Theil Indeks. Studi ini melakukan perbandingan sebelum dan sesudah perubahan tingkat desentralisasi di Indonesia. Selain itu, studi ini juga melakukan perbandingan periode dengan krisis ekonomi dan periode tanpa krisis ekonomi. Data yang digunakan adalah data sekunder cross-sectional berasal dari Survei Sosial Ekonomi Indonesia (Susenas) tahun 1996, 1998, 2000, 2002, 2005, 2008, 2011, dan 2014. Selanjutnya, indeks Theil didekomposisi menjadi antar- dan dalam-wilayah di tingkat provinsi dan kabupaten/Kota. Indeks Theil ketimpangan layanan kesehatan memberikan gambaran dinamika ketimpangan layanan kesehatan selama periode tahun 1996-2014. Ketimpangan layanan kesehatan cenderung memburuk selama krisis ekonomi tahun 1998. Selain itu ketimpangan cenderung membaik terutama selama fase kedua desentralisasi dan adanya kebijakan jaminan kesehatan sosial pada periode 2005-2014. Kombinasi desentralisasi administratif, desentralisasi politik dan adanya jaminan kesehatan sosial di Indonesia terkait dengan menurunnya tingkat ketimpangan secara keseluruhan, ketimpangan dalam wilayah (provinsi dan kabupaten/kota) dalam provinsi dan ketimpangan antar kabupaten/kota untuk layanan kesehatan rawat jalan dan rawat inap. Ketimpangan dalam wilayah berkontribusi signifikan terhadap ketimpangan total. Oleh karena itu, perhatian yang lebih besar terhadap penurunan ketimpangan dalam wilayah akan berkontribusi pada penurunan ketimpangan secara keseluruhan. Selanjutnya, tujuan penelitian kedua adalah mengevaluasi indikasi dampak kebijakan desentralisasi administrasi dan politik (pemilihan langsung di tingkat daerah) dan jaminan kesehatan sosial terhadap ketimpangan pelayanan kesehatan di tingkat kabupaten/kota di Indonesia. Dalam hal ini variabel ketimpangan pelayanan kesehatan dua kelompok layanan kesehatan yaitu layanan kesehatan rawat jalan dan rawat inap diukur dengan Theil indeks. Berdasarkan dataset pseudo-panel tingkat kabupaten/kota dari tahun 1996 hingga 2014, hasil estimasi fixed effect menunjukkan bahwa kombinasi desentralisasi administratif desentralisasi politik dan jaminan kesehatan sosial berkontribusi pada penurunan ketimpangan layanan kesehatan rawat jalan dan rawat inap. Mekanisme transmisi indikasi dampak desentralisasi pada pengurangan ketimpangan layanan kesehatan terjadi melalui efek langsung kebijakan desentralisasi dan kebijakan jaminan kesehatan sosial maupun melalui efek interaksi antara kebijakan desentralisasi dan kebijakan jaminan kesehatan sosial dengan penyediaan sumber daya kesehatan maupun efek langsung. Desentralisasi administratif saja belum memberikan efek penurunan ketimpangan layanan kesehatan rawat jalan dan cenderung meningkatkan ketimpangan layanan kesehatan rawat inap. Sedangkan, desentralisasi administratif yang dikombinasikan dengan kebijakan jaminan kesehatan sosial memberikan efek penurunan ketimpangan layanan kesehatan rawat jalan dan rawat inap. Kombinasi kebijakan desentralisasi administratif, demokratisasi di tingkat pemerintah kabupaten/kota dan kebijakan jaminan kesehatan sosial memberikan efek penurunan ketimpangan layanan kesehatan terbesar dibanding kondisi lainnya. Secara rata-rata, penyediaan sumber daya kesehatan memberikan efek terhadap penurunan ketimpangan layanan kesehatan. Penyediaan sumber daya kesehatan pada kondisi kombinasi kebijakan desentralisasi administratif yang ditambah dengan kebijakan desentralisasi politik serta adanya kebijakan jaminan kesehatan sosial memberikan efek penurunan ketimpangan layanan kesehatan rawat jalan maupun ketimpangan layanan kesehatan rawat inap yang terbesar dibandingkan kondisi lainnya. Efek penyediaan sumber daya kesehatan menjadi lebih besar terhadap penurunan ketimpangan layanan kesehatan seiring peningkatan nilai indeks sumber daya kesehatan. Secara keseluruhan, efektivitas penyediaan sumber daya kesehatan bervariasi antar pemerintah daerah. Berdasarkan analisis marginal effect, dibutuhkan suatu batas minimum penyediaan sumber daya kesehatan untuk bisa memberikan dampak penurunan ketimpangan layanan kesehatan. Terdapat batasan nilai minimum (threshold) bagi penyediaan sumber daya kesehatan agar dapat memberikan efek penurunan ketimpangan layanan kesehatan yaitu 12 untuk memberikan efek penurunan ketimpangan layanan kesehatan rawat jalan dan 27 untuk memberikan efek penurunan ketimpangan layanan kesehaan rawat inap. Pada tahun 2014, terdapat variasi yang besar untuk nilai indeks sumber daya kesehatan di tingkat kabupaten/kota. Nilai terendah adalah 9,16 dengan nilai tertinggi adalah 74,67 dengan rata-rata 34,49. Dengan demikian, masih ada kabupaten/kota yang ketersediaan sumber daya kesehatannya belum cukup untuk dapat memberikan efek penurunan ketimpangan layanan kesehatan. Terkait dengan penyediaan sumber daya kesehatan, Pemerintah Indonesia telah menetapkan Peraturan Pemerintah No. 2 tentang Standar Pelayanan Minimum (SPM). Peraturan pemerintah ini standar layanan minimum di sektor kesehatan. Selanjutnya, Menteri Kesehatan juga telah menetapkan Peraturan Menteri Kesehatan No. 4 tahun 2019 tentang Standar Teknis Pemenuhan Mutu Pelayanan Dasar pada Standar Pelayanan Minimal Bidang Kesehatan. Penyediaan sumber daya kesehatan merupakan elemen penting bagi pencapaian standar pelayanan minimum yang diatur dalam peraturan Menteri Kesehatan ini. Oleh karena itu, implementasi peraturan Menteri Kesehatan No 4 tahun 2019 secara konsisten penting untuk menurunkan ketimpangan layanan kesehatan di suatu wilayah kabupaten/kota dan selanjutnya berkontribusi pada penurunan ketimpangan layanan kesehatan secara keseluruhan.

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This study has two main objectives. The first research objective is to evaluate the achievement of healthcare equty in Indonesia and to examine the geographical dimension of inequity using a perfectly decomposable measure of inequality, the Theil Index. This study uses outpatient and inpatient healthcare as healthcare variables. This study compares before and after changes in the level of decentralization in Indonesia. In addition, this study also compares periods with economic crises and periods without economic crises. The data used are secondary cross-sectional data from the Indonesian Socio-Economic Survey (Susenas) in 1996, 1998, 2000, 2002, 2005, 2008, 2011, and 2014. Furthermore, the Theil index is decomposed into inter- and intra-regional at the provincial and district/city levels. Theil Index of Healthcare Inequity provides an overview of the dynamics of healthcare inequity dynamics during the period 1996-2014. Healthcare inequity tended to worsen during the economic crisis of 1998. In addition, healthcare inequity tended to improve especially during the second phase of decentralization and the introduction of social health insurance policies in the period 2005-2014. The combination of administrative decentralization, political decentralization, and the introduction of social health insurance in Indonesia is associated with a decline in overall healthcare inequity, intra-regional (provincial and district/city) disparities within provinces, and inter-district/city inequity for outpatient and inpatient healthcare. Intra-regional inequity contributes significantly to total inequity. Therefore, greater attention to reducing intra-regional inequity will contribute to a decline in overall healthcare inequity. Furthermore, the second research objective is to evaluate the indication of the impact of administrative and political decentralization policies (direct elections at the regional level) and social health insurance on healthcare inequity at the district/city level in Indonesia. In this case, the healthcare variable of two groups of healthcare, namely outpatient and inpatient healthcare, is measured by the Theil index. Based on the pseudo-panel dataset at the district/city level from 1996 to 2014, the results of the fixed effect estimation show that the combination of administrative decentralization, political decentralization, and social health insurance contribute to reducing outpatient and inpatient healthcare inequity. The transmission mechanism of the indication of the impact of decentralization on reducing healthcare inequity occurs through the direct effects of decentralization policies and social health insurance policies as well as through the interaction effects between decentralization policies and social health insurance policies with the provision of health resources and direct effects. Administrative decentralization alone has not provided an effect on reducing outpatient healthcare inequity and tends to increase inpatient health services inequity. Meanwhile, administrative decentralization combined with social health insurance policies provides an effect on reducing outpatient and inpatient healthcare inequity. The combination of administrative decentralization policies, democratization at the district/city government level, and social health insurance policies has had the greatest effect in reducing healthcare inequity compared to other conditions. On average, the provision of health resources reduces healthcare inequity. The provision of health resources in conditions of a combination of administrative decentralization policies coupled with political decentralization policies and the existence of social health insurance policies has the greatest effect on reducing inequality in outpatient health services and inequality in inpatient health services compared to other conditions. The effect of the provision of health resources becomes greater on reducing healthcare inequity as the value of the health resource index increases. Overall, the effectiveness health resources provision varies between local governments. Based on the marginal effect analysis, a minimum limit of the provision of health resources is needed to be able to have an impact on reducing inequality in health services. There is a minimum value limit (threshold) for the provision of health resources to be able to provide an effect on reducing inequality in health services, namely 12 to provide an effect on reducing outpatient healthcare inequity and 27 to provide an effect on reducing inpatient healthcare inequity. In 2014, there was a large variation in the value of the health resource index at the district/city level. The lowest score was 9.16 with the highest score being 74.67 with an average of 34.49. Thus, there are still districts/cities whose health resource availability is not sufficient to be provide an effect on reducing healthcare inequity. Regarding the provision of health resources, the Government of Indonesia has stipulated Government Regulation No. 2 concerning Minimum Service Standards (SPM). This government regulation is the minimum service standard in the health sector. Furthermore, the Minister of Health has also stipulated Regulation of the Minister of Health No. 4 of 2019 concerning Technical Standards for Fulfilling Basic Service Quality in Minimum Service Standards in the Health Sector. The provision of health resources is an important element for achieving the minimum service standards regulated in this regulation of the Minister of Health. Therefore, consistent implementation of the Regulation of the Minister of Health No. 4 of 2019 is important to reduce healthcare inequity in a district/city area and further contribute to reducing healthcare inequity as a whole."

"This paper is a literature review laying out empirical evidence of healthcare access inequity within an implementation of social health insurance (SHI) programs. The research question of this paper is: in what way, and how, inequity in healthcare access potentially happens, even if a type of SHI covers the whole, or most, of a society. This paper is mainly motivated by the implementation of Jaminan Kesehatan Nasional (JKN), an SHI program in Indonesia. Even though the program aims to create better equity in healthcare access, the existing health system and the program’s design may prevent the achievement of this goal. By laying out evidence on how healthcare access inequity in other countries remains within an SHI mechanism, this paper illuminates that JKN may face the same risk. In reviewing the papers, this study applied Goddard and Smith’s (2001) concept of healthcare access inequity in the area of availability, quality, cost, and information. The findings suggest that healthcare access inequity could happen despite the implementation of an SHI program. Four types of circumstances that might have led to healthcare access inequity include geographical disparities of health facilities; adequacy of insurance program’s reimbursement and healthcare providers’ financial motive; healthcare providers’ prejudices toward patients; and unequal personal advantages of health treatment seekers. When applied to the context of JKN implementation in Indonesia, the risks of healthcare access inequity are imminent, mostly due to the uneven concentration of health facilities, the program’s segmented tariff rates, and the socioeconomic diversity among JKN members. The findings imply that JKN members might be at risk of healthcare access inequity. While the risks are plausible, this study is limited to predicting the potential inequity within JKN, mirroring from the empirical evidence. This study signifies the need for further empirical research on this area, which will potentially inform policymakers to improve the program."

"Indonesia sebagai negara dengan populasi terbanyak ke empat didunia memiliki kebijakan keluarga berencana, yang dikelola oleh Badan Kependudukan Keluarga Berencana Nasional (BKKBN), dalam upaya pengendalian jumlah penduduk. BKKBN memiliki enam indikator startegis di periode 2020-2024, yaitu Total Fertility Rate (TFR), modern Contraceptive Prevalence Rate (mCPR), unmet need KB, Age Spesific Fertility Rate (ASFR) 15-19 tahun, indeks pembangunan Keluarga (iBangga) dan Median Usia Kawin Pertama Perempuan (MUKP). Secara nasional unmet need belum memenuhi target dan bila dilihat secara provinsi terdapat disparitas. Tujuan penelitian ini adalah untuk megkuantifikasi ketidakmertaan sosial unmet need kontrasepsi di Indonesia tahun 2012 dan 2017. Penelitian ini adalah penelitian kuantitatif dengan desain cross sectional dari data SDKI tahun 2012 dan 2017. Sampel pada penelitian ini adalah pasangan usia subur (PUS) yang tinggal bersama dan aktif secara seksual dalam 4 minggu terakhir. Jumlah sampel pada penelitian ini adalah 22477 (2012) dan 24173 (2017) pasangan. Pembentukan variabel akses pelayanan KB menggunakan Principal Component Analysis (PCA). Analisis ketidakmerataan yang digunakan merupakan bantuan alat ukur Health Equity Assesment Toolkit (HEAT) yang dikembangkan oeh World Health Organization (WHO) dan dilakukan juga analisis pengelompokkan dengan metode hirarkial. Hasil penelitian akses pelayanan KB paling dipengaruhi oleh informasi kontrasepsi yang diberikan oleh dokter. Secara umum terjadi penurunan nilai absolut unmet need kontrasepsi di Indonesia dari tahun 2012 ke tahun 2017. Namun bila dilihat pada populasinya (confident interval) tidak terdapat perbedaan unmet need dari tahun 2012 dan 2017. Ketidakmerataan unmet need kontrasepsi di Indonesia tahun 2017 masih terjadi dengan dimensi paling dominan adalah paritas (>2 anak) dan umur suami (>45 tahun), kemudian disusul oleh wilayah tempat tinggal (rural) serta sosial ekonomi (teratas). Terdapat perubahan wilayah prioritas unmet need dari tahun 2012 (12 provinsi) ke tahun 2017 (14 provinsi). Dari hasil ini diasumsikan bahwa wilayah berdekatan tidak selalu memiliki karakteristik yang serupa. Artinya, unmet need tidak dipengaruhi kewilayahan. Variabel yang menjadi irisan dari penurunan unmet need dan ketidakmerataan adalah umur suami (>45 tahun), paritas (>2 anak), sosial ekonomi dan wilayah tempat tinggal. Jika hal ini dilihat kembali dengan kluster analisis maka variabel umur suami dan paritas masuk dalam kriteria provinsi prioritas. Provinsi prioritas di tahun 2017 memiliki interval rata-rata umur suami yang paling tua (37.71-40.52 tahun) diantara kelompok lainnya dan juga memiliki paritas yang paling tinggi >2 anak (2.09 – 3.01 anak) di anggota klusternya. 

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Indonesia as the fourth most populous country in the world has a family planning policy, which is managed by the National Family Planning Population Agency (BKKBN), in an effort to control population numbers. The BKKBN has six strategic indicators for the 2020-2024 period, namely Total Fertility Rate (TFR), Modern Contraceptive Prevalence Rate (mCPR), Unmet need for family planning, Age Specific Fertility Rate (ASFR) 15-19 years, Family development index (iBangga) and Median Age of First Marriage for Women (MUKP). Nationally, unmet need has not met the target and when viewed by province, there are disparities. The purpose of this research is to quantify the social inequity of unmet need for contraception in Indonesia in 2012 and 2017. This research is a quantitative study with a cross-sectional design based on data from the 2012 and 2017 IDHS. The sample in this study was couples of childbearing age (PUS) who lived together and were sexually active in the last 4 weeks. The number of samples in this study were 22477 (2012) and 24173 (2017) couples. Formation of family planning service access variables using Principal Component Analysis (PCA). The inequality analysis used was the help of the Health Equity Assessment Toolkit (HEAT) developed by the World Health Organization (WHO) and grouping analysis was also carried out using a hierarchical method. The results of the research on access to family planning services are most influenced by contraceptive information provided by doctors. In general, there has been a decline in the absolute value of unmet need for contraception in Indonesia from 2012 to 2017. However, when viewed from the population (confident interval), there is no difference in unmet need from 2012 and 2017. Inequality in unmet need for contraception in Indonesia in 2017 still occurs with dimensions parity (> 2 children) and husband's age (> 45 years), followed by area of residence (rural) and social economy (top). There was a change in the priority areas of unmet need from 2012 (12 provinces) to 2017 (14 provinces). From these results it is assumed that adjacent areas do not always have similar characteristics. That is, unmet need is not influenced by territory. Variables that intersect the decline in unmet need and inequality are husband's age (> 45 years), parity (> 2 children), socioeconomic status and area of residence. If this is seen again with the cluster analysis, the variables of husband's age and parity are included in the priority province criteria. Priority provinces in 2017 have the oldest husband's average age interval (37.71 – 40.52 years) among other groups and also have the highest parity of >2 children (2.09-3.01 children) in their cluster members."

"Tesis ini membahas usaha tokoh utama Balram Halwai untuk mengakhiri posisinya dalam ruang sosial yang menekan dan berusaha untuk menjadi seseorang yang mandiri, serta bagaimana perspektif Adiga terhadap novel The White Tiger. Penelitian ini menggunakan teori unsur-unsur naratif serta menggunakan konsep Pierre Bourdieu tentang ruang sosial, arena, kapital (modal), habitus, dan distinction.Hasil analisis menunjukkan bahwa Balram yang berasal dari keluarga miskin dan kasta bawah mendapatkan tekanan dari keluarganya dan keluarga majikannya. Balram kemudian melakukan berbagai upaya dan strategi untuk keluar dari ruang sosial yang menekannya tersebut sehingga ia menjadi seorang yang sukses. Novel ini menjadi media bagi Adiga untuk menyatakan kritiknya terhadap masalah kemiskinan dan masalah ketidakadilan kasta sebagai permasalahan yang menekan kasta bawah dan merupakan permasalahan yang kompleks dan terstruktur.

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This thesis analyses the main character named Balram Halwai and his efforts to get himself out of his sophisticated social space in order to build himself as an independent man, and this thesis also discusses Aravind Adiga?s perspective toward the novel The White Tiger itself. This research uses the theory of the elements of novel and Pierre Bourdie?s concepts of field, habitus, capital, and distinction.

The result shows that Balram, who comes from poor family and belongs to lower caste, get domination from his family as well as his master's family. Balram, then, do some efforts and strategies to make himself out of the stressing social space until he becomes a success man. Furthermore, this novel functions as a media for Aravind Adiga to declare his critics toward poverty and inequity of caste system as problems that dominate lower caste as well as complex and structural problems."

"This paper analyzes health outcomes and inequality in Indonesia, and the links to intermediate factors and inputs. Between 1997-2015, the country's health performance indicators had improved and became more equal. This achievement could potentially be correlated with improvement in health care access, which might be a result of the Indonesian government's policy to expand health insurance coverage, mainly to the most impoverished population. By 2020, the Indonesian government operates national social health insurance, the Jaminan Kesehatan Nasional (JKN), which covers about 83% of the country's population, including the poor and vulnerable. This paper uses the Control Knob Framework and focuses on the health insurance expansion as the financing knob adjustment conducted by the government. The analysis starts with the improvement of health status indicators and tracks back its association with health care access and health insurance coverage expansion. This paper finds that health status improvement in Indonesia between 1997-2015 was correlated with health care access increase. The decline in the infant mortality rate (IMR) and the under-five mortality rate (U5MR) between 1997-2015 were associated with an increase in health care utilization, including the use of trained birth attendants and diphtheria-pertussis-tetanus (DPT) immunization. This paper then observes a strong correlation between the expansion of health care access and health insurance coverage. In terms of equality, the article sees a weaker, but evident, correlation between health insurance equalization across different population groups with more equitable health care access and health outcomes. The findings of this paper justify the effectiveness of the financing knob (expanding and equalizing health insurance coverage) in increasing access to care (outpatient and inpatient care, trained birth attendants, immunization) and improving health status (IMR and U5MR). This study is among the firsts to utilize Control Knob Framework as an analytical tool for health insurance assessment. The study recommends the government to combine health insurance expansion with other progressive policy, such as financial support to poor patients to cover the non-medical expenses of attending health care, to optimize the effectiveness of the interventions."

"Latar belakang masalah. Epidemi HIV/AIDS membawa berbagai dampak bagi kehidupan individu. Dan berbagai laporan dunia, ada kecenderungan peningakatan kasus pada perempuan. Saat ini perempuan berisiko tertular HIV/AIDS karena risiko tinggi yang dimiliki oleh pasangannya. Kerentanan perempuan terhadap HIV/AIDS antara lain karena perempuan rentan secara biologis, sosial, ekonomi, ketidakadilan gender, dan kultural. Berdasarkan atas kenyataan ini peneliti tertarik untuk mengetahui lebih dalam tentang perempuan yang terpapar HIV dari pasangannya.Tujuan. Penelitian ini bertujuan mendapatkan gambaran stigmatisasi, diskriminasi, dan ketidaksetaraan gender pada ODHA perempuan, serta perjuangannya untuk hidup karena HIV/AIDS yang disandangnya.Metodologi. Penelitian kualitatif dengan berperspektif perempuan dengan pendekatan life history. Penelitian dilakukan di Jakarta selama 6 bulan pada tahun 2005 dengan teknik pengumpulan data melalui wawaneara mendalam lebih dari sate kali dan observasi selama wawancara. Enam informan (ODHA perempuan yang terpapar HIV/AIDS karena berhubungan seksual) berhasil diwawancara.Hasil. Stigmatisasi dan diskriminasi masih dialami oleh informan terutarna di pelayanan kesehatan. Dari hasil penelitian juga didapatkan bahwa informan terinfeksi HIV antara lain karena adanya pemaksaan secara seksual dan penggunaan kondom yang rendah karena ketidaktahuan dan merasa tidak enak terhadap pasangannya untuk meminta menggunakan kondom. Dampak HIV/AIDS menyebabkan informan harus bekerja lebih keras untuk menghidupi keluarga dan dirinya sendiri. Dukungan dari lembaga peduli AIDS menyadarkan mereka untuk menyuarakan pengalaman mereka kepada masyarakat terutama perempuan agar pengalaman tersebut tidak dialami oleh perempuan lagi.

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Background. HIV/AIDS epidemic has brought impacts on individual life. Worldwide reports there is increasing trends of women being infected HIV. Nowadays, many women who have less risk of being infected HIV eventually have been infected by high-risk HIV partners who for example have IDU history or have many sexual partners. Women who are biologically, socially, economically, and culturally vulnerability have led women's vulnerability.

Objective. This study aims at investigating stigmatization, discrimination, and gender inequity suffered by an HIV positive women and their struggle against those mentioned above.

Method. This study is qualitative study with women perspective using life history approach. The study conducted in Jakarta during 6 months in 2005. The data collection gathered by in-depth interview and conducted more than once and observation for six women informants who have HIV positive from her partners.

Result. Stigmatization and discrimination are experienced by informants especially at health services. This Study also found that women infected HIV among others through sexual force, absence of condom using due to their ignorance or reluctance asks their partner. Being infected, women have to work much harder as the sole breadwinner to replace their already deceased husbands' roles. Support from NGOs care for HIV have pushed them to expose their experience to so as prevents women from having similar experiences."