Political economy analysis of health taxes (tobacco, alcohol drink and sugar-sweteened beverage): qualitative study of three provinces in Indonesia
Document Type
Article
Publication Date
8-1-2024
Abstract
Objective Efforts to implement health tax policies to control the consumption of harmful commodities and enhance public health outcomes have garnered substantial recognition globally. However, their successful adoption remains a complex endeavour. This investigates the challenges and opportunities surrounding health tax implementation, with a particular focus on subnational government in Indonesia, where the decentralisation context of health tax remains understudied.Design Employing a qualitative methodology using a problem-driven political economy analysis approach.Setting We are collecting data from a total of 12 focus group discussions (FGDs) conducted between July and September 2022 in three provinces-Lampung, Special Region of/Daerah Istimewa Yogyakarta and Bali, each chosen to represent a specific commodity: tobacco, sugar-sweetened beverages (SSBs) and alcoholic beverages-we explore the multifaceted dynamics of health tax policies.Participant These FGDs involved a mean of 10 participants in each FGD, representing governmental institutions, non-governmental organisations and consumers.Results Our findings reveal that health tax policies have the potential to contribute significantly to public health. Consumers understand tobacco's health risks, and cultural factors influence both tobacco and alcohol consumption. For SSBs, the consumers lack awareness of long-term health risks is concerning. Finally, bureaucratic complexiting and decentralised government hinder implementation for all three commodities.Conclusion Furthermore, this study underscores the importance of effective policy communication. It highlights the importance of earmarking health tax revenues for public health initiatives. It also reinforces the need to see health taxes as one intervention as part of a comprehensive public health approach including complementary non-fiscal measures like advertising restrictions and standardised packaging. Addressing these challenges is critical for realising the full potential of health tax policies.
Keywords
health economics, health policy, public health
Divisions
Faculty_of_Business_and_Accountancy
Funders
Universitas Indonesia through the International Indexed Publication Grant (Hibah Publikasi Terindeks Internasional (PUTI Q1) ; (NKB-299/UN2.RST/HKP.05.00/2023),Alliance for Health Policy and Systems Research,WHO Departments,Inter-Agency Working Group on Health Taxes,Royal Government of Norway
Publication Title
BMJ Open
Volume
14
Issue
8
Publisher
BMJ Publishing Group
Publisher Location
BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND