White Misconducts: Informal Acts in Crossborder Primary Health Service Delivery (Case of Panggang, Central Java, Indonesia)

Abstract

Public health services in Indonesia are managed in a territorialism approach that limits services to a specific administrative area. Refferal system in health care sets primary health facilities to each citizen and limits crossborder services. The absence of primary health care in Glagaharjo border settlement and the limitation of crossborder services created barriers for universal health care in rural provincial border settlements. Interruptions in providing services to borderland communities were a major problem with the system during the era of good governance. Informal crossborder services involving changes in health-care administration came as a viable option for ensuring universal health-care services. This paper examines the process of crossborder primary health service delivery by Pustu Panggang, Central Java Province, to communities in Glagaharjo, Daerah Istimewa Yogyakarta Province, sharing provincial borderline. Data was gathered through in-depth interviews with local officials and stakeholders. Using the compare and contrast technique, the concepts of good governance and cross-border health services are compared and contrasted. Thefindings shows that informal acts including exceeding-authority decision making, ignorance, and other forms of misconducts come as the impromptu strategy to keep primary care available to those in need. As Covid-19 pandemic unfolded, informal acts save community from the lack of access to primary healthcare due to the cost of formal arrangement.