Desentralisasi Penanggulangan HIV/AIDS: Studi Pada Pemerintah Daerah Kabupaten Tulungagung

Authors

  • Muhammad Akbar Nursasmita Fakultas Hukum Universitas Brawijaya
  • Putri Langgeng Sari Fakultas Hukum Universitas Brawijaya
  • Ahmad Ibnu Riza Badan Riset dan Inovasi Daerah Kabupaten Tulungagung
  • Annisa Nurul Hakim Badan Riset dan Inovasi Daerah Kabupaten Tulungagung

DOI:

https://doi.org/10.22225/kw.20.1.2026.27-37

Keywords:

decentralization, HIV/AIDS, local government, regent regulation, health policy

Abstract

Decentralization of health governance places significant responsibility on local governments to address public health challenges, including HIV/AIDS, through context-sensitive and integrated policies. In Indonesia, particularly in Tulungagung Regency, East Java, despite the establishment of local regulations on HIV/AIDS prevention, a gap remains between the normative legal framework and its practical implementation at the local level. This study examines the decentralized HIV/AIDS response in Tulungagung, with particular attention to the absence of a Regent's Regulation as an implementing instrument for Regional Regulation No. 4 of 2021 concerning HIV/AIDS Prevention and Control. Using socio-legal research methods, this study combines legal analysis with sociological and policy approaches to examine how legal norms operate in practice. The findings indicate that despite the existence of a local legal framework, the absence of a Regent's Regulation as an implementing instrument has resulted in weak policy orchestration, limited intersectoral coordination, limited budgeting mechanisms, and reduced administrative accountability. These conditions undermine the effectiveness of decentralized HIV/AIDS governance and diminish the protection of the right to health for people living with HIV/AIDS. This study concludes that the formulation of Regional Head Regulations not only resolves normative problems and delegation of local regulations, more than that, it can be used as a mechanism for orchestrating cross-sector policies at the local level.

References

Abimbola, S., Baatiema, L., & Bigdeli, M. (2019). The impacts of decentralization on health system equity, efficiency, and resilience: A realist synthesis of the evidence. Health Policy and Planning, 34(8), 605–617. https://doi.org/10.1093/heapol/czz055

Cao, Y. (2023). Affirmative action: The problem and the solution. In Proceedings of the 2nd International Conference on Interdisciplinary Humanities and Communication Studies. Atlantis Press.

Efriliani, F. T., Angelina, S. L., Oktaviani, R. D., Usman, M., & Marsal, I. (2026). The function of legislation in ensuring legal certainty and good governance. Media Hukum Indonesia, 4(1)

European Commission, Directorate-General for International Cooperation and Development. (2016). Supporting decentralisation, local governance and local development through a territorial approach. Brussels: European Union.

Fitria, F. (2025). Administrative law and the efficiency of local government. Assiyasi Journal.

Hadjon, P. M., Lotulung, P. E., Laica, M. F., & Djatmiati, T. S. (2011). Pengantar hukum administrasi Indonesia. Yogyakarta: Gadjah Mada University Press.

Indrati, M. F. S. (2007). Ilmu perundang-undangan: Jenis, fungsi, dan materi muatan. Yogyakarta: Kanisius.

Kardin, M. S. (2015). Implementasi kebijakan desentralisasi pemerintahan di Indonesia. Jurnal Bina Praja, 7(2), 111–130.

Mahendra, G. K. (2019). Analisis dampak penghentian tugas KPA Kota Yogyakarta berdasarkan Peraturan Presiden Nomor 124 Tahun 2016. Kebijakan: Jurnal Ilmu Administrasi, 10(2).

Mahmood, S., Sequeira, R., Siddiqui, M. M. U., Herkenhoff, M. B. A., Ferreira, P. P., & Campos Fernandes, A. (2024). Decentralization of the health system: Experiences from Pakistan, Portugal, and Brazil. Health Research Policy and Systems, 22, https://doi.org/10.1186/s12961-024-01145-3

Mann, J., Gruskin, S., Grodin, M. A., & Annas, G. J. (1994). AIDS and human rights. Health and Human Rights, 1(1), 6–23.

Maneemai, O., Maneemai, K., Rattanatanyapat, P., & Choorassamee, J. (2026). A systematic review of the effects of decentralization on health system performance, equity, and health outcomes. Journal of Cultural Analysis and Social Change, 11(1), 1007–1018.

Mitsel, M., Mahendradhata, Y., & Padmawati, R. S. (2024). Peran stakeholder kunci dalam kebijakan penanggulangan dan pencegahan HIV/AIDS: Studi kasus di Kabupaten Sorong, Provinsi Papua Barat. Jurnal Kebijakan Kesehatan Indonesia.

Munafhal, Y. (2015). Hukum administrasi negara. Riau: Marpoyan Tujuh.

Odoom, D. (2016). Conceptualizing decentralization: Reflecting on some existing literature. Applied Research Journal, 1(4), 21–38.

Oliveira, R., Santinha, G., & Sá Marques, T. (2024). The impacts of health decentralization on equity, efficiency, and effectiveness: A scoping review. Sustainability, 16(1), 386. https://doi.org/10.3390/su16010386

Peters, B. G. (2010). The politics of bureaucracy (6th ed.). London: Routledge.

Pradana, A. A. (2021). Epidemiologi penyakit menular: Pengantar bagi mahasiswa kesehatan. Depok: Rajawali Press.

Rahardjo, S. (2006). Ilmu hukum. Bandung: Citra Aditya Bakti.

Rupiarsieh. (2020). Evaluasi kebijakan penanggulangan HIV/AIDS di Kabupaten Bojonegoro (Studi kasus di Dinas Kesehatan). JIAN (Jurnal Ilmiah Administrasi Negara), 4(1), 14–19.

Saltman, R. B., Vaida, B., & Karsten, V. (2010). Decentralization in health care: Strategies and outcomes. New York: Open University Press.

Siswidiyanto, & Sahputri, R. A. M. (2023). Decentralisation and human development in Indonesia: The importance of local government capacity in delivering development outputs and outcomes. Lex Localis – Journal of Local Self-Government, 21(2), 393–419. https://doi.org/10.4335/21.2.393-419(2023)

United Nations. (1998). HIV/AIDS and human rights: International guidelines (Second international consultation on HIV/AIDS and human rights). New York & Geneva: United Nations.

Witcahyo, E., Gani, A., & Suwandi, I. M. (2025). The role of decentralized health systems in shaping service quality: A systematic review in low- and middle-income countries. Jurnal Kesehatan Masyarakat, 21(2)

Published

2026-03-10

Issue

Section

Articles