Community Health Centers (Puskesmas) are the spearhead of primary health services in Indonesia, playing an important role in ensuring equitable access and improving the quality of health services. However, the performance of Puskesmas still faces challenges related to the effectiveness and efficiency of resource utilization. This study aims to analyze strategies for improving the Puskesmas system from an economic perspective, focusing on the Health System Performance Framework approach based on WHO standards. The study employs a qualitative research method with a literature study approach. The research findings highlight key areas such as service delivery, health workforce, health financing, medical products and technologies, information systems, and leadership and governance. These are addressed through measures such as providing targeted, effective, and high-quality services; ensuring equitable distribution and competence of health workers; implementing fair and sustainable health financing; maintaining accurate and timely health data; and fostering transparent and accountable governance structures. Specifically, the study emphasizes the importance of strengthening service provision, improving the competency distribution of health workers, securing sustainable health financing mechanisms, maintaining reliable health information systems, and enhancing governance practices. The research underscores that a holistic and integrated approach is essential for strengthening Puskesmas performance, with critical implications for policy development, resource allocation, and management practices within the Indonesian primary healthcare system.
Putranto et al. (Wed,) studied this question.