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 Epidemiology and Society Health Review| ESHR 
Vol. 4, No. 1, 2022, pp. 38-39 ISSN 2656-6052 (online) | 2656-1107 (print) 

 
 

      10.26555/eshr.v4i1.5705  

 
38 

 
 

  

Viewpoint 

Emerging Challenges in Implementing Universal Health 
Coverage Due to COVID-19 in Indonesia 

 
Rosyidah Rosyidah1,2*  

1 Centre for Intelligent Healthcare, Faculty of Health and Life Sciences, Coventry University, 
the United Kingdom 

2 Faculty of Public Health University of Ahmad Dahlan, Yogyakarta, Indonesia 
 
* Correspondence: rosyidahrosyidah29@gmail.com  

Received 31 January 2022; Accepted 01 February 2022; Published 22 February 2022 

The goal of Universal Health Coverage (UHC) means a situation in which all individuals and 
communities have access to health services, whenever and wherever they need them, 
without financial barriers to obtaining them. UHC covers a wide range of essential health 
services, from promotion, prevention, treatment, care, rehabilitation, and palliative care for 
patients with chronic diseases. On the other hand, the COVID-19 Pandemic is devastating 
national health systems in countries that have strived to provide UHC, hampering their 
efforts to fulfill the ethos of universal health coverage, which is to "leave no one behind." As 
mentioned in the World Economic Forum 2021, this issue is interesting because an 
estimated 400 million people worldwide lack access to essential health services. 
Approximately 100 million people fall into poverty each year due to not paying their health 
costs. This number has increased with COVID-19 and will continue to up as people lose their 
jobs, health insurance, and health spending rise due to COVID-19-related spending on 
testing, treatment, and vaccines.  

Due to the pandemic, Indonesia is experiencing many challenges in implementing UHC. For 
example, maintaining the quality of health services with various innovations, including; 
mobile JKN, online queues, online referral systems (P-care), and various efforts supporting 
the effectiveness of due and post COVID-19 health services. Socialization on how to use 
digital health services, especially for laypeople, needs to be improved by BPJS Kesehatan 
as a Social Health Insurance administrator body in Indonesia.   

Furthermore, expanding access to health services for the missing-middle group, namely, 
people who are not included in the Government Contribution Assistance Recipients (PBI) but 
still find it challenging to pay health care services. People in this category have difficulty 
paying their BPJS Kesehatan monthly premiums. Mostly, the informal sector's missing-
middle group does not have a permanent income. So, they cannot afford to pay the UHC 
premium regularly. BPJS Kesehatan and relevant stakeholders need to find a suitable 
strategy to resolve this problem, such as conducting studies on the ability to pay and 
willingness to pay (ATP/WTP). Synchronization of premium and health service benefits is 
also essential and needs re-examining. 



 
 

 

Vol. 4, No. 1, 2022, pp. 38-39    10.26555/eshr.v4i1.5705 
  

39 

Partnerships and coordination with multiple sectors will make it easier to overcome various 
obstacles in overcoming the COVID-19 pandemic. Access to health services in remote areas 
is also a challenge, to be resolved immediately. At this point, commitment and partnership 
from all parties are needed, including BPJS Kesehatan, the Ministry of Health, health 
providers, and policymakers at the regional and central levels. In addition, further studies 
regarding partnerships are interesting. 

Keywords: Universal Health Coverage, Social Health Insurance, Jaminan Kesehatan 
Nasional (JKN), BPJS Kesehatan, COVID-19  


