ANALYSIS OF THE IMPLEMENTATION OF THE NATIONAL HEALTH INSURANCE (JKN) POLICY IN INDONESIA: A SYSTEMATIC LITERATURE REVIEW

Abstract

The National Health Insurance (JKN) policy represents a crucial milestone in Indonesia’s health financing system, aimed at achieving Universal Health Coverage (UHC). Since its implementation in 2014, JKN has faced challenges related to equitable access, service quality, funding efficiency, and coordination among stakeholders. This study employs a Systematic Literature Review (SLR) method following PRISMA guidelines, analyzing 25 scientific articles (20 national and 5 international) published between 2020–2025 from databases including PubMed, Garuda, DOAJ, ScienceDirect, and Google Scholar. The analysis shows that JKN has successfully improved healthcare access, particularly in urban areas, while disparities in remote regions persist. Service quality has also improved, though it remains constrained by INA-CBGs tariff structures, health workers’ workloads, and limited funding. The effectiveness of JKN implementation is influenced by good governance and a strategic purchasing–based financing system. In addition, community participation is affected by predisposing factors, socioeconomic support, and individual perceptions and motivation. Strengthening coordination between central and local governments and improving public literacy are key to successful implementation. This study concludes that although JKN has made significant contributions to expanding access and improving the quality of health services, continuous reforms in governance, financing, and public outreach are essential to ensure system sustainability and equity. Strategic actions such as enhancing bureaucratic efficiency, aligning tariffs with real costs, and actively involving communities are vital to support the achievement of UHC in Indonesia.