Health system transformation in Indonesia: Implementation and challenges of six policy pillars

Penulis

  • Ashfiya Vi'aqila El-Tsana Universitas Pembangunan Nasional Veteran Jakarta
  • Rizka Ayu Alvianty Universitas Pembangunan Nasional Veteran Jakarta
  • Putri Octaviani Universitas Pembangunan Nasional Veteran Jakarta
  • Raisha Syahidah Universitas Pembangunan Nasional Veteran Jakarta
  • Riswandy Wasir Universitas Pembangunan Nasional Veteran Jakarta

DOI:

https://doi.org/10.54957/ijhs.v5i3.1548

Kata Kunci:

Health System Evaluation, Health Transformation, Indonesia, Policy Implementation, Six Pillars

Abstrak

Indonesia’s health system transformation is structured around six strategic pillars: primary care, referral services, system resilience, financing, human resources, and health technology. This study aims to assess the implementation progress and challenges associated with these pillars. A literature review was conducted using national and international databases (Google Scholar and ScienceDirect), focusing on peer-reviewed articles published between 2016 and 2025. Four studies were selected based on inclusion criteria that emphasized relevance to Indonesia’s health system transformation agenda. The review identified key challenges, including limited digital infrastructure, uneven distribution of the health workforce, rigid financing mechanisms, particularly within Public Service Agency (BLU) institutions and weak intersectoral coordination. Many facilities remain unprepared for digital integration, particularly the implementation of Electronic Medical Records (EMR). Although some improvements have been observed, structural barriers continue to hinder the overall progress. Strengthening digital readiness, enhancing workforce capacity, adopting more flexible budgeting mechanisms, and improving coordination, especially through platforms such as SATUSEHAT are recommended as strategic responses. However, this study has several limitations, such as the limited availability of articles that cover all six pillars comprehensively and most of the studies used emphasize legal and administrative aspects rather than specific analysis in the health sector. These limitations limit the generalization of the findings. These findings are expected to inform more adaptive and equitable health policy reforms in Indonesia.

Referensi

Aisyah, D. N., Setiawan, A. H., Lokopessy, A. F., Faradiba, N., Setiaji, S., Manikam, L., & Kozlakidis, Z. (2024). ICT Maturity Assessment at Primary Healthcare Services across 9 Provinces in Indonesia: An Evaluation Study. JMIR Medical Informatics, 12, 1–33. https://doi.org/10.2196/55959

Cahyadini, A., Safiranita, T., Putri, S. A., Hutagalung, J. I. G., & Fahriza. (2025). Adopting Pillar One: an ideal model for the transformation of Indonesia’s Tax Law to realize SDGs goal XVII and it’s challenges. In Cogent Social Sciences (Vol. 11, Issue 1, pp. 1–13). Cogent OA. https://doi.org/10.1080/23311886.2025.2459321

Isasih, W. D., Inayati, R., Damayanti, V. A. R., & Gunawan, I. (2024). Implementation of Nawa Cita’s 5th Agenda in The Healthy Indonesia Program with a Family Approach. MAHESA : Malahayati Health Student Journal, 4(2), 507–520. https://doi.org/10.33024/mahesa.v4i2.13388

Kementerian Kesehatan Republik Indonesia. (2023). Transformasi Kesehatan Mewujudkan Masyarakat Indonesia Sehat dan Unggul (Biro Komunikasi dan Pelayanan Publik Kementerian Kesehatan Republik Indonesia (ed.)). Kementrian Kesehatan RI.

Loganathan, T., Rui, D., Ng, C. W., & Pocock, N. S. (2019). Breaking down the barriers: Understanding migrant workers’ access to healthcare in Malaysia. PLoS ONE, 14(7), 1–24. https://doi.org/10.1371/journal.pone.0218669

Massuda, A., Hone, T., Leles, F. A. G., De Castro, M. C., & Atun, R. (2018). The Brazilian Health System at Crossroads: Progress, Crisis and Resilience. BMJ Global Health, 3(4), 1–8. https://doi.org/10.1136/bmjgh-2018-000829

Novianti, & Bakhtiar, H. S. (2024). Implementation of Electronic Medical Record System in Indonesia Viewed from the Perspective of Legal Certainty. International Journal of Engineering Business and Social Science, 2(04), 1114–1122. https://doi.org/10.58451/ijebss.v2i04.145

Nugraheni, W. P., Mubasyiroh, R., & Hartono, R. K. (2020). The influence of Jaminan Kesehatan Nasional (JKN) on the cost of delivery services in Indonesia. PLoS ONE, 15(7), 1–16. https://doi.org/10.1371/journal.pone.0235176

Rahmawati, E. (2024). Policy Strategies in the Implementation of Referral Health Service Transformation. Jurnal Multidisiplin Indonesia, 3(10), 4446–4457. https://doi.org/10.58344/jmi.v3i10.1857

Safiranita, T., Ramli, A. M., Olivia, D., Gunawan C., F., & Ramadayanti, E. (2022). The Role of E-Commerce in Escalation of Digital Economy in The New Normal Era Based on Law Number 27 of 2022 Concerning Personal Data Protection. Jurnal Penelitian Hukum De Jure, 22(4), 437–450. https://doi.org/10.30641/dejure.2022.v22.437-450

Sekretariat Konsil Tenaga Kesehatan Indonesia. (2020). Pedoman Umum Program Pengembangan Keprofesian Berkelanjutan (P2KB) Tenaga Kesehatan Republik Indonesia. In Kemenkes RI. Kementrian Kesehatan RI.

Setiaasih, R., Sunjaya, D. K., Sofiatin, Y., Afriandi, I., Hilfi, L., & Herawati, D. M. D. (2025). Readiness of health posts for primary health care integration in Indonesia: a mixed-methods study. BMC Public Health, 25(1), 1–13. https://doi.org/10.1186/s12889-025-22520-x

Sistem Monitoring & Evaluasi Jaminan Sosial DJSN. (2024). Laporan Kinerja Program JKN Kuatal II Tahun 2024.

Tangcharoensathien, V., Witthayapipopsakul, W., Panichkriangkrai, W., Patcharanarumol, W., & Mills, A. (2018). Health systems development in Thailand: a solid platform for successful implementation of universal health coverage. The Lancet, 391, 1205–1223. https://doi.org/10.1016/S0140-6736(18)30198-3

World Health Organization. (2023). Strengthening health emergency prevention, preparedness, response and resilience. In World Health Organization: Health Emergency Preparedness, Response and Resilience. World Health Organization. https://cdn.who.int/media/docs/default-source/emergency-preparedness/who_hepr_wha2023-21051248b.pdf?sfvrsn=a82abdf4_3&download=true

Unduhan

Diterbitkan

26-05-2025

Cara Mengutip

El-Tsana, A. V., Alvianty, R. A., Octaviani, P., Syahidah, R., & Wasir, R. (2025). Health system transformation in Indonesia: Implementation and challenges of six policy pillars. Indonesian Journal of Health Science, 5(3), 553–560. https://doi.org/10.54957/ijhs.v5i3.1548

Terbitan

Bagian

Articles

Artikel paling banyak dibaca berdasarkan penulis yang sama

1 2 > >>