Collaborative Governance Framework in Health Care: A Qualitative Exploration of Hospital Pharmacy Management Reform at Hospital Setting in Indonesia
Hardi Warsono, Retna Hanani, Halim Dwi Putra.
Since January 2014, the Indonesian government has implemented national health insurance (NHI) policy which aims to achieve universal health coverage by 2019. Through the new insurance scheme, hospitals are obliged to reform its pharmacy management practices by following national formulary and implementing e-catalogue. However, researches on pharmacy management under the NHI suggests that hospitals as the forefront of health services have limited resources to manage competing interests that hamper the reform. In this paper we examine local hospitals’ governing strategies and adaptations to implement the reform. Through extensive in-depth interviews with hospital managers, doctors and staffs at the hospitals pharmacy units in government hospitals in Central Java, we demonstrate the importance of collaborative governance in health care reform including pharmacy management. From the cases, we argue that the national’s policy reform is only effective when hospitals’ leaderships are able to create collaboration among stakeholders. Trust to leadership plays a crucial role in establishing organizational change including mitigating negative responses from actors that losing financial benefits due to the reform.