Multi-Hazard Preparedness In Indonesian Health System Resilience: Literature Review

Abstract

Background: Health system resilience is increasingly important in the context of multi-hazard risks, where infectious disease outbreaks, hydrometeorological disasters, and climate-related threats may occur simultaneously or sequentially. In Indonesia, preparedness policies have expanded, but available evidence remains fragmented across policy, organizational, and service-delivery levels. Objective: This review aimed to synthesize evidence on Indonesia’s preparedness for multi-hazard risks within a health system resilience framework. Methods: A literature review with thematic narrative synthesis was conducted using articles from PubMed, Scopus, ScienceDirect, and Google Scholar, complemented by official government documents. Sources published between 2021 and 2026 in Indonesian or English were included if they addressed preparedness, health system resilience, policy, implementation, or evaluation related to multi-hazard risks in Indonesia. Results: Preparedness has developed at both policy and operational levels through health transformation policies, crisis regulations, contingency planning, and climate-health adaptation agendas. However, implementation remains uneven and is more visible at hospital and workforce levels than across the health system as a whole. Enabling factors included training, disaster experience, organizational support, leadership, and disaster management systems, while barriers included limited trained personnel, inadequate funding, insufficient facilities, non-specific procedures, and weak coordination. Strengthening strategies emphasized routine training, simulations, contingency planning, stronger management systems, integrated information systems, and cross-sector coordination, with evaluation indicators covering workforce capacity, facility and logistics readiness, procedures, coordination, and adaptive capacity. Conclusion: Multi-hazard preparedness in Indonesia has progressed, but it has not yet been fully institutionalized as an integrated systemic capacity.

Keywords: health system resilience; preparedness; multi-hazard; policy implementation; Indonesian