Governance priorities and causal relationships in bpjs health insurance integration for vulnerable communities in banten province using a Fuzzy AHP–Fuzzy DEMATEL analysis

This study examines health insurance governance in the context of BPJS integration for vulnerable communities in Banten Province within the broader framework of Sustainable Development Goal (SDG) 3 and Universal Health Coverage (UHC). The study aims to assess the relative priority and structural relationships of selected governance dimensions using an integrated Fuzzy AHP–Fuzzy DEMATEL approach. Data were obtained from 15 experts representing health authorities, BPJS administrators, healthcare providers, academics, and practitioners. Five governance dimensions were assessed: Policy Coordination, Budget Transparency, Service Accessibility, Institutional Accountability, and Community Participation. Fuzzy AHP was used to determine their relative priorities, while Fuzzy DEMATEL was used to examine their relational positions within the assessed governance structure. The Fuzzy AHP results rank Policy Coordination first (0.4405), followed by Budget Transparency (0.2417), Service Accessibility (0.1611), Institutional Accountability (0.1021), and Community Participation (0.0545). The Fuzzy DEMATEL results place Policy Coordination (D − R = + 1.0631) and Institutional Accountability (+ 0.0871) in the cause group, while Budget Transparency (− 0.0695), Service Accessibility (− 0.4444), and Community Participation (− 0.6364) are positioned in the effect group. Service Accessibility records the highest R value (5.6283). These findings provide an expert-based assessment of the relative priorities and structural positions of selected governance dimensions in the Banten BPJS integration context. The results offer a context-specific analytical reference for further research on health insurance governance and should not be interpreted as evidence of empirical causal effects or as a universal ranking applicable to other settings.