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Journal of Health Policy and Management
Published by Universitas Sebelas Maret
ISSN : -     EISSN : 25490281     DOI : -
Core Subject : Health,
Medicine & Pharmacology Public Health
Journal of Health Policy and Management (JHPM) is an electronic, open-access, double-blind and peer-reviewed international multidisciplinary and integrative journal, focusing on health policy, health system, and healthcare management. It began its publication on October 21, 2015. The journal is published twice yearly. It aims to improve the design and implementation of health policies, health systems, and healthcare management, primarily in low- and middle-income countries. JHPM analyzes policy initiatives and healthcare systems and provides evidence-based research to guide policymaking and management decision-making.
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Articles 11 Documents
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Search results for , issue "vol. 11 no. 2 (2026)" : 11 Documents clear
Indonesian Medical Students' Perceptions of Computer Based Test (CBT) Questions on Public Health Competency Test: An Evaluation Study Burhannudin Ichsan; Anika Candrasari; Flora Ramona Sigit Prakoeswa; Ratih Pramuningtyas; Noval Gentha Mahesa; Schedar Shafrizal Amar
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

Background: The Indonesian Medical Competency Standards (SKDI) are the educational standards for doctors in Indonesia. To prove that students have met the competency requirements, a competency test is necessary. Research results show that CBT of Public Health questions fall into the moderate-difficult category. This means that institutions must have a specific strategy to guide students. Subjects and Method: This qualitative study conducted in-depth interviews with Indonesian medical students who had passed or failed the Indonesian Medical Competency Test. The interviews were conducted online using Zoom. Informants were selected from various regions in Indonesia. Results: The study identified five themes. The five themes are: 1) varying perceptions of the difficulty level of public health questions, 2) lack of focus, 3) question patterns and reference books, 4) sources and methods of learning for the public health question, and 5) examinees' expectations. Conclusion: Students' perceptions of the difficulty level vary. This is also related to the students' own preparedness. Students have specific expectations regarding certain questions, such as those related to Indonesian national health insurance (BPJS), epidemiology, and others
Personal and Institutional Factors Affecting Physiotherapist Performance in Nusa Tenggara Barat, Indonesia Rizka Dwi Yulianti; Anik Lestari; Eti Poncorini Pamungkasari
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

Background: Physiotherapist performance is an important indicator in determining the quality of medical rehabilitation services, influenced by the interaction of personal and institutional factors. This study aims to analyze the influence of personal factors (motivation, formal and non-formal education) and institutional factors (leadership and work environment) on physiotherapist performance. Subjects and Method: This study used a quantitative approach with a cross-sectional design. The subjects consisted of 183 physiotherapists in West Nusa Tenggara (NTB) Province. Data collection was conducted using a questionnaire that had been tested for validity and reliability. Independent variables included motivation, formal education, non-formal education, leadership, and work environment. The dependent variable was physiotherapist performance. Data analysis included bivariate analysis using Spearman's rho and multivariate analysis using path analysis with STATA. Results: Motivation (b = 0.44; 95% CI = 0.34 to 0.54; p < 0.001), work environment (b = 0.40; 95% CI = 0.29 to 0.51; p < 0.001), and formal education (b = 0.22; 95% CI = 0.13 to 0.32; p < 0.001) had a direct and significant influence on physiotherapist performance. Work environment (b = 0.40; 95% CI = 0.28 to 0.53; p < 0.001), leadership (b = 0.15; 95% CI = 0.03 to 0.28; p = 0.016), and non-formal education (b = 0.31; 95% CI = 0.19 to 0.44; p < 0.001) had an indirect effect on performance through motivation. Leadership also had an indirect effect on performance through work environment (b = 0.45; 95% CI = 0.34 to 0.56; p < 0.001). The model showed good fit (Chi-square = 9.92; p = 0.105; RMSEA = 0.066; CFI = 0.99; TLI = 0.97; SRMR = 0.024). Conclusion: Motivation, work environment, and formal education have a direct influence on physiotherapist performance, while leadership and non-formal education have an indirect influence through motivation and work environment as mediators.
Evaluation of the Implementation of Clinical Accreditation Standards in Surakarta, Central Java, Indonesia Sari Tyaswikaning Aji; Tonang Dwi Ardyanto; Argyo Demartoto; Yeny Ristaning Belawati; Selfi Handayani
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

Background: Clinical accreditation is an effort to improve the quality of healthcare services, but its implementation in primary healthcare facilities still faces various challenges, particularly in ensuring quality sustainability. This study aims to evaluate the implementation of clinical accreditation standards and analyze their impact on service quality based on the 5M management approach. Subjects and Methods: This study used a qualitative evaluative approach, encompassing four levels: input, process, output, and outcome evaluation. Data were collected through in-depth inter-views with key informants, field observations, and document studies at four clinics in Surakarta, Central Java, Indonesia. The study was conducted from September to December 2025. Data validity was triangulated by creating a descriptive analysis. Results: Accreditation implementation has improved aspects of service structure and processes, including organizational governance, availability of SOPs, increased human resource understanding, and arrangement of service facilities and documentation. However, implementation is still dominated by administrative fulfillment and has not been fully integrated into a sustainable quality management system. Impacts on outcomes, such as patient satisfaction and quality culture, are beginning to be seen, but are not yet supported by data-based quality indicators and systematic evaluation. Key supporting factors include leadership commitment, availability of basic resources, and regulatory support, while inhibiting factors include limited human resources, workload, a suboptimal monitoring system, and the perception of accreditation as an administrative burden. Conclusion: Implementation of accreditation acts as an initial step in improving service quality, but is not enough to guarantee sustainability without strengthening the monitoring system, indicator-based evaluation, and internalization of a quality culture
Health Insurance Ownership and Factors Related to the Utilization of Health Services in Blitar, East Java, Indonesia Afrizal Ikhsanul Fathoni; Yeny Ristaning Belawati; Hafi Nurinasari; Selfi Handayani; Arsita Eka Prasetyawati
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpm.2026.11.02.09

Abstract

Background: Blitar City, Indonesia, aims to achieve 99.74% universal health coverage (UHC) by 2024. However, public health services are only accessible to 34.6% of the population. Utilization of services for non-communicable diseases such as hypertension remains below 20%. The aim of this research was to analyze the relationship between health insurance ownership, predisposing factors, and supporting factors on the utilization of health services. Subjects and Method: This was a cross-sectional study design and involved 405 respondents in Blitar City, East Java, Indonesia. Data collection was conducted using a structured questionnaire instrument measuring demographic characteristics, socioeconomic status, health status, health insurance ownership, and psychological behavioral aspects (self-efficacy, attitude, and intention) rated on a Likert scale. Data were analyzed using a structural equation modeling (SEM) approach for path analysis. Results: Path analysis revealed five main factors that significantly influenced healthcare utilization. Directly, gender (b=0.15; CI 95%=0.05 to 0.26; p=0.005), marital status (b=0.13; CI 95%=0.02 to 0.24; p=0.017), and behavioral intention (b=0.07; CI 95%=0.03 to 0.12; p=0.003) had a significant positive effect. Indirectly, self-efficacy was the most dominant positive predictor of behavioral intention (b= 0.54; CI 95%=0.49 to 0.59; p<0.001), followed by behavioral attitude (b=0.09; CI 95%= 0.02 to 0.15; p=0.009). Conclusion: Self-efficacy, gender, marital status, attitudes, and intentions are dominant factors. The government needs to simplify digital systems, optimize men's health programs, and transform service quality to keep pace with the high pace of UHC achievement.
Transformational Leadership and Tuberculosis Control Performance: Mediating Roles of Well-Being and Motivation Dedi Ari Saputro; Setyo Sri Rahardjo; Revi Gama Hatta Novika; Anik Lestari; Eti Poncorini Pamungkasari
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

Background: Tuberculosis control requires optimal performance from healthcare workers. Psychosocial factors such as transformational leadership, subjective well-being, and work motivation are believed to play a role in enhancing this performance. This study aims to analyze the effects of transformational leadership and subjective well-being on the performance of healthcare workers in TB control, as well as to examine the role of work motivation as a mediating variable. Subjects and Method: This study employed a cross-sectional design with a sample of 265 health workers at nine community health centers in Sragen Regency, selected using purposive sampling. The independent variables included transformational leadership and subjective well-being; the dependent variable was health worker performance; and work motivation served as the mediating variable. The data were analyzed using path analysis. Results: The results of the study indicate that work motivation has a positive and significant effect on the performance of healthcare workers (b = 1.04; 95% CI 0.63 to 1.45; p<0.001). Transformational leadership also has a positive and significant effect on performance (b=0.36; 95% CI 0.14 to 0.57; p=0.001), while subjective well-being has a positive but not significant effect (b=0.21; 95% CI -0.02 to 0.43; p=0.075). Transformational leadership (b=0.18; 95% CI 0.11 to 0.24; p<0.001) and subjective well-being (b= .38; 95% CI 0.33 to 0.42; p<0.001) have a significant effect on work motivation. Furthermore, work motivation significantly mediated the effects of transformational leadership (b=0.19; 95% CI 0.10 to 0.27; p<0.001) and subjective well-being (b=0.39; 95% CI 0.23 to 0.56; p<0.001) on healthcare workers’ performance. Conclusion: Work motivation and transformational leadership significantly influence healthcare workers’ performance in tuberculosis control, with work motivation serving as the primary mediator linking transformational leadership and subjective well-being to performance.
Exploring Readiness for Change among Community Health Cadres in Indonesia’s Minimum Service Standards Program: A Path Analysis Ani Afifah; Revi Gama Hatta Novika; Setyo Sri Rahardjo; Eti Poncorini Pamungkasari; Anik Lestari
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

Background: The increasing workload of integrated health service post cadres in implementing the six minimum service standards has not been fully accompanied by adequate cadre readiness. This condition may affect the optimization of the community-based integrated health service post service quality. This study aimed to analyze the effects of perceived program feasibility, perceived benefits, perceived management support, and self-efficacy on cadre readiness in implementing the six minimum service standards. Subjects and Method: This analytic observational study used a cross-sectional design conducted in Sragen Regency, Central Java, Indonesia, from February to March 2026. A total of 217 active Integrated Health Service Post cadres were selected using purposive sampling from 25 primary healthcare centers. The dependent variable was cadre readiness, while the independent variables included perceived program feasibility, perceived benefits, perceived management support, and self-efficacy. Data were collected using a structured and validated questionnaire developed from the Organizational Readiness for Change framework. Data were analyzed using descriptive statistics, bivariate linear regression, and multivariate path analysis with STATA. Results: Self-efficacy had a direct and significant effect on cadre readiness (b=0.45; 95% CI=0.34 to 0.53; p<0.001). Perceived benefits also had a direct and significant effect on cadre readiness (b=0.34; 95% CI=0.26 to 0.42; p<0.001). Regarding indirect effects through self-efficacy, perceived program feasibility had a significant indirect effect on cadre readiness (b=0.37; 95% CI=0.15 to 0.59; p=0.001). Perceived benefits also showed a significant indirect effect (b=0.29; 95% CI=0.12 to 0.46; p=0.001), as did perceived management support (b=0.16; 95% CI=0.04 to 0.28; p=0.009). Conclusion: Cadre readiness to implement the six MSS is influenced by perceived program feasibility, perceived benefits, management support, and self-efficacy. Strengthening organizational support and cadre capacity is essential for successful implementation.
Service Quality and Insurance Status as Determinants of Patient Satisfaction at Dr. Soehadi Prijonegoro Hospital, Sragen, Central Java, Indonesia Alifia Ayu Romadhona; Bhisma Murti; Revi Gama Hatta Novika; Setyo Sri Rahardjo; Sumardiyono
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

Background: Dr. Soehadi Prijonegoro Hospital, Sragen, Central Java, Indonesia, served 127,443 outpatient visits in 2019; however, visits declined sharply during 2020–2021 and began to increase again in 2022. A decline in service quality may reduce patient visits, which represent an important asset for hospitals. This study aimed to analyze the effects of service quality, patient education, patient status, and insurance status on patient satisfaction at RSUD dr. Soehadi Prijonegoro Sragen. Subjects and Method: This was a cross-sectional study conducted among 200 outpatients selected using purposive sampling based on inclusion and exclusion criteria. The study population comprised all outpatients at RSUD dr. Soehadi Prijonegoro Sragen. Data were collected using a Google Form questionnaire and analyzed using multiple linear regression and path analysis with Structural Equation Modeling (SEM). Results: Service quality had a direct, positive, and significant effect on patient satisfaction (b = 0.44; 95% CI = 0.24–0.63; p < 0.001). Empathy was the dominant factor, showing the strongest indirect effect (b = 0.77; 95% CI = 0.69–0.86; p < 0.001), followed by assurance (b= 0.69; 95% CI= 0.59–0.78; p < 0.001), tangibles (b= 0.55; 95% CI= 0.43–0.67; p < 0.001), responsiveness (b= 0.42; 95% CI = 0.29–0.55; p < 0.001), and reliability (b = 0.25; 95% CI = 0.11–0.39; p = 0.001). Patient trust had a significant indirect effect on service quality (b = 0.64; 95% CI= 0.54–0.74; p < 0.001), and insurance status also showed a significant indirect effect on service quality (b = 0.37; 95% CI = 0.24–0.50; p < 0.001). The direct effect of trust on patient satisfaction was positive but not statistically significant (b = 0.21; 95% CI = 0.04–0.37; p = 0.12). Conclusion: Service quality has a significant positive effect on patient satisfaction, with empathy as the most influential factor, followed by assurance, responsiveness, tangibles, and reliability. Patients with certain insurance coverage reported better perceptions of service quality. These findings suggest that strengthening empathy and assurance is crucial for improving patient satisfaction and loyalty in hospital settings.
Evaluation of Smoke-Free Area Policy Implementation in Sragen Regency: A Qualitative Study of Governance, Enforcement, and Health Communication Meidyan Thomas Setiawan; Eti Poncorini Pamungkasari; Revi Gama Hatta Novika; Argyo Demartoto; Ratih Puspita Febrinasari
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/

Abstract

Background: Sragen Regency has adopted a smoke-free area policy; however, its implementation continues to face challenges related to governance, enforcement, health communication, and compliance. This study aimed to evaluate the implementation of the smoke-free area policy in Sragen Regency, with a focus on governance, enforcement, and health communication Subjects and Method: This qualitative study used an embedded case study design and was conducted from February to June 2026 within the Sragen Regency Government setting, including the Integrated Government Office Complex and selected subdistrict offices. Informants were purposively selected based on their involvement in smoke-free policy implementation, with recruitment continuing until data saturation was reached. In-depth interviews were conducted with 19 informants, comprising seven key informants, eight primary informants, and four supporting informants. Two focus group discussions (FGDs) involved 19 participants. Data were collected through in-depth interviews, FGDs, field observations, and document review. Policy implementation was evaluated using the Context, Input, Process, and Product (CIPP) framework. Data were analyzed using the interactive model of Miles, Huberman, and Saldaña. Trustworthiness was strengthened through source and method triangulation. Results: Smoke-free policy implementation was supported by local regulations, acceptance among government employees, no-smoking signs, and monitoring activities. Enforcement largely relied on persuasive approaches, including interpersonal communication, social monitoring, direct verbal reminders, and leadership by example, rather than formal sanctions. Organizational culture, social norms, leadership involvement, designated smoking areas, the physical environment, and informal communication influenced compliance. The implementation of the smoke-free policy improved workplace comfort; however, compliance remained uneven. Conclusion: Smoke-free policy implementation was influenced by governance arrangements, predominantly persuasive enforcement, and health communication that largely occurred through interpersonal interactions. Stronger implementation management, supervision, monitoring and evaluation, and more systematic health communication are needed to improve the consistency of smoke-free policy implementation.
Contextual Influence of Anesthesia Nursing Care by the Anesthesia Care Team on Service Quality Among Anesthesia Patients Muh Anan Wais Lahay; Adi Prayitno; Dewi Pratiwi; Erindra Budi Cahyanto; Sri Mulyani
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpm.2026.11.02.12

Abstract

Background: The quality of general anesthesia care depends on the non-technical skills of nurse anesthetists and the socio-administrative factors of patients. This study aimed to analyze the relation­ships among emergency training status, clinical competence, health financing types, and patient satisfaction. Subjects and Method: This study used an observational analytic cross-sectional design conducted at Dr. Moewardi Hospital, Surakarta, Central Java, Indonesia. The sample consisted of 19 nurse anesthetists selected through total sampling and 80 general anesthesia patients selected through consecutive sampling. Data were collected using modified Anaesthetists' Non-Technical Skills (ANTS) observation sheet and Rater questionnaire. Data analysis included One-Way ANOVA, Linear Regression, and mediation analysis using the PROCESS macro in SPSS. Results: There was a significant difference between trained and untrained providers in anesthesia nursing care skills (p<0.001) and patient satisfaction (p=0.004). Patient satisfaction also varied significantly by financing type (p=0.034). Linear regression indicated that training status predicted anesthesia nursing care scores (p<0.001) and patient satisfaction (p=0.004). However, anesthesia nursing care scores did not significantly predict patient satisfaction (p=0.061). There was no significant relationship between provider training status and patient financing type (p=0.089). Mediation analysis showed that financing type did not mediate the relationship between training status and patient satisfaction (b=-1.61; p=0.193). Conclusion: Emergency training improves both the non-technical skills of nurse anesthetists and patient satisfaction. Since intraoperative clinical competence does not directly predict post-operative satisfaction, hospitals should evaluate clinical safety and service quality as separate metrics. Furthermore, the findings indicate that anesthesia care is provided equally to all patients, regardless of their health financing type.
Intrinsic and Extrinsic Factors Associated with Job Satisfaction among Acupuncture Therapists in Indonesia Afrita Nurlaylia; Selfi Handayani; Dewi Pratiwi; Erindra Budi Cahyanto; Yeny Ristaning Belawati
Journal of Health Policy and Management Vol. 11 No. 2 (2026)
Publisher : Master's Program in Public Health, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/thejhpm.2026.11.02.11

Abstract

Background: Job satisfaction is influenced by various intrinsic and extrinsic factors originating from both individual characteristics and the organizational environment. The lack of empirical evidence regarding job satisfaction among acupuncture therapists may hinder the strengthening of the complementary healthcare workforce in Indonesia. Without evidence-based knowledge of the factors influencing job satisfaction, the integration of acupuncture services into the national healthcare system may proceed without adequate evaluation and without comprehensive human resource management strategies. Subjects and Method: This quantitative study employed a cross-sectional design. A total of 173 respondents from across Indonesia participated in the study. The sample size was determined using the Daniel and Cross formula, and participants were recruited through accidental sampling. Data were collected using a structured questionnaire and analyzed using Pearson's correlation for bivariate analysis and multiple linear regression for multivariable analysis. Results: Among the intrinsic factors, work achievement was significantly associated with job satisfaction (b = 0.36; 95% CI = 0.18 to 0.53; p < 0.001). Among the extrinsic factors, coworker relationships (b = 0.36; 95% CI = 0.18 to 0.57; p < 0.001) and recognition (b = 0.31; 95% CI = 0.11 to 0.51; p = 0.003) were also significantly associated with job satisfaction. In contrast, social status (b = 0.12; 95% CI = −0.07 to 0.31; p = 0.224), organizational policy (b = −0.11; 95% CI = −0.26 to 0.04; p = 0.163), and working conditions (b = 0.02; 95% CI = −0.23 to 0.26; p = 0.894) were not significantly associated with job satisfaction. Conclusion: Work achievement, coworker relationships, and recognition were significant factors associated with job satisfaction among acupuncture therapists in Indonesia. Conversely, social status, organizational policy, and working conditions were not significantly associated with job satisfaction.

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