Proses Collaborative Governance dalam Inovasi Pelayanan Kesehatan Berbasis Bumdes (Studi Kasus Perlindungan BPJS Kesehatan bagi Masyarakat Lokal di Desa Wisata Ponggok Kabupaten Klaten)

Muhammad Alifian Mukhrizal, Dr. Dra. Ambar Teguh Sulistiyani, M.Si.

2026 | Tesis | S2 Administrasi Publik

Peningkatan cakupan Jaminan Kesehatan Nasional (JKN) belum sepenuhnya menjamin akses layanan kesehatan dan perlindungan finansial masyarakat, khususnya di wilayah perdesaan. Desa Ponggok mengembangkan inovasi pelayanan kesehatan berbasis BUMDes melalui Program Perlindungan BPJS Kesehatan Berbasis Desa dengan melibatkan Pemerintah Desa, BUMDes Tirta Mandiri, BPJS Kesehatan, fasilitas kesehatan, dan masyarakat. Penelitian ini bertujuan menganalisis proses collaborative governance dalam penyelenggaraan program serta implikasinya terhadap akses layanan kesehatan, perlindungan finansial, dan keberlanjutan program. Penelitian menggunakan pendekatan kualitatif dengan desain studi kasus. Data diperoleh melalui wawancara mendalam, studi dokumentasi, dan instrumen pertanyaan singkat kepada masyarakat sebagai data pendukung. Hasil penelitian menunjukkan bahwa collaborative governance berkembang secara bertahap dari governance gap menuju collective action melalui penyamaan persepsi, negosiasi kepentingan, pembentukan kepercayaan, komitmen bersama, pembagian peran, koordinasi, serta mobilisasi dan konversi sumber daya. Struktur jaringan menunjukkan Pemerintah Desa menempati posisi paling sentral sebagai lead organization yang menjalankan fungsi steering dan mengintegrasikan kapasitas berbagai aktor. BUMDes berperan sebagai social financeryang memungkinkan kapasitas ekonomi desa ditransformasikan menjadi mekanisme pembiayaan sosial. Proses kolaborasi berimplikasi pada penguatan akses layanan kesehatan, perlindungan finansial, dan keberlanjutan program. Penelitian ini merumuskan Village Health Governance sebagai model konseptual yang mengintegrasikan Health Governance Actor, Social Financer, Local Fiscal Capacity, dan Institutional Adaptation dalam membangun tata kelola kesehatan berbasis desa yang adaptif, berkelanjutan, dan berorientasi pada public value. Temuan menunjukkan bahwa efektivitas perlindungan kesehatan di tingkat desa tidak semata-mata ditentukan oleh ketersediaan sumber daya, tetapi oleh kemampuan mengintegrasikannya secara kolaboratif untuk mencapai tujuan bersama.

Increasing National Health Insurance (JKN) coverage does not fully guarantee access to health services and financial protection for the community, especially in rural areas. Ponggok Village is developing innovative BUMDes-based health services through the Village-Based BPJS Health Protection Program involving the Village Government, BUMDes Tirta Mandiri, BPJS Health, health facilities and the community. This research aims to analyze the collaborative governance process in program implementation and its implications for access to health services, financial protection and program sustainability. The research uses a qualitative approach with a case study design. Data was obtained through in-depth interviews, documentation studies, and short question instruments to the community as supporting data. The research results show that collaborative governance develops gradually from a governance gap to collective action through equalizing perceptions, negotiating interests, building trust, mutual commitment, dividing roles, coordinating, and mobilizing and converting resources. The network structure shows that the Village Government occupies the most central position as the lead organization which carries out steering functions and integrates the capacities of various actors. BUMDes acts as a social financer which enables village economic capacity to be transformed into a social financing mechanism. The collaboration process has implications for strengthening access to health services, financial protection and program sustainability. This research formulates Village Health Governance as a conceptual model that integrates Health Governance Actor, Social Financer, Local Fiscal Capacity, and Institutional Adaptation in building village-based health governance that is adaptive, sustainable, and oriented towards public value. The findings show that the effectiveness of health protection at the village level is not solely determined by the availability of resources, but by the ability to integrate them collaboratively to achieve common goals.

Kata Kunci : Collaborative Governance, BUMDes, Perlindungan BPJS Kesehatan, Tata Kelola Kesehatan Desa, Village Health Governance.