Strengthening local health system resilience in coastal Indonesia: Lessons from post-disaster governance and preparedness

This study assessed the resilience of local health systems in three disaster-prone coastal provinces of Indonesia—Aceh, West Sumatra and Central Sulawesi—by comparing preparedness and mitigation capacities before and after major natural disasters. Using a descriptive pre-post evaluation design, the authors analysed secondary data from Health Crisis Management profiles published by the Indonesian Ministry of Health, focusing on six dimensions: governance, coordination, human resources, infrastructure, logistics and financing. The pre-disaster and post-disaster conditions were compared based on major events such as earthquakes and tsunamis, and composite scores were calculated for each province using a standardised scale and methodology.

Results showed substantial improvements in governance and coordination, particularly in Aceh, driven by regulatory reforms and the establishment of crisis management units. However, persistent weaknesses remain, especially in logistics and human resource capacity, limiting the operational readiness of remote districts. The authors recommend that health crisis management units should be embedded within formal local government structures and routines, with continued investments in training, financing, and inter-agency coordination. Strengthening these pillars, along with embedding institutional learning and simulation exercises, is essential for sustained resilience and effective disaster risk governance in coastal regions.