Journal of Economic, Finance Research and Review (JEFRR)

Analysis of the Implementation of BLUD Financial Management on the Sustainability of Public Health Center Services

Kusuma, Scolastika Andyna Tiara, Zulvina, Fitri

31 January 2026 · Vol. 2, Issue 1, pp. 50-57

DOI: 10.65150/EP-jefrr/V2E1/2026-06

Abstract

The Regional Public Service Agency (BLUD) framework represents a key fiscal innovation within Indonesia’s decentralized health governance system, allowing public institutions such as Puskesmas to manage finances with greater flexibility while maintaining accountability. This study aims to systematically analyze the implementation of BLUD financial management and its impact on the sustainability of public health center services in Indonesia. Using the Systematic Literature Review (SLR) method under the PRISMA protocol, 25 peer-reviewed studies published between 2015 and 2025 were reviewed from both international and SINTA-indexed journals. The analysis incorporated four dimensions: financial autonomy, accountability mechanisms, efficiency of resource utilization, and service sustainability outcomes. The results show that financial autonomy under the BLUD mechanism enhances operational efficiency and service innovation, but the degree of success depends strongly on governance capacity, digitalization, and leadership quality. Regions with robust internal control systems and skilled managers experience improved service sustainability, whereas weaker administrative environments face challenges in accountability and reporting. The study concludes that BLUD financial management contributes positively to sustainable health service delivery when supported by standardized oversight and continuous institutional development. The implication of this review is that Indonesia’s fiscal decentralization should prioritize the balance between flexibility and control to ensure equitable, efficient, and accountable health service governance.

Keywords: BLUD financial management, public health center, fiscal autonomy, accountability, service sustainability

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Kusuma, Scolastika Andyna Tiara, Zulvina, & Fitri (2026). Analysis of the Implementation of BLUD Financial Management on the Sustainability of Public Health Center Services. Journal of Economic, Finance Research and Review, 2(1), 50-57. https://doi.org/10.65150/EP-jefrr/V2E1/2026-06

@article{Kusuma2026,
  title   = {Analysis of the Implementation of BLUD Financial Management on the Sustainability of Public Health Center Services},
  author  = {Kusuma and Scolastika Andyna Tiara and Zulvina and Fitri},
  journal = {Journal of Economic, Finance Research and Review},
  year    = {2026},
  volume  = {2},
  number  = {1},
  pages   = {50-57},
  doi     = {10.65150/EP-jefrr/V2E1/2026-06},
  url     = {https://doi.org/10.65150/EP-jefrr/V2E1/2026-06}
}

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