ANALISA EMPAT TANTANGAN UTAMA DALAM PERUMUSAN KEBIJAKAN KESEHATAN DI INDONESIA

Abstrak

Penelitian ini bertujuan untuk menganalisis empat tantangan utama dalam perumusan kebijakan kesehatan di Indonesia, yaitu kendala geografis, ketimpangan distribusi Sumber Daya Manusia Kesehatan (SDMK), keterbatasan pembiayaan, dan beban penyakit ganda (double burden of disease). Meskipun berbagai regulasi seperti Jaminan Kesehatan Nasional (JKN) telah diimplementasikan, sistem kesehatan Indonesia masih menghadapi hambatan struktural yang kompleks dalam mencapai pemerataan layanan. Metode yang digunakan adalah literature review dengan pendekatan narrative review. Data bersumber dari literatur ilmiah nasional dan internasional dalam rentang tahun 2015–2026 yang dianalisis secara tematik untuk mengidentifikasi akar permasalahan dalam proses perumusan kebijakan. Hasil analisis menunjukkan bahwa karakteristik geografis sebagai negara kepulauan menjadi determinan utama ketimpangan akses, terutama di wilayah terpencil dan Indonesia bagian timur. Hal ini diperburuk oleh distribusi SDMK yang masih terkonsentrasi di wilayah maju, kapasitas fiskal daerah yang rendah, serta sistem pembiayaan yang belum sepenuhnya berbasis kebutuhan wilayah. Selain itu, transisi epidemiologi yang ditandai dengan tingginya penyakit menular bersamaan dengan peningkatan penyakit tidak menular menambah tekanan pada sistem kesehatan yang belum siap secara struktural.

Indonesia continues to face structural challenges in achieving equitable health service delivery despite the implementation of various health policies, including the National Health Insurance (JKN) program. This study aims to analyze four major challenges in the formulation of health policy in Indonesia: geographical constraints, unequal distribution of the Health Human Resources (HHR), limited health financing, and the double burden of disease. The study employs a literature review using a narrative review approach. Data were obtained from national and international scientific literature published between 2015 and 2026 and analyzed thematically to identify the root causes influencing the health policy formulation process. The findings indicate that Indonesia’s geographical characteristics as an archipelagic country constitute a major determinant of unequal access to health services, particularly in remote areas and the eastern regions of Indonesia. This condition is further exacerbated by the unequal distribution of health human resources, which remain concentrated in more developed regions, limited regional fiscal capacity, and a health financing system that has not yet fully adopted a needs-based allocation approach. In addition, the ongoing epidemiological transition, characterized by the persistence of infectious diseases alongside the increasing prevalence of non-communicable diseases places additional pressure on a health system that is not yet structurally prepared to address these challenges. These findings suggest that future health policy formulation should adopt a more contextual and region-sensitive approach while strengthening the integration of geographical considerations, human resource distribution, health financing mechanisms, and strategies to address the double burden of disease.