The impact of the 1997-98 East Asian economic crisis on health and health care in Indonesia

Abstract

This article identifies the effects of the 1997-98 East Asian economic crisis on health care use and health status in Indonesia. The article places the findings in the context of a framework showing the complex cause and effect relationships underlying the effects of economic downturns on health and health care. The results are based on primary analysis of Indonesian household survey data and review of a wide range of sources from the Indonesian government and international organizations. Comparisons are drawn with the effects of the crisis in Thailand. The devaluation of the Indonesian currency, the Rupiah, led to inflation and reduced real public expenditures on health. Households' expenditures on health also decreased, both in absolute terms and as a percentage of overall spending. Self-reported morbidity increased sharply from 1997 to 1998 in both rural and urban areas of Indonesia. The crisis led to a substantial reduction in health service utilization during the same time period, as the proportion of household survey respondents reporting an illness or injury that sought care from a modern health care provider declined by 25%. In contrast to Indonesia, health care utilization in Thailand actually increased during the crisis, corresponding to expansion in health insurance coverage. The results suggest that social protection programmes play a critical role in protecting populations against the adverse effects of economic downturns on health and health care.

Did the strategy of skilled attendance at birth reach the poor in Indonesia?

“…In the descriptive analyses of trends in professional attendance and caesarean section, we used 3-and 4-year groupings of the year of birth, combining 1998 and 1999 into one group to represent the 2 years during which the economic crisis was most severe. 17 For our adjusted regressions, we modelled time as a linear variable (assuming a constant change per year), allowing for changes in the trend at 1991, when the village midwife programme was fully under way, and at 1997, when the economic crisis began.…”

“…After the crisis hit the country in 1997, incomes fell, prices of basic goods increased and the government's expenditure on health and education declined. 12,17 The purported effects of the crisis on healthcare use have been contradictory, but there were reports of declining use of government-run health centres and village health posts. 17 However, some strategies to mitigate the effects of the crisis on the health of the poor may have protected the midwife programme.…”

“…12,17 The purported effects of the crisis on healthcare use have been contradictory, but there were reports of declining use of government-run health centres and village health posts. 17 However, some strategies to mitigate the effects of the crisis on the health of the poor may have protected the midwife programme. For example, the resources allocated to essential health services such as the village midwife were maintained, and funds were made available so that poor and vulnerable members of the population could be exempt from user fees.…”

Motivation in Words: Promotion- and Prevention-Oriented Leader Communication in Times of Crisis

“…All three studies focus on economic crises because economic crisis are regularly encountered by organizations and are also very impactful (Cutler et al, 2002;Waters, Saadah, & Pradhan, 2003).…”

Recovery From Crisis for Turkish Firms: Synergistic Action Between Foreign Policy and Marketing Process

“…Economic effects, in consumer side, can be considered as direct effect since it is the result of the shrink in trade volume, employment and the purchasing power. Consumers can also be exposed to psychological effects due to the possibility of decreasing their own income and the general demoralizing climate in market place (Waters, Saadah and Pradhan, 2003). In their study, Zurawicki and Braidot (2005) demonstrated clearly the changing behaviors of consumers to adjust their spending in the parallel of economic crisis.…”