Abstract
Effective management of environmental health programs in community health centers (Puskesmas) is crucial to prevent diseases such as acute respiratory infections, diarrhea, and leptospirosis. However, existing practices often rely on reactive rather than preventive risk assessments, limiting program effectiveness. This study investigates the application of the Government Internal Control System (SPIP) in managing environmental health programs, focusing on the mediating roles of transparency and data quality, and the reinforcing role of internal audits. A qualitative descriptive approach was used through interviews with Puskesmas leaders, sanitarians, program staff, and internal auditors, combined with observations and document review. The findings show that transparency in budgeting and program activities, as well as the quality of health data, critically mediate SPIP’s effectiveness, while internal audits remain compliance-oriented. The study contributes conceptually by extending internal control literature to program outcomes and recommends integrating SPIP with transparent, data-driven, and outcome-focused monitoring to strengthen accountability.
References
Abdillah, R. P. A., Aisy, A. R., & Wasir, R. (2025). Mengatasi Hambatan Struktural Dalam Peningkatan Akses Universal Ke Layanan Kesehatan di Indonesia. Indonesian Journal of Health Science, 5(2), 382-388. http://dx.doi.org/10.54957/ijhs.v5i2.1454
COSO. (2013). COSO Internal Control – Integrated Framework (2013). KPMG. https://assets.kpmg.com/content/dam/kpmg/pdf/2016/05/2750-New-COSO-2013-Framework-WHITEPAPER-V4.pdf
Kamara, A. K. (2023). The Study on Effectiveness of Internal Audit on the Performance of the Public Sector in Sierra Leone: A Case Study of the National Social Security Insurance Trust. Open Access Library Journal, 10, 1-30. https://doi.org/10.4236/oalib.1110431
Kementerian Kesehatan. (2022). Peraturan Menteri Kesehatan Nomor 18 Tahun 2022 tentang Satu Data Kesehatan. Jakarta: Kemenkes RI.
Kementerian Kesehatan. (2023). Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/MENKES/165/2023 tentang Instrumen Akreditasi Puskesmas, Klinik Pratama, Tempat Praktik Mandiri Dokter, dan Dokter Gigi. Jakarta: Kemenkes RI.
Kementerian Kesehatan . (2023). Petunjuk Teknis Peningkatan Kualitas Data Bidang Kesehatan 2023. Pusat Data dan Teknologi Informasi: Jakarta. https://kemkes.go.id/app_asset/file_content_download/172248141466aafb0645ec63.56962287.pdf
Liu, Y., Liu, Q., & Wei, Y. (2025). Digital finance, Internal Control, and Audit Quality. Finance Research Letters, 76, 107033. https://doi.org/10.1016/j.frl.2025.107033
Lubis, H. Z., Sari, M., Ramadhany, A. A., Ovami, D. C., Brutu, I. R. (2024). Effect of Internal Audit, Internal Control, and Audit Quality on Fraud Prevention: Evidence from the Public Sector in Indonesia. Problems and Perspectives in Management, 22(2), 40-50. http://dx.doi.org/10.21511/ppm.22(2).2024.04
Miles, B., Huberman, A. M., & Saldana, J. (2014). Qualitative Data Analysis, A Methods Sourcebook Edition 3. USA: Sage Publications.
Nuryanto., Ma’aruf, F., & Purnomo, B. C. (2024). Analisis Kualitas Proses Layanan Kesehatan Lingkungan Dengan Pendekatan Quality Improvment Process (QIP), 23(2), 215-225. http://dx.doi.org/10.14710/jkli.23.2.215-225
OECD. (2020). OECD Public Integrity Handbook. OECD Publishing: Paris. https://doi.org/10.1787/ac8ed8e8-en
Oktavidiati, E., Yedilau, S., Wati, N., Yanuarti, R. (2023). Pelaksanaan Klinik Sanitasi Lingkungan Puskesmas Jalan Gedang Kota Bengkulu. Avicenna Jurnal Ilmiah, 17(2), 196 – 211. http://dx.doi.org/10.36085/avicenna.v17i3.4582
Pratolo, S., Mukti, A. H., & Sofyani, H. (2022). The Service Quality of Community Health Centers During the COVID-19 Pandemic: Do Governance Practices Benefit? Journal of Accounting and Investment, 23(2), 360-378. https://doi.org/10.18196/jai.v23i2.14324
Sihombing, A. V. D., & Triani, N. N. A. (2024). Internal Control’s Effect on Health Workers’ Performance in Puskesmas, Sidoarjo. Proceeding International Economic Conference of Business and Accounting, 1(01), 214–222. https://proceeding.unesa.ac.id/index.php/iecba/article/view/434
Suwardi., Choerudin, A., & Widodo, F. (2022). The Effect of Internal Control System on Financial Accountability of Regional Public Service Agency of Public Health Center (BLUD Puskesmas) During Covid-19 Pandemic . Jurnal Multidisiplin Madani, 2(8), 3421–3428. https://doi.org/10.55927/mudima.v2i8.1066
WHO. (2023a). Tracking Universal Health Coverage: 2023 Global Monitoring Report. WHO: Indonesia. https://www.who.int/publications/i/item/9789240080379
WHO. (2023b). Indonesia In The 2023 Universal Health Coverage Global Monitoring Report. WHO: Indonesia. https://www.who.int/indonesia/id/news/detail/16-11-2023-indonesia-in-the-2023-universal-health-coverage-global-monitoring-report
WHO. (2024). Laporan Bulanan WHO Health Emergencies. WHO: Indonesia. https://www.who.int/indonesia/id/publications/m/item/who-health-emergencies-monthly-report--june-2024
Zendrato, N., Nababan, D., Silitonga, E. M., Hidayat, W., Sitorus, M. E. J., Pane, M. (2022). Pengaruh Pengendalian Internal dan Gaya Kepemimpinan terhadap Kinerja Pegawai di UPTD Puskesmas Lotu Kabupaten Nias Utara. Prepotif: Jurnal Kesehatan Masyarakat, 6(1), 145-150. https://doi.org/10.31004/prepotif.v6i1.2761
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2025 Tika Pustika Fersari, Maureen Lewis; Anders Anell
