Evaluasi Implementasi Universal Health Coverage di Kabupaten Sambas Sebagai Dasar Perumusan Strategi Peningkatan Cakupan Kepesertaan

Wahyu Aji Anindhiyo Satriojati, Dr. Diah Ayu Puspandari, Apt, MBA., M.Kes. ; dr. Likke Prawidya Putri, MPH, Ph.D.

2026 | Tesis | MAGISTER KEBIJAKAN DAN MANAJEMEN KESEHATAN

Latar Belakang: Universal Health Coverage (UHC) bertujuan menjamin seluruh penduduk memperoleh akses layanan kesehatan berkualitas tanpa kesulitan finansial. Di Indonesia, UHC diwujudkan melalui Program JKN yang diselenggarakan oleh BPJS Kesehatan. Secara nasional cakupan kepesertaan telah melampaui 98%, namun beberapa daerah masih menghadapi tantangan dalam mencapai target UHC, termasuk Kabupaten Sambas yang baru mencapai sekitar 80%. Penelitian ini bertujuan mengevaluasi implementasi UHC di Kabupaten Sambas serta merumuskan strategi peningkatan cakupan kepesertaan JKN. 

Metode: Penelitian menggunakan pendekatan mixed methods dengan desain explanatory sequential. Data kuantitatif diperoleh dari BPJS Kesehatan, pemerintah daerah, dan Badan Pusat Statistik, sedangkan data kualitatif diperoleh melalui wawancara mendalam dengan pemangku kepentingan. Analisis penelitian menggunakan kerangka evaluasi CIPP (Context, Input, Process, Product).

Hasil: Implementasi UHC dipengaruhi oleh kondisi geografis wilayah, karakteristik sosial ekonomi masyarakat, serta dukungan kebijakan dan koordinasi antar pemangku kepentingan. Program JKN telah meningkatkan akses layanan kesehatan, namun cakupan kepesertaan masih perlu diperluas melalui strategi yang lebih adaptif.

Kesimpulan: Peningkatan cakupan kepesertaan JKN di Kabupaten Sambas memerlukan penguatan kolaborasi antara BPJS Kesehatan dan pemerintah daerah, inovasi mekanisme pembayaran iuran bagi sektor informal, serta peningkatan literasi masyarakat tentang program JKN guna mempercepat pencapaian UHC.

Kata Kunci: Jaminan Kesehatan Nasional; Kabupaten Sambas; Cakupan Kepesertaan JKN; Model CIPP; Universal Health Coverage.

Background: Universal Health Coverage (UHC) aims to ensure that all people have access to quality health services without experiencing financial hardship. In Indonesia, UHC is implemented through the National Health Insurance (JKN) program administered by BPJS Kesehatan. Nationally, JKN coverage has exceeded 98%; however, several regions still face challenges in achieving the UHC target, including Sambas Regency, where coverage has only reached around 80%. This study aims to evaluate the implementation of UHC in Sambas Regency and to formulate strategies to increase JKN membership coverage.

Methods: This study employed a mixed-methods approach with an explanatory sequential design. Quantitative data were obtained from BPJS Kesehatan, local government agencies, and the Central Bureau of Statistics, while qualitative data were collected through in-depth interviews with key stakeholders. Data were analyzed using the CIPP evaluation framework (Context, Input, Process, Product).

Results: The implementation of UHC is influenced by geographical conditions, the socio-economic characteristics of the population, as well as policy support and coordination among stakeholders. The JKN program has improved access to health services; however, membership coverage still needs to be expanded through more adaptive strategies.

Conclusion: Increasing JKN membership coverage in Sambas Regency requires stronger collaboration between BPJS Kesehatan and local government, innovative contribution payment mechanisms for the informal sector, and improved public literacy regarding the JKN program to accelerate the achievement of UHC.

Keywords: CIPP evaluation model; JKN membership coverage; National Health Insurance; Sambas Regency; Universal Health Coverage.

Kata Kunci : Jaminan Kesehatan Nasional, Kabupaten Sambas, Cakupan Kepesertaan JKN, Model CIPP, Universal Health Coverage.