Universal Health Coverage Acceleration Through the UHC Village Approach: The (Supporting Universal Health Coverage So Express and Sustainable (SUCSES) Innovation in Indonesia’s in National Health Insurance Program
DOI:
https://doi.org/10.69855/mgj.v2i3.410Keywords:
Universal Health Coverage, National Health Insurance Enrollment, SUCSES Innovation, UHC Village, Decentralized GovernanceAbstract
Universal Health Coverage (UHC) is a cornerstone global health target, reaffirmed by the World Health Organization (WHO) and United Nations' pledge to achieve it by 2030. Despite Indonesia's sustained national initiatives, structural barriers persist, including membership gaps, subnational disparities, and elevated out-of-pocket expenditures. This qualitative descriptive study investigates the SUCSES Innovation (Supporting Universal Health Coverage So Express and Sustainable)—a decentralized, village-level model designed to accelerate UHC progress. Conducted at the BPJS Kesehatan Bukittinggi Branch from January 2023 to December 2024, the research engaged purposively selected key informants: branch managers, local government officials, village leaders, and program implementers. Data collection encompassed in-depth interviews, reviews of policy/administrative documents, and membership record analyses. Thematic analysis identified governance mechanisms, implementation strategies, and outcome pathways, yielding four interconnected themes: (1) institutionalizing UHC targets via integration into village certification frameworks; (2) bolstering subnational governance and accountability; (3) enabling community micro-targeting through data-driven outreach; and (4) achieving quantifiable gains in coverage and financial performance. SUCSES implementation yielded ~135,000 new registrations, elevated coverage from 87% to 97%, generated IDR 68 billion in additional revenue, and transformed Agam Regency from zero to 50 certified UHC villages. These results position SUCSES as a scalable, context-adapted governance innovation for decentralized health systems. Recommendations urge wider institutional adoption and alignment of UHC indicators with local development plans to advance Indonesia's 2030 universal coverage ambition.
References
Alawode, G. B., et al. (2025). Optimizing the health workforce for universal health coverage in low- and middle-income countries. Human Resources for Health, 23(1), 1–12.
Alshehari, A. H., et al. (2024). Measuring progress towards universal health coverage in the Middle East and North Africa (MENA) region. The Lancet Regional Health – Middle East and North Africa, 10, 100234.
Ayton, D. (2023). Chapter 5: Qualitative descriptive research. In Qualitative research in health. Open Educational Resources Collective.
Churiana Sudrajat, D. A., Simanjorang, C., Fitrianti, A. D., & Zahra, A. S. A. (2024). Keterbatasan Mobile JKN sebagai bentuk Universal Health Coverage di era digitalisasi: Literature review. Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan, 4(3), Article 4.
Cometto, G., Buchan, J., & Dussault, G. (2020). Developing the health workforce for universal health coverage. Bulletin of the World Health Organization, 98(2), 109–116.
Dhillon, I., Jhalani, M., Thamarangsi, T., Siyam, A., & Khetrapal Singh, P. (2023). Advancing universal health coverage in the WHO South-East Asia Region with a focus on human resources for health. The Lancet Regional Health – Southeast Asia, 18, 100313.
Doyle, L., McCabe, C., Keogh, B., Brady, A., & McCann, M. (2020). An overview of the qualitative descriptive design within nursing research. Journal of Research in Nursing, 25(5), 443–455.
Hall, S., et al. (2024). Qualitative description as an introductory method to health research. International Journal of Qualitative Methods, 23, 1–10.
Hasnah, F., & Asyari, D. P. (2024). Analysis of universal health coverage (UHC) implementation and health service readiness in Indonesia. International Journal of Multidisciplinary Approach and Studies, 11(1), 45–56.
Herawati, H., Franzone, R., & Chrisnahutama, A. (2020). Universal health coverage: Tracking Indonesia’s progress. Perkumpulan PRAKARSA.
Maulana, A. N., Purwaningrum, F., Thabrany, H., Fitrianti, Y., & Tri Hartini, F. (2022). Mengukur kemampuan mengiur untuk Jaminan Kesehatan Nasional (JKN) tahun 2021 di Indonesia. Jurnal Jaminan Kesehatan Nasional, 2(1), 39–52.
Nirmalasari, M. Y., Idris, H., & Flora, R. (2023). Implementasi capaian program Universal Health Coverage di Indonesia: Narrative review. Health Information: Jurnal Penelitian, 15(3), e1322.
Pyo, J. (2023). Qualitative research in healthcare: Necessity and characteristics. Journal of Preventive Medicine and Public Health, 56(1), 1–7.
Saputro, C. R. A., & Fathiyah, F. (2022). Universal Health Coverage: Internalisasi norma di Indonesia. Jurnal Jaminan Kesehatan Nasional, 2(2), 204–216.
Sumando, E. (2024). The impact of universal health coverage on health outcomes and fiscal sustainability in Indonesia. In Proceedings of PSIC 2024 Conference (pp. xxx–xxx).
Susilo, D. (2025). Can Indonesia achieve universal health coverage through the JKN scheme? Health Policy OPEN, 6, 100123.
Systematic Review of Financing Functions for Universal Health Coverage in Low- and Middle-Income Countries. (2025). Public Health Reviews, 46, 7.
Wagstaff, A., & Neelsen, S. (2020). A comprehensive assessment of universal health coverage in 111 countries: A retrospective observational study. The Lancet Global Health, 8(1), e39–e55.
World Health Organization & World Bank. (2021). Tracking universal health coverage: 2021 global monitoring report. World Bank.
World Health Organization (WHO). (2024). Strengthening clinical trials to improve high quality evidence on health interventions: Guidance for best practices on clinical trials. WHO.
World Health Organization (WHO). (2025). Universal health coverage (UHC) [Fact sheet]. WHO.
World Health Organization (WHO). (2025). WHO guidance on the ethics of health research priority setting. WHO.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Miracle Get Journal
This work is licensed under a Creative Commons Attribution 4.0 International License.
