This study aims to analyze health financing governance in improving the achievement of Minimum Service Standards (MSS) in the health sector in Sabu Raijua Regency, focusing on maternal and newborn health services in a 3T region. This qualitative case study involved 25 informants and collected data through interviews, observations, Focus Group Discussions (FGDs), and documentation. Data were analyzed using the Miles and Huberman model. The findings show that health financing governance has been implemented administratively but has not been fully effective in improving MSS achievement. Accountability remains focused on administrative compliance, while community participation in planning and monitoring is not yet substantive. Financing effectiveness is constrained by limited fiscal capacity, geographical barriers, socio-cultural factors, and low health literacy. Supporting factors include family support, village fund utilization, and cross-sector collaboration. The study emphasizes the need for local needs-based financing governance integrating fiscal governance, geographical accessibility, socio-cultural responsiveness, and cross-sector collaboration to improve health MSS achievement in 3T regions.
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