AN ADAPTIVE GOVERNANCE MODEL FOR ENHANCING REGIONAL HEALTH SERVICE RESILIENCE: A STUDY AT THE SIDOARJO REGENCY HEALTH OFFICE

Abstract

Shifts in the strategic environment, technological advancements, and rising public expectations regarding healthcare quality require local government organizations to adopt adaptive governance and build service resilience. This study aims to analyze the implementation of adaptive governance at the Sidoarjo Regency Health Office, identify factors facilitating or hindering the development of healthcare service resilience, and formulate an adaptive governance model suited to the characteristics of local government organizations. A qualitative approach with a case study design was employed. Informants were selected via purposive sampling, comprising leadership, division heads, Community Health Center (Puskesmas) heads, healthcare workers, and relevant stakeholders. Data were collected through in-depth interviews, observation, and document analysis, then processed using the Miles, Huberman, and Saldaña interactive model, involving data condensation, data display, and conclusion drawing. The findings indicate that adaptive governance has been implemented through adaptive leadership, data-driven decision-making, organizational learning, cross-sector collaboration, and the use of digital technology in healthcare services. Healthcare service resilience is supported by visionary leadership, human resource competence, a learning-oriented organizational culture, information system integration, multi-stakeholder collaboration, and regulatory support. Conversely, hindering factors include rigid bureaucracy, resource limitations, resistance to change, suboptimal cross-unit coordination, a digital competence gap, and suboptimal data utilization. The study produces an "Adaptive Governance Model for Enhancing Regional Healthcare Service Resilience," integrating input, process, output, and outcome components into an adaptive governance framework designed to strengthen organizational capacity in delivering resilient, responsive, innovative, and sustainable healthcare services.