A qualitative study on psychiatrists’ experiences of the Universal Health Coverage in psychiatric daily practice in Indonesia

Annemieke Bikker, Niko Tiliopoulos, Cokorda Bagus Jaya Lesmana

Research output: Contribution to conferencePosterpeer-review

Abstract

Abstract
Background
Achieving Universal Health Coverage (UHC) worldwide is part of the international health agenda as reflected in the United Nations' Sustainable Development Goals. UHC is important for people suffering from mental health conditions because it provides access to essential quality health services and reduces out-of-pocket spending. Indonesia - a low-middle income country - launched a stepwise UHC in 2014. Recent figures indicate that 9.8% of the Indonesian population suffers from a mental health condition, though this is likely to be an underestimation. Thus, the introduction of the UHC is perceived as a key element in improving Indonesian mental health outcomes.
Aim
This study aimed to obtain insight into psychiatrists’ experiences of the UHC and how it affects their daily practice.
Method
This cross-cultural, qualitative study was conducted in Bali, Indonesia in 2018. From the 52 active psychiatrists, 27 participated in an in-depth semi-structured interview. We followed an interpretivist approach. Transcripts and fieldnotes were coded and analysed through thematic analysis, and we arrived at two themes. The relevant ethical approvals were obtained.
Findings
1. Patients accessing services.
Most participants did not notice an increase in the number of patients accessing their services since the UHC. However, they noticed a shift in the types of conditions that patients presented, which they attributed to a reduction in financial barriers and increased awareness of mental health. Yet, many acknowledged that stigmatisation and supernatural beliefs continued to be strong.
2. Providing quality mental healthcare.
Most psychiatrists experienced some limitations from the UHC that affected the efficiency of care. With the UHC covering only ICD diagnostic codes and for the duration of a fixed period for treatment, psychiatrists faced challenges when faced with cultural illnesses and long-term conditions.
Conclusions and implications
UHC is promoted internationally as a clear pursuit of equity and social justice. While, according to the participants in our study, the UHC improved access to mental healthcare in Indonesia to some extent, cultural belief systems and integration of services for patients with chronic mental illness are also key to patients’ recovery that need to be taken into account.
Original languageEnglish
Publication statusPublished - 10 Mar 2021
EventTrinity Health and Education International
Research Conference
- Virtual/ online
Duration: 10 Mar 202111 Mar 2021

Workshop

WorkshopTrinity Health and Education International
Research Conference
Abbreviated titleTHEConf2021
Period10/03/2111/03/21

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