Hanani, Retna and Rahman, Amni Zarkasyi (2022) Policy Dynamics to Achieve Universal Health Coverage at District Governments in Indonesia. Solution in Motion Insight for Social and Political Issues in Indonesia . UNDIP Press, Semarang. ISBN 978-623-417-180-8 (Submitted)

Text 8.Policy Dynamics to Achieve Universal Health Coverage at District Governments in Indonesia.pdf - Submitted Version Download (3MB)

Abstract

The 144th WHO Executive Board in 2019 has mandated that by 2023 all WHO member
countries including Indonesia must achieve the UHC targets. These goals include providing UHC to
one billion people, protecting one billion people from health emergencies, and providing one billion
people with a better and healthier life. In the context of Indonesia, universal health coverage aims to
improve access to quality essential health services, reduce the number of individuals experiencing
health-related financial hardships, and increase access to medicines, vaccines, diagnostics, and essential
medical devices in primary health care. The paper examines the policy dynamics of achieving UHC at
the district government level. The paper starts with the decentralization frameowork where health care
is one of the decentralized government functions to the ditsrict level. As such, the paper asks how local
governments in Indonesia lies the path to achieve UHC with their respective capacities and policy
dynamics. The paper analyzes the case of Kulon Progo to illustrate the policy dynamics of achieving
UHC at local level. Authors implement political economy framework to examine the interactions
including tensions in Kulon Progo district. Based on the case study we argue that strong concerted
efforts between executive as well as legislative support for achieving UHC is important to achieve UHC.
The case of Kulon Progo also shows how political support from the legislative might surpass the limited
government capacity argument and could expand UHC for more citizens.
Keywords: policy dynamics, decentralization, universal health coverage, Indonesia

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