Determinants of Compliance in Paying Contributions among Independent JKN Participants

BPJS Health has incurred losses exceeding 200 billion rupiah over a two-year period due to the payment of contributions that were discontinued by participants who had utilized maternity services. Data show that 64.7% of mothers registered as BPJS Health participants only one month prior to childbirth, after which 43% either withdrew their membership or failed to continue paying contributions following delivery. The highest proportion of this behavior was observed among independent participants or non-wage recipients (PBPU). In Jambi Province, the highest level of contribution non-compliance occurs in Jambi City. In 2023, there were 77,489 participants with contribution arrears, resulting in financial losses amounting to 60.1 billion rupiah. Contribution non-compliance is influenced by various factors. This study aims to analyze the factors contributing to non-compliance among independent participants in paying BPJS Health contributions after utilizing childbirth services in Jambi City. The findings revealed that 33.3% of independent participants were non-compliant in paying BPJS Health contributions after using maternity services. Significant associations were found between contribution non-compliance and the number of family members (p = 0.001), level of knowledge (p = 0.000), illness perception (p = 0.001), clinical assessment (p = 0.000), and willingness to pay (WTP). Based on these findings, it is recommended that BPJS Health consider implementing a waiting period policy for participants intending to utilize maternity services. In addition, the Jambi City Government should strengthen promotive efforts to educate the public and raise awareness of the importance of health insurance in safeguarding household financial security.