Health system resilience in the face of climate change: A policy scoping review of Indonesia

Fadilah Fitri Arsy, Michał Zabdyr-Jamróz , Saut Aritua Hasiholan Sagala, Ardhasena Sopaheluwakan, Bony Wiem Lestari 

Indonesia has experienced more frequent climate-driven disasters and a rise in climate-sensitive diseases, underscoring the need for stronger climate adaptation strategies in health. This study assessed policies across health and supporting sectors to evaluate their contribution to building a climate-resilient health system (CRHS) and strengthening emergency response capacity. We conducted a scoping review of national-level policies published between January 2015 and October 2025 to examine how regulations and programs contribute to the development of a CRHS and resilient emergency response. The analysis applied the World Health Organization framework to assess CRHS and the World Bank Frontline Scorecard to evaluate health system capacity for emergency response and climate- and disaster-risk management (CDRM). Ninety-eight policy documents and nine datasets were included. Overall progress toward a CRHS and capacity for emergency response and CDRM remains at a moderate or emerging level. Stronger performance was observed in leadership and governance alongside integrated disaster-response regulations, primarily reflecting long-standing programs addressing infectious diseases and recurrent natural hazards. However, substantial gaps persist in resilient infrastructure and technologies, surveillance systems, financing, health workforces, and climate and health research. Policies also remain concentrated mainly at the national level, with limited translation into technical guidance, insufficient attention to emerging risks such as heatwaves, and inadequate consideration of vulnerable populations. These findings indicate that, while Indonesia has established a policy foundation for a CRHS, advancing climate resilience will require stronger government commitment, multisectoral and cross-country collaboration, better integration of climate information into existing policies, sustainable and equitable financing, investment in health and climate research, as well as development of more technical guidance.