 |
| Illustration by Ai |
A collaborative partnership between the Mojokerto Regency Government and BPJS Kesehatan has helped nearly all residents gain access to Indonesia’s National Health Insurance (JKN) program, according to a 2026 study published in the International Journal of Applied and Advanced Multidisciplinary Research (IJAAMR). The research was conducted by Muhammad Aji Pamungkas, Endang Indartuti, and Rachmawati Novaria from Universitas 17 Agustus 1945 Surabaya. The findings are significant because they demonstrate how local government leadership, policy innovation, and institutional cooperation can accelerate Universal Health Coverage (UHC) while reducing barriers to healthcare access.
Why Universal Health Coverage
Matters
Universal Health Coverage has
become a major policy priority in Indonesia. Through the JKN system managed by
BPJS Kesehatan, the government seeks to ensure that all citizens can access
healthcare services without facing financial hardship.
Despite national progress,
challenges remain. Millions of vulnerable Indonesians still experience
difficulties accessing healthcare due to registration issues, inaccurate
beneficiary data, administrative barriers, and inactive insurance memberships.
These challenges often prevent low-income households from receiving timely
medical treatment, increasing both health risks and economic burdens.
Against this backdrop, Mojokerto Regency in East Java emerged as one of
Indonesia’s leading examples of successful UHC implementation. With a
population exceeding one million people, the region faced common problems such
as inactive BPJS memberships and lengthy enrollment procedures. Local
authorities responded by creating a close working partnership with BPJS
Kesehatan, resulting in a series of policy innovations that significantly
improved healthcare access.
How the Study Was Conducted
The researchers used a
qualitative descriptive approach to examine how collaborative governance
contributed to UHC success in Mojokerto Regency. Data were collected through
in-depth interviews with key stakeholders, including the Regent of Mojokerto,
the BPJS Kesehatan Mojokerto Branch Manager, and officials from the Regency
Health Office.
The study also included direct
observations at healthcare facilities and BPJS offices, as well as analysis of
government documents, budget reports, and BPJS performance records. The
researchers evaluated the collaboration using the collaborative governance
framework developed by Ansell and Gash, focusing on leadership, institutional
design, trust, and inter-agency cooperation.
Nearly 99 Percent Coverage
Achieved
The study found that Mojokerto
Regency achieved an impressive JKN enrollment coverage rate of 98.76 percent,
equivalent to 1,141,807 insured residents out of a total population of
1,156,144. This achievement earned the regency UHC Priority status, a recognition
granted to regions that meet national coverage and service standards.
Several policy innovations contributed to this outcome:
- Same-day BPJS activation for eligible residents
requiring urgent healthcare.
- Elimination of the standard 14-day waiting period for
coverage activation.
- Conversion of delinquent independent BPJS members
into government-funded participants.
- Significant regional budget support for healthcare
financing.
- Continuous coordination between local government
agencies and BPJS Kesehatan.
One of the most notable commitments was the allocation of approximately Rp66 billion from the regional budget to support healthcare coverage. This included an initial allocation of Rp22 billion and an additional Rp44 billion budget adjustment during the fiscal year.
Trust and Leadership Drove
Success
According to the study,
long-standing cooperation between BPJS Kesehatan and the Mojokerto Regency
Government created a strong foundation of trust. Both institutions recognized
their mutual dependence: BPJS provided health insurance expertise and infrastructure,
while the local government supplied funding, regulatory authority, and
community outreach capabilities.
Leadership also played a critical
role. The Regent of Mojokerto placed UHC among the administration’s top
priorities and actively supported budget reallocations when healthcare
financing needs increased. The study notes that local leadership extended beyond
policy declarations by directly monitoring hospitals and health centers to
ensure that healthcare services were delivered as intended.
Institutional arrangements
further strengthened the collaboration. Clear divisions of responsibility were
established among BPJS Kesehatan, the Health Office, Social Services,
healthcare facilities, and regional legislators. Transparency in data sharing and
financial management helped reduce conflicts and maintain accountability.
Challenges Remain
Although the program achieved
strong results, researchers identified several obstacles that could threaten
long-term sustainability.
One major challenge is limited
public understanding of JKN procedures. Many residents remain unfamiliar with
referral systems, eligibility requirements, and payment obligations, creating
unnecessary pressure on healthcare facilities.
Another concern is demographic
data synchronization. Differences between local population records, social
welfare databases, and BPJS membership systems can delay service activation and
create inefficiencies in healthcare financing.
The researchers also warn that
relying heavily on regional budgets may create financial pressure in the
future. If more residents shift from self-funded insurance to
government-supported coverage, fiscal sustainability could become a growing
concern.
Expanding Collaboration Beyond
Government
The study argues that Mojokerto’s
next challenge is broadening collaboration beyond government institutions.
Researchers recommend adopting a “Pentahelix” model that involves universities,
media organizations, non-governmental organizations, and private companies
alongside government agencies.
According to Pamungkas,
Indartuti, and Novaria of Universitas 17 Agustus 1945 Surabaya, stronger
participation from academics, media, and the private sector could improve
public health literacy, reduce misinformation, and help share the financial
burden of maintaining UHC programs. Their analysis suggests that broader
community involvement will be essential for preserving healthcare access in the
long term.
Real-World Impact
The Mojokerto experience provides
a practical model for other regions across Indonesia seeking to strengthen
healthcare access. The findings demonstrate that successful UHC implementation
requires more than insurance enrollment targets. Effective governance depends
on trust between institutions, strong political commitment, adequate funding,
clear administrative responsibilities, and ongoing communication among
stakeholders.
For policymakers, the study
offers evidence that local innovation can complement national healthcare
strategies. For healthcare administrators, it highlights the importance of
integrated data systems and citizen education. For communities, it shows how coordinated
public policies can remove barriers that prevent vulnerable populations from
receiving essential medical services.
Author Profile
Muhammad Aji Pamungkas is
a researcher from Universitas 17 Agustus 1945 Surabaya specializing in
public administration, governance, and public policy. He co-authored this study
with Dr. Endang Indartuti and Dr. Rachmawati Novaria, academics
from the same university whose expertise includes public governance, public
services, and policy implementation. Together, they examine how collaborative
governance models can improve public sector performance and social welfare
outcomes.
Source
Article Title: Collaborative
Governance in the Universal Health Coverage (UHC) Program in Mojokerto Regency
Authors: Muhammad Aji Pamungkas, Endang Indartuti, Rachmawati Novaria
Journal: International
Journal of Applied and Advanced Multidisciplinary Research (IJAAMR)
Year: 2026
DOI: https://doi.org/10.59890/ijaamr.v4i7.245
0 Komentar