Journal of Contemporary Governance and Public Policy, 6 .
October 2025, 117-134 ISSN: 2722-3981 (Prin.
ISSN: 2722-3973 (Onlin.
Available Online at https://journal.
org/index.
php/jcgpp Universal Health Coverage and Hospital Service Satisfaction in Socio-Economically Vulnerable Tourism Areas Nurillah Agustina1*.
Rahmad Hidayat2.
Ariy Darmawan3.
Ayatullah Hadi4 1 Department of Public Administration.
Universitas Muhammadiyah Mataram.
Indonesia 2 Department of Public Administration.
Universitas Muhammadiyah Mataram.
Indonesia 3 Department of Public Administration.
Universitas Muhammadiyah Mataram.
Indonesia 4 Department of Government Studies.
Universitas Muhammadiyah Mataram.
Indonesia *Corresponding Author Email: rahmad_dayat22@yahoo.
Received: 5 May 2025.
Revised: 16 August 2025.
Accepted: 18 August 2025 Abstract This study examines the implementation of Universal Health Coverage (UHC) at the Mataram City General HospitalAia referral facility situated in a socio-economically vulnerable, tourism-dependent area of West Nusa Tenggara.
Indonesia.
Service quality is assessed across three dimensions: .
administrative service quality, .
accessibility of health services, and .
clinical service quality, framed against the challenges of achieving SDG 3 (Good Health and Well-Bein.
SDG 1 (No Povert.
, and SDG 10 (Reduced Inequalitie.
Using a descriptive qualitative design, we conducted interviews, observations, and document analysis, and coded the data in NVivo 12 Plus.
Findings indicate that administrative processes have improved in clarity, speed, and ease of however, responsiveness and lengthy waiting times persist.
Digital platforms have enhanced access, yet geographical barriers and a digital divide continue to constrain equity.
Overall clinical quality is satisfactory but limited by insufficient empathy and suboptimal communication from health workers.
The study contributes empirically by showing how systemic constraintsAiuneven resource allocation, workforce shortages, and infrastructure deficitsAiundermine UHC objectives in vulnerable, tourism-reliant settings.
Policy implications include the need for area-based planning, stronger inter-agency coordination, and context-sensitive innovation to deliver more equitable and inclusive services across West Nusa Tenggara.
Keywords: Hospital Service Satisfaction.
Socio-Economically Vulnerable.
Universal Health Coverage Copyright A 2025 by the Authors.
Published by the Pusat Penelitian Ilmu Sosial dan Humaniora Kontemporer.
Indonesia.
This is an open access article distributed under the terms of the CC BYSA Licence .
ttps://creativecommons.
org/licenses/by-sa/4.
How to Cite: Hidayat.
Agustina.
Darmawan.
, & Hadi.
Universal Health Coverage and Hospital Service Satisfaction in Socio-Economically Vulnerable Tourism Areas.
Journal of Contemporary Governance and Public Policy, 6.
, 117-134.
https://doi.
org/10.
46507/jcgpp.
Permalink/DOI: https://doi.
org/10.
46507/jcgpp.
Introduction Policy may be understood as a consensus or agreement on an issue to achieve specified objectives by setting priorities and targets.
While definitions vary, health policy refers to actions or approaches that shape the institutions and organisations of the health system, as well as health services and financing structures (Mbau et al.
, 2023.
Mills.
The Universal Health Coverage (UHC) policy seeks to improve the quality of health services for the whole population by raising standards and expanding hospital capacity (Faizi & Kazmi, 2017.
Fox & Reich, 2.
Health policy supports the values upheld in society and organisations, pursues long-term goals, and guides strategic decision-making (Andrieiev et al.
, 2.
Achieving such goals requires innovation in outreach and effective collaboration between hospitals and wider service networks.
In Indonesia.
UHC is one of the health service policies regulated under the Law concerning the National Social Security System.
UHC is a system designed to ensure that all people can access high-quality health care without incurring significant financial hardship (Darrudi et al.
, 2022.
Jaca et al.
Yanful et al.
, 2.
Everyone has the right to equitable health services, reflecting providersAo commitment to deliver high-quality, effective, accessible, and measurable care (Carroll & Walsh, 2024.
Guzmyn-Leguel & Rodryguez-Lara, 2.
In Indonesia.
UHC commenced in January 2014 through the National Health Insurance, which aims to provide equal access to health services for all Indonesians (Pisani et al.
, 2.
The programme is founded on principles of justice, sustainability, and social protection (Rizky Perdana et al.
, 2.
Globally.
UHC aspires to guarantee access to quality services at affordable cost for all residents (Bloom et al.
, 2018.
Chapman, 2.
The GovernmentAos strategic steps toward UHC are stipulated in Minister of Health Regulation No.
71/2013,
which provides the legal basis for service delivery within the national health insurance framework to protect population health and ensure access to comprehensive services.
However, at Mataram City General Hospital, administrative constraintsAisuch as long queuesAihave been reported to reduce public satisfaction, with service performance indicators declining toward the end of 2024.
Evidence highlights the need to streamline administrative systems, accelerate processes, and strengthen patientAeofficer collaboration (Winarti & Djamhur, 2.
Despite this regulatory foundation, disparities in UHC implementation persist, particularly in geographically and socio-economically vulnerable settings.
West Nusa Tenggara Province illustrates these challenges: the distribution of health services is poverty rates remain high.
infrastructure is limited.
and geographic barriers impede access in remote islands such as Sumbawa and North Lombok.
The province continues to struggle with key public health indicatorsAimaternal and infant mortality and a high prevalence of stunting among children under fiveAireflecting chronic malnutrition and inequities in service provision.
Although the UHC agenda aligns closely with Sustainable Development Goal (SDG) 3 on access to essential services and affordable medicines, progress in West Nusa Tenggara remains limited.
Contributing factors include shortages of qualified health workers, inadequate infrastructure, and weak integration Volume 6 Issue 2 October 2025 between primary care and referral services.
These structural constraints intersect with SDG 1 (No Povert.
and SDG 10 (Reduced Inequalitie.
, as many residents are concentrated in informal employment with limited access to vocational training and social protection.
As the main referral facility treating approximately 400 patients daily.
Mataram City General Hospital faces administrative inefficienciesAiincluding queues, service delays, and constrained patientAestaff communicationAithat depress public satisfaction even amid quality assurance and patient safety initiatives (Winarti & Djamhur, 2.
This reveals a central tension: while policy aims to guarantee equitable, high-quality care, administrative capacity and responsiveness remain critical bottlenecks.
Prior UHC research has largely examined macro-level outcomes such as health-care costs (Prinja et , 2012.
Tang et al.
, 2.
, socio-economic disparities (Malaviya et al.
, 2022.
Norton et , 2.
, and national-level policy efficiency (Arhin et al.
, 2023.
Eze et al.
, 2.
contrast, fewer studies interrogate micro-level patient satisfaction with hospital administrative services, particularly in tourism-based localities such as Mataram, where seasonal population surges and economic vulnerability complicate service delivery and Health problems in West Nusa Tenggara are summarised in Table 1.
Table 1.
Health Problems in West Nusa Tenggara Source: Processed by the authors .
Problem Category Problem Description Related Data Additional Notes Regional Disparities Uneven Distribution of Medical Personnel and Specialist Services The Doctor-toPopulation Ratio is Markedly Lower in Bima.
Dompu, and West Sumbawa than in Mataram City Ambulances and Medical Transport are Difficult to Access in Some Remote SubDistricts Basic Health Services Limited Medical Personnel.
Equipment, and Health-Centre Facilities.
Particularly in Rural Areas and Small Islands Many Community Health Centres Lack Inpatient Facilities.
Laboratories, or Specialist Doctors Service Provision is Concentrated in Mataram City Nutrition and Stunting High Stunting Prevalence Driven by Poor Nutrition.
Poverty, and Limited Nutrition Education Stunting in West Nusa Tenggara is Among the Highest in Indonesia Central Lombok and Sumbawa Record Particularly High Prevalence Journal of Contemporary Governance and Public Policy Scholars seldom assess UHC in terms of community satisfaction with administrative services, and few link the effectiveness of UHC implementation to broader outcomes such as stunting or maternal and child healthAiissues that are especially salient in West Nusa Tenggara.
In this respect, coherence between health financing schemes and nutrition interventions is crucial yet under-explored.
Accordingly, this study analyses the effectiveness of UHC implementation in improving the quality of administrative services and community satisfaction at Mataram City General Hospital, situated in a socioeconomically vulnerable, tourism-intensive context.
It also examines potential relationships between administrative efficiency under UHC and wider health outcomesAi particularly stunting and maternalAechild health indicatorsAiwhich remain underinvestigated in localised UHC assessments.
Specifically, this study aims to: .
evaluate the effectiveness of UHC implementation in improving administrative service quality and community satisfaction at Mataram City General Hospital, a key referral hospital in a socio-economically vulnerable, tourism-intensive region.
explore potential linkages between administrative efficiency under UHC and broader health outcomes, especially the prevalence of stunting and maternalAechild health indicators.
West Nusa Tenggara faces stark regional health disparities.
Public resources are concentrated in Mataram, leaving peripheral districts chronically underserved.
The Indonesian Doctors Association notes that specialist physicians cluster in Mataram while outlying areas have minimal coverage.
officials likewise acknowledge uneven distribution of personnel and facilities, with many villages in mountainous or island subdistricts lacking basic infrastructure (Shan et al.
, 2.
In practice, most community clinics outside the capital provide only rudimentary outpatient care, with few inpatient beds, laboratories, or specialists, prompting patients to travel to Mataram for advanced services (Boutros et al.
, 2.
The result is a severe urbanAerural access gap.
overwhelmingly prefer Mataram, where facilities and incentives are stronger, and avoid remote locales.
Chronic malnutrition further compounds these disparities (Putri et al.
, 2024.
Rizal et al.
, 2.
Stunting prevalence in West Nusa Tenggara remains well above the national average and is linked to pervasive poverty, food insecurity, and limited maternal In sum, the provinceAos health challenges are systemic: an inequitable distribution of clinicians and facilities leaves rural communities vulnerable.
services outside Mataram are under-resourced.
and persistent under-nutrition sustains high stunting rates across the province.
Research Methods This study employs a descriptive qualitative approach comprising documentation, interviews, direct observation of ongoing events, and interpretive description of their Qualitative research gathers rich, contextual information and uses the researcher as the primary instrument to integrate detailed materials, actions, and consequences, thereby revealing holistic and contextual features (Khoa et al.
, 2.
The Volume 6 Issue 2 October 2025 article is situated in the implementation of Universal Health Coverage (UHC) to examine community satisfaction with services at Mataram City Regional Hospital.
Data analysis was conducted using NVivo 12 Plus: sources were transferred to a computer and imported into the NVivo qualitative analysis environment.
NVivo facilitates systematic organisation and interpretation of qualitative data (Edwards-Jones, 2014.
Mortelmans, 2.
To assess administrative performance at Mataram City Regional Hospital, three domains were specified: Administrative Service Quality.
Health Service Accessibility, and Health Service Quality.
Administrative Service Quality was operationalised as ease of registration, clarity of information, responsiveness, and data accuracy/suitability.
Health Service Accessibility encompassed facility availability, travel distance, costs, waiting times, and access to basic services.
Health Service Quality focused on overall service quality, medical care, patient safety, and patient satisfaction.
Figure 1.
Research Procedure Flow Source: Processed by the authors .
Figure 1 depicts the sequential stages of the research: problem formulation.
specification of research objectives.
selection of methods.
data collection.
data analysis.
and drawing conclusions.
Problem formulation narrowed the focus to UHC and satisfaction with hospital services in socio-economically vulnerable tourism areas.
The study aimed to analyse the impact of UHC implementation on community satisfaction, particularly among poor and vulnerable groups in settings characterised by unequal distribution of health services.
Data collection comprised semi-structured interviews, direct observation, and document analysis.
All materials were processed in NVivo 12 Plus to support organisation, coding, and visualisation of emerging themes.
To enhance the validity and reliability .
of the findings, several procedures were implemented prior to analysis: triangulation across data sources Journal of Contemporary Governance and Public Policy .
nterviews, observations, and document.
member checking to verify transcription accuracy and interpretive claims with informants.
and peer debriefing to maintain analytical transparency.
Before import to NVivo, the dataset was screened and cleaned to remove irrelevant, incomplete, or inconsistent entries, ensuring a focus on high-quality, contextually relevant information.
Within NVivo, thematic coding was guided by recurring keywords and concepts, and saturation was used to confirm that no new significant themes emerged, indicating data adequacy.
These systematic steps support the credibility of the NVivo 12 Plus analysis and enable confident interpretation of results related to UHC and hospital service satisfaction.
Results and Discussion Assessing health care quality is essential to building an effective and efficient Three core domainsAiAdministrative Service Quality.
Health Service Accessibility, and Health Service QualityAishape the patient experience.
Accordingly, the findings reported here provide evidence base for better decision-making to improve health care standards.
The relationships among these domains are illustrated in Figure 2.
Figure 2.
Indicators for Measuring Service Quality Source: Analysis using NVivo 12 Plus .
Figure 2 summarises the key findings and their interpretation.
Significant results centre on the three indicators noted above, which are used to assess service quality at Mataram City Regional Hospital under the implementation of Universal Health Coverage (UHC).
The studyAos conclusions are organised around these indicators and consider how UHC relates to public satisfaction with administrative services in this setting.
Administrative Service Quality High-quality service is the aspiration of all segments of society.
when achieved, it advances the effectiveness of government bureaucracy itself.
In practice, however, various challenges and obstacles often arise in attempts to realise this goal.
Poorly managed bureaucratic servicesAiineffective or inefficientAican erode public trust and Volume 6 Issue 2 October 2025 reduce the efficiency of governmental functions.
Proper bureaucratic management is therefore essential to ensure optimal public service delivery and to enhance the quality of governance (Salam, 2023.
Zafarullah & Huque, 2.
Public service refers to any activity undertaken by government or its implementing agencies to meet community needs (Bovaird, 2007.
Kirlin, 1.
Within the Universal Health Coverage (UHC) framework at Mataram City Regional Hospital, policy implementation prioritises fast and efficient administrative procedures to raise community satisfaction.
Streamlined processesAisuch as easy registrationAi enable communities, especially underprivileged groups, to obtain health care without financial or administrative barriers.
This reflects the success of UHC in providing affordable, quality services.
Across levels of government, three core functions apply:
serving the public, enabling development, and providing protection.
In public administration, service denotes the calibre of bureaucratsAo interactions with the community (Pepinsky et al.
, 2017.
Wang et al.
, 2.
In health care, conventional quality dimensionsAisuch as performance and reliabilityAiare operationalised through standard operating procedures (SOP.
, complaint-handling systems, service charters, and other documented protocols that seek to ensure consistent, accessible, and patient-centred Figure 3.
Word Frequencies Generated from the Data Source: Analysis using NVivo 12 Plus .
Health facilities in socially and economically vulnerable areasAisuch as West Nusa Tenggara ProvinceAiexperience high patient volumes, signalling substantial demand amid persistent poverty, unequal access, and limited basic infrastructure.
In this context, the quality of public service delivery is pivotal for addressing structural inequalities and strengthening public trust in government institutions.
Visual evidence from the service environment indicates systematic improvement efforts .
, digital queue systems, bright and clean waiting rooms, and direct staffAepatient interactio.
The visible demographic diversity of service users underscores inclusive access, aligning with SDG 10 on reducing inequalities.
This highlights the importance of equity- and diversityoriented approaches in public service organisations (Kim & Park, 2.
In West Nusa Journal of Contemporary Governance and Public Policy Tenggara, service quality that is responsive to socio-economic needs is critical to the effective implementation of UHC.
The findings thus underscore that service quality is closely tied to local socio-economic dynamics and point to the need for adaptive and inclusive governance to uphold justice and equity in public service delivery.
Based on Figure 3, analysis of key elements in public servicesAiparticularly administration and UHCAishows that service quality and efficiency are central to increasing public access and satisfaction.
Interviews with key informants indicate that major challenges at Mataram City Regional Hospital concern limited human resources and administrative constraints that impede service effectiveness.
This finding is consistent with research noting similar barriers in several African countries, particularly shortages of health workers (Anyangwe & Mtonga, 2.
Moreover, salient keywords such as AuserviceAy.
AupriorityAy, and AuinformationAy emphasise the need for clear public information and efficient administrative governance to support even implementation of UHC.
In the socio-economic context of West Nusa TenggaraAiwhere many residents remain vulnerable and low-incomeAipoor administrative quality risks deepening inequalities in access.
Effective financial governance can help ensure fair resource allocation, transparency, and accountability within the health system (Barroy et al.
Accordingly, the results indicate that improving service qualityAiencompassing administrative processes and financial managementAiis a prerequisite for a health system that is responsive to vulnerable socio-economic groups, while strengthening equitable and sustainable UHC implementation in West Nusa Tenggara.
Health Service Accessibility Accessibility of health care refers to individualsAo ability to receive care without physical, financial, or informational barriers and is a core component of Universal Health Coverage (UHC).
It encompasses physical proximity, affordability, and awareness of available services.
UHC seeks to minimise financial hardship by ensuring access to basic services, reducing costs, and improving public health literacy.
This aligns with SDG 3 (Good Health and Well-Bein.
, which emphasises expanding access to essential health services to achieve equitable health for all.
Target 3.
8 on UHC assesses how easily and affordably individuals can obtain preventive, curative, rehabilitative, and promotive services tailored to their needs.
Reducing mortality, managing communicable and noncommunicable diseases, and achieving optimal population health depends critically on the accessibility and affordability of health care.
Organisational effectiveness is pivotal for achieving institutional goals and is evidenced by an organisationAos capacity to operate successfully (Matthews, 2.
Effectiveness involves maximising goal attainment while minimising resource waste and internal tensions (Aguilera et al.
, 2.
It may be evaluated through productivity, adaptability, co-operation, and harmony (Rampersad et al.
, 2.
In health care, these dimensions are closely connected to service accessibilityAiespecially in socially and economically vulnerable settings.
Key accessibility indicators include waiting time, service availability, and community satisfactionAimeasurable factors that are useful for policy evaluation (Cabrera-Barona et al.
, 2.
Volume 6 Issue 2 October 2025 In West Nusa Tenggara, a region marked by geographical and socio-economic constraints, improving accessibility is both a strategic imperative and a meaningful indicator of service effectiveness.
Strengthening access is therefore not only consistent with UHC objectives.
it also enhances organisational performance, reduces disparities, and improves overall community health outcomes (Matthews, 2011.
Aguilera et al.
, 2024.
Rampersad et al.
, 2010.
Cabrera-Barona et al.
, 2.
Health Service Quality In public service delivery, qualitative assessment of service quality is often more complex than quantitatively measuring organisational profit or benefits (Cepiku & Mastrodascio, 2021.
Rowley, 1.
Public service quality is commonly assessed across five fundamental dimensions: tangibles .
dequacy of physical infrastructure and facilitie.
, reliability .
onsistency and accuracy of deliver.
, responsiveness .
bility and readiness to address community need.
, assurance .
nowledge, skills, and integrity of official.
, and empathy .
ersonal attention to user.
(Wisniewski, 2.
Complementing these are six normative principlesAitransparency, accountability, conditionality, participation, equality of rights, and a balance between rights and obligationsAiwhich together underpin public legitimacy and satisfaction and are frequently highlighted as foundations for strengthening trust in government services.
The overarching aim of global health development is to ensure that everyone can access necessary, affordable, inclusive, and equitable health services (Chapman, 2.
This aim is encapsulated in Universal Health Coverage (UHC), which emphasises access to preventive, curative, rehabilitative, and promotive services irrespective of cost or In this respect.
SDG 3 aligns with equitable access to quality health services, while SDG 1 relates to welfare governance and poverty reduction.
Stunting remains a pressing concern in West Nusa Tenggara, closely associated with the quality of maternal and child health services, nutrition interventions, and health education.
Figure 4.
Community Satisfaction Index for Service Units Source: Processed by the authors .
Journal of Contemporary Governance and Public Policy Within health services, quality is determined by the degree to which services meet patientsAo expectations, comply with safety standards, and deliver effective clinical interventions (Mohammad Mosadeghrad, 2013.
Strandyus et al.
, 2.
Traditional quality dimensionsAiperformance, reliability, ease of access, and aesthetic aspectsAialso remain Service effectiveness is reflected in optimal health outcomes, time efficiency, affordability, and the use of evidence-based practices (Walters et al.
, 2.
In socioeconomically vulnerable areas such as West Nusa Tenggara, the urgency of improving service quality is heightened.
integration of technical factors, human resources, and system governance is a principal determinant of fair, responsive, and high-quality public Figure 4 shows that the Community Satisfaction Index (CSI) across service units at Mataram City Hospital is relatively stable, ranging from 94.
5 to 97.
Although scores vary by unit, most remain above 95, indicating high community satisfaction.
Units such as the General Surgery Clinic and the Skin Clinic record consistently high scores, suggesting effective and responsive services.
By contrast, the Plastic Surgery Clinic shows lower scores, signalling challenges in meeting user expectations.
Fluctuations in CSI values may be influenced by waiting times, the quality of communication by medical personnel, and facility conditions.
Sopamena et al.
emphasised that effective clinicianAepatient communication is a key determinant of satisfaction, while Abdul Rahim and Mwanri .
found that long waiting times significantly reduce satisfaction.
Xia et al.
added that continuous evaluation based on satisfaction data is essential for decisionmaking to improve quality.
In the socio-economic context of West Nusa Tenggara Province, variations between units indicate the need for an equality-based approach within UHC implementation.
These results are thus an important instrument for assessing whether public services reach vulnerable groups fairly, efficiently, and with January-March April-June July-September October-December Figure 5.
Public Satisfaction Index in 2024 Source: Processed by the authors .
Volume 6 Issue 2 October 2025 As depicted in Figure 5, the JanuaryAeMarch period .
records the highest public satisfaction indexAijust over 97%.
A notable decline appears in AprilAeJune .
, to 5%, continuing into JulyAeSeptember .
, which approaches 96% .
he annual lo.
OctoberAeDecember .
improves slightly but remains below the yearAos first-quarter level, illustrating the difficulty of sustaining very high satisfaction through International evidence offers useful points of comparison: in Thailand.
Viryasiri et .
report the use of SERVQUAL to assess patient satisfaction in public hospitals.
lower empathy towards the poor or towards populations in tourist areas reflects shortfalls in achieving UHCAos equity values.
SERVQUAL has also been applied elsewhere in developing countries, for example Umoke et al.
in general hospitals, and in Malaysia.
Rahim et al.
combined SERVQUAL with social media analysis to evaluate hospital service quality.
Table 2.
Collaboration to Achieve Universal Health Coverage in Mataram City Source: Processed by the authors .
Stakeholder Percentage (%) Social Service Public Health Office Health Social Security Administering Body Mataram City General Hospital Table 2 indicates that inter-agency collaboration in Mataram City to support UHC has yielded notable results.
The Social Service (UHC participation rate 97.
49%) helps vulnerable groups access services via the Health Social Security Administering Body.
The Health Service .
02%) facilitates services and ensures facility readiness for UHC participants.
Based on the latest data, the Health Social Security Administering Body .
13%) manages enrolment and access, and the City General Hospital .
5%) contributes to delivery.
Overall, the high participation rates reflect effective synergy in ensuring access and quality.
Nevertheless.
Erlangga et al.
show that inequalities in access persistAiparticularly between subsidised and uninsured groupsAiwhile Viryasiri et al.
emphasise the need for policy reform and financing innovation to strengthen social health insurance systems.
According to Figure 6, administrative service qualityAisuch as ease of registration, clarity of information, and an adequate number of polyclinicsAicontributes significantly to community satisfaction in West Nusa Tenggara.
However, low staff responsiveness negatively affects perceptions, as reflected in the CSI.
High accessibilityAiboth online and offline at accessible locationsAiincreases utility but waiting times remain a structural Facility availability and affordable costs support satisfaction, although complaints about staff interactions and security underscore areas for improvement.
Journal of Contemporary Governance and Public Policy Figure 6.
UHC Assessment Results at Mataram City Hospital Source: Processed by the authors .
In Thailand.
Iamtrakul et al.
report that limited empathy in services, especially for poor communities and in tourist areas, reflects inequalities in UHC In the diverse and vulnerable socio-economic context of West Nusa Tenggara, low service quality tends to exacerbate inequality.
Hence, the relationship between service quality and socio-economic conditions is mutually reinforcing and requires an integrated response.
Figure 7.
Word Frequencies Generated from the Data Source: Processed by the authors .
Finally.
Figure 7 illustrates the relationship between AuserviceAy and AusatisfactionAy, highlighting dimensions of administrative service quality that significantly influence patient satisfaction, particularly accurate information and service efficiency.
This aligns with Shen et al.
, who emphasise the importance of service efficiency in shaping public perceptions.
The terms AucoverageAy and AuaccessibilityAy indicate structural access problems highly relevant to West Nusa Tenggara, where poor and vulnerable groups Volume 6 Issue 2 October 2025 frequently face obstacles to basic services.
Infrastructure availability and government support are also critical determinants of service quality.
In this context, e-governmentAi as discussed by the World Bank and operationalised in practiceAican be a strategic instrument to improve transparency, efficiency, and public participation (Alfaro-Ponce et , 2.
Overall, the findings underscore the need for synergy among administrative quality, accessibility, and infrastructure support to address socio-economic disparities in West Nusa Tenggara.
Conclusion The implementation of Universal Health Coverage (UHC) at Mataram City Hospital is associated with high levels of community satisfaction, chiefly through improvements in administrative service quality, health service accessibility, and health service quality.
Micro-level evidence from interviews, observations, and document analysis .
rganised and coded in NVivo 12 Plu.
shows that streamlined registration, clearer information, and better data accuracy support positive perceptions.
however, staff responsiveness and waiting times remain binding constraints that depress satisfaction for certain units, as reflected in CSI variation across clinics.
These findings reinforce the core premise that UHC success hinges not only on the availability of basic services but also on responsive frontline administration, effective communication, and the operational capacity to deliver consistently across units and over time.
In a province marked by geographical and socio-economic vulnerability, the equity promise of UHC depends on reducing access frictionsAitravel distance, time costs, and information gapsAiand on co-ordinated inter-agency action to keep participation high and pathways simple.
The study underscores three actionable levers.
First, digital hospital information systems .
, queue management, e-registration, and transparent service update.
can shorten throughput times and raise perceived fairness.
Second, spatially targeted micro-policiesAiincluding outreach to islands and peripheral districts, mobile/telehealth options, and adaptive staffingAican mitigate uneven clinician distribution and infrastructure gaps.
Third, administrative quality assurance .
outine satisfaction tracking, standard operating procedures, and feedback loop.
is necessary to sustain gains and address unit-level disparities.
Taken together, these strategies align UHC delivery with SDG 3 (Good Health and Well-Bein.
by improving timely access to preventive, curative, rehabilitative, and promotive services, while also advancing SDG 10 (Reduced Inequalitie.
through fairer distribution of service capacity.
The West Nusa Tenggara contextAicharacterised by uneven deployment of health workers, under-resourced primary facilities beyond Mataram, and persistently high stuntingAipoints to system-level issues that demand joined-up solutions.
Strengthening maternalAechild health services, nutrition counselling, and targeted protection for lowincome households links UHC execution to stunting reduction, thereby contributing indirectly to SDG 1 (No Povert.
through improved human capital.
In practical terms, the hospital and city authorities can prioritise: .
responsiveness reforms .
ervice scripts, wayfinding, and real-time triag.
appointment and referral optimisation across Journal of Contemporary Governance and Public Policy primary and referral care.
data governance that integrates CSI, complaints, and clinical safety indicators for timely corrective action.
equity safeguards for tourist-season surges and hard-to-reach communities.
Acknowledgements The authors express their sincere gratitude to all parties who supported the completion of this research.
Special thanks are extended to Universitas Muhammadiyah Mataram.
Indonesia, for its academic and institutional support, and to Mataram City General Hospital and related health institutions in West Nusa Tenggara for facilitating access to valuable data and information.
The authors also thank the community members and respondents who generously shared their time and perspectives, enabling a comprehensive understanding of the challenges of health-care delivery in socioeconomically vulnerable, tourism-dependent areas.
References