Anja Reid

This chapter focuses on the factors influencing Mekong Delta farmers’ satisfaction with health insurance services in the context of agricultural practice. The study identifies three key factors affecting farmers’ satisfaction with health insurance services: participation and payment procedures, hospital service quality, and the support of hospital and social insurance staff. Statistical analysis indicates that these factors significantly impact farmers’ satisfaction levels, with women rating health insurance services higher than men. Moreover, the study underscores the importance of improving access to quality care and enhancing client satisfaction to address the challenges faced by farmers in accessing healthcare services. The research employs a mixed-method approach, including surveys, interviews, and focus group discussions, to gather empirical data from 180 farming households in An Giang, Can Tho, and Soc Trang provinces. The chapter recommends policy reforms to address the socio-economic and environmental changes in the Mekong Delta, advocating for the integration of technological innovations such as telemedicine and artificial intelligence (AI) diagnostic tools to enhance healthcare accessibility. The study’s implications extend to the Vietnam Ministry of Health and Social Security Agency, providing insights to identify areas for improvement in health insurance policies and social security systems. The research contributes to the ongoing discourse on enhancing healthcare services for rural populations, with implications for policymakers, healthcare providers, and social security agencies.

Background: As a Hindu-majority province in Indonesia, Bali presents a unique and distinctive culture. Patrilocal (purusa) marriage and patrilineal inheritance as a continuation of the patriarchal system puts a man in the key role as a family successor. Having a son is a priority for a married couple in Balinese society. As a consequence, Balinese women experience several constraints related to their economic productive, reproductive, and adat (ritual) roles. When a family does not have a male heir, their daughter is pressed to find a spouse willing to accept sentana (matrilocal) marriage. This secondary form of marriage brings another complication for Balinese-Hindu women and does not necessarily relieve their submissive position.

This research analyzes Balinese-Hindu women’s perspectives on their marriage experiences and fertility decisions.
Methods: The data was collected in two areas representing rural (Banjar Tumbakasa in Gianyar) and urban (Banjar Biaung in Denpasar) locations in Bali Province, Indonesia from November 2019 to February 2020. Primary data was based on in-depth interviews of six rural and six urban married Balinese-Hindu women.

Results: This qualitative inquiry into Balinese women's experience of the marriage system and fertility options in urban and rural Bali revealed varying degrees of social expectation to provide male descendants for their families. At the same time, economic burdens still haunt them in this development era, and have conflicting implications for family size. Their stories of purusa (patrilocal) and sentana (matrilocal) marriage were complex, being strongly associated with customary law (adat) in traditional society. Paradoxically, however, it was rural women in the study sample who disproportionately opted for the sentana arrangement and limitation of family size.

Conclusions: This study explores women's fertility aspirations, notably regarding son precedence. It problematizes the sentana marriage alternative as a solution to lighten the expectations and burdens affecting women.

As a Hindu-majority province in Indonesia, Bali presents a unique and distinctive culture. Patrilocal (purusa) marriage and patrilineal inheritance as a continuation of the patriarchal system puts a male in the key role of family representative and successor. Having a son is a priority for a married couple in Balinese society. As a consequence, Balinese women experience several constraints related to their economic productive, reproductive, and adat (ritual) roles. When a family does not have a male heir, their daughter is pressed to find a spouse willing to accept sentana (daughter succession) marriage. This secondary form of marriage brings another complication for Balinese-Hindu women and does not necessarily relieve their submissive position. This study analyzes Balinese-Hindu women’s perspectives on their marriage experiences and fertility decisions in patrilineal society in changing rural and urban conditions.

The data was collected in two areas representing rural (Gianyar) and urban (Denpasar) locations in Bali Province, Indonesia from November 2019 to February 2020. Primary data was based on in-depth interviews of six rural and six urban married Balinese-Hindu women.

This qualitative inquiry into Balinese women's experience of the marriage system and fertility options in urban and rural Bali revealed varying degrees of social expectation to provide male descendants for their families. At the same time, economic burdens still haunted them in this development era and manifested conflicting implications for family size. Their stories of purusa and sentana marriage were complex because it has strongly associated with customary law (adat) in traditional society. Paradoxically, this study found that it was predominantly rural women who opted for the sentana arrangement and expressed a preference for smaller family sizes.

This study explores women's fertility aspirations, notably regarding son precedence. It problematizes the sentana marriage alternative as a potential solution to alleviate the expectations and burdens placed on women.