In 2014, Indonesia launched an ambitious national health insurance program, Jaminan Kesehatan Nasional (JKN), to achieve universal health coverage (UHC) by 2019. USAID collaborated with the Government of Indonesia to conduct implementation research (IR) in five districts to understand how national UHC policies were affecting front line primary care. USAID contracted Abt Global to build in-country IR capacity by working with a local university partner. National and district stakeholders were convened to develop the IR questions. Extensive data collection with a broad range of key informants followed. Results were fed back to stakeholders, who then revised the IR questions for a second cycle of data collection and feedback intended to lead to policy improvements.
Substantively, JKN accomplished many of its intended goals, although not in the desired time frame. The number of people able to access primary care services increased dramatically and preventive services expanded.. There were challenges, too: capitation funds were not optimally used due to unclear regulations, government agencies did not share all the data that could support primary care monitoring and health workers felt that their individual performance was not reflected in their compensation.
However, the IR engagement process successfully brought national and local government officials together for focused discussions.