Navigating Hybrid Organizations: Bridging Governance Gaps in Healthcare Policy Implementation in Indonesia

Authors

  • Rulinawaty Universitas Terbuka
  • Lukman Samboteng Politeknik STIA LAN Makassar
  • Andriyansah Universitas Terbuka
  • M. Rachmat Kasmad Universitas Negeri Makassar
  • Alwi Universitas Hasanuddin
  • Mutmainnah Basit Universitas Negeri Makassar

DOI:

https://doi.org/10.11111/ujost.v4i1.167

Keywords:

Healthcare policy, Policy implementation, Governance, Institutional capacity, Community engagement.

Abstract

Effective healthcare policy implementation is critical for achieving universal healthcarecoverage. This study evaluates the implementation of Indonesia's National Health Insurance Program (Jaminan Kesehatan Nasional - JKN), aiming to identify significant regional variations and underlying factors influencing policy effectiveness. A qualitative case study approach was adopted, employing semi-structured interviews, focus group discussions, and document analysis across selected Indonesian regions. Findings indicate substantial discrepancies in policy implementation outcomes, primarily driven by institutional capacities, governance quality, administrative complexities, resource constraints, and varying levels of community engagement. The discussion highlights the necessity of addressing institutional fragmentation, improving governance mechanisms, and strengthening stakeholder collaboration to overcome existing barriers. This research underscores the importance of context-specific strategies and contributes to a deeper understanding of healthcare policy implementation challenges. The insights offer valuable guidance for policymakers and suggest areas for further investigation into governance improvements and region-specific implementation frameworks.

References

Agustina, R., Dartanto, T., Sitompul, R., Susiloretni, K. A., Suparmi, Achadi, E. L., ... & Thabrany, H. (2019). Universal health coverage in Indonesia: Concept, progress, and challenges. The Lancet, 393(10166), 75-102. https://doi.org/10.1016/S0140-6736(18)31647-7

Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). Sage Publications.

Dartanto, T., Rezki, J. F., Nurhasana, R., Siregar, C. H., Bintara, H., Pramono, W., ... & Thabrany, H. (2020). Why do informal sector workers not pay the premium regularly? Evidence from the National Health Insurance system in Indonesia. Applied Health Economics and Health Policy, 18(1), 81-96. https://doi.org/10.1007/s40258-019-00518-y

Fossati, D. (2021). Multi-level governance and health policy in Indonesia: The role of sub-national governments. Journal of Contemporary Asia, 51(4), 576-597. https://doi.org/10.1080/00472336.2020.1765187

Krueger, R. A., & Casey, M. A. (2015). Focus groups: A practical guide for applied research (5th ed.). Sage Publications

Laksono, A. D., Wulandari, R. D., & Soedirham, O. (2021). Regional disparities in hospital utilisation in Indonesia: A cross-sectional analysis data from the 2018 Basic Health Survey. Indonesian Journal of Health Administration, 9(1), 8-17. https://doi.org/10.20473/jaki.v9i1.2021.8-17

Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Sage Publications.

Mahendradhata, Y., Trisnantoro, L., Listyadewi, S., Soewondo, P., Marthias, T., Harimurti, P., & Prawira, J. (2017). The Republic of Indonesia health system review. Health Systems in Transition, 7(1), 1-292. Retrieved from https://apps.who.int/iris/handle/10665/254716

Patton, M. Q. (2002). Qualitative research and evaluation methods (3rd ed.). Sage Publications.

Putri, N. K., Setiawan, D., & Nugroho, S. A. (2021). Implementation challenges in Indonesia's health insurance program: An analysis of health service providers' perspective. Journal of Health Policy and Management, 6(2), 101-112. https://doi.org/10.26911/thejhpm.2021.06.02.01

Rokx, C., Giles, J., Satriawan, E., Marzoeki, P., Harimurti, P., & Yavuz, E. (2018). New insights into the provision of health services in Indonesia: A health workforce study. The World Bank. https://doi.org/10.1596/978-1-4648-1285-0

Stake, R. E. (1995). The art of case study research. Sage Publications.

Wiseman, V., Thabrany, H., Asante, A., Haemmerli, M., Kosen, S., Gilson, L., ... & Mills, A. (2019). An evaluation of health systems equity in Indonesia: Study protocol. International Journal for Equity in Health, 18(1), 1-9. https://doi.org/10.1186/s12939-019-0944-y

World Health Organization. (2020). World health statistics 2020: Monitoring health for the SDGs, sustainable development goals. World Health Organization. Retrieved from https://apps.who.int/iris/handle/10665/332070

Yin, R. K. (2018). Case study research and applications: Design and methods (6th ed.). Sage Publications.

Published

2025-03-17

How to Cite

Rulinawaty, R., Samboteng, L., Andriyansah, A., Kasmad, M. R., Alwi, A., & Mutmainnah Basit, M. B. (2025). Navigating Hybrid Organizations: Bridging Governance Gaps in Healthcare Policy Implementation in Indonesia. UJoST- Universal Journal of Science and Technology, 4(1), 20–34. https://doi.org/10.11111/ujost.v4i1.167

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Section

Articles