BackgroundIndonesia introduced a universal National Health Insurance (NHI) programmeJaminan Kesehatan Nasional(JKN) in 2014. However, challenges in timely consultation and access to health services resulted in the introduction of formal and informal patient navigation initiatives which facilitates access for patients. Informal patient navigation may emerge from the gaps in the services of the formal patient navigation. This study assesses how threeinformalnon-government patient navigation initiatives emerged, are organised, operate and interact with JKN authorities to enhance patient empowerment and JKN responsiveness.MethodsThis was a qualitative study comprising of document review, semi-structured interviews with key stakeholders and direct observations at JKN-contracted health facilities. Data was analysed deductively and inductively using Molyneuxet al’s accountability assessment framework to assess context, content, and process of the informal patient navigation initiatives.ResultsOur study found that informal patient navigation initiatives bridge a gap left by formal navigation initiatives. The navigators help spread awareness among patients of their benefits and entitlements and assist patients to communicate with health providers and authorities. However, we find limited effects on people’s ability to navigate the system themselves, on systemic change, or on JKN responsiveness.ConclusionWe may know that when access to health services is challenged then formal or informal patient navigation initiatives to facilitate access for patients may emerge. What this study adds is how informal patient navigation bridge a gap left by formal navigation initiatives, from how they are organized, operate and interact with the NHI authorities. We demonstrate that in the absence of well-functioning formal navigation initiatives, the informal initiatives may fill a critical gap. However, their efforts are time intensive and do not translate across the population. What is implied here is that more is required from JKN authorities to enhance interaction with informal patient navigation to advance systemic change toward equitable access to NHI.
Finding consensus has been argued as a stumbling block for actions in ASEAN, including in ASEAN�s Human Rights Body: the AICHR (ASEAN Intergovernmental Commission on Human Rights). While past studies discussed the limits of consensus making in ASEAN, there is lacunae of research on the institutional performance pressure to get things done in an intergovernmental setting and the impacts of diverse mandates among AICHR Representatives to finding human rights consensus. There are at least four types of approaches that has been employed by AICHR Representatives to find consensus where the constructivist and pragmatist collided, but it becomes clear that the challenge is cross-sectoral rather than merely internal AICHR, which makes it imperative to assess the direction for ASEAN�s institutional performance when evaluating consensus building.
COVID-19 suffers fishers all over the world, including those in Indonesia. While the pandemic triggered the state to provide relief for fishers, initial interviews and media tracing suggests that in Indonesia, the world�s second largest producer of capture fish, the reaction is not enthusiastic. This paper explores the possible factors behind such reaction, taking the focus on how existing new global governance affected the perspectives of fishers. This paper explores the dimensions of governance that link the perspectives of problem solving at the global level and the way fishers operate. Through in-depth interviews of state apparatus and fishers, also tracing past studies of governance, the paper noted problems that current global governance offered to solve and describe the layers of convergence on �common problems� but not necessarily on �specific problems� that stakeholders try to solve nationally, locally or operationally under the umbrella of global governance. Bringing in the wicked problem discourse, this paper humbly suggests �bringing back embedded liberalism� as inseparable part of new global governance for the sector.
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