Health System Inequality and the Dynamics of Population Health Complaints
Spatial Evidence from an Archipelagic Province in Indonesia
DOI:
https://doi.org/10.63892/aletheia.2.2025.95-107Keywords:
Health Complaints, Health Inequality, Spatial Dynamics, Health Facilities, West Nusa Tenggara Province (NTB)Abstract
Population health complaints are a key indicator of subjective morbidity that reflects both community health conditions and the performance of health service systems across regions. Despite a national decline in health complaints, West Nusa Tenggara Province (NTB) continues to record the highest prevalence in Indonesia, accompanied by substantial spatial disparities among districts and cities. Previous studies have largely relied on static annual snapshots and have not adequately captured the speed of health improvement or deterioration as an outcome of regional health system development. This study aims to analyze trends in population health complaints, identify disparities in the rate of change across regions, and examine their relationship with the availability of health service facilities in NTB during 2019–2023. A quantitative descriptive-comparative approach was employed using secondary data from Statistics Indonesia (BPS), analyzed through trend analysis and Compound Annual Growth Rate (CAGR) calculations. The findings indicate that, at the provincial level, NTB experienced an overall decline in health complaints with a CAGR of –2.94%, yet interregional disparities were pronounced, ranging from –13.16% to +4.66%. Urban areas exhibited significantly faster improvements in health complaints than rural districts, while several districts experienced increasing complaints despite relatively extensive health infrastructure. These results suggest that quantitative expansion of health facilities alone does not necessarily reduce health complaints without effective service quality and referral system integration. The study concludes that health dynamics in NTB are structural and systemic in nature. Accordingly, policy recommendations emphasize strengthening service quality, improving referral system integration, and institutionalizing health complaint indicators as a continuous evaluation tool for regional health policies.
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