Health System Preparedness for Sea-Level Rise in Jakarta: A Scoping Review Revealing Critical Evidence Gaps

This scoping review systematically maps empirical and grey literature evidence on Jakarta's health system preparedness for sea-level rise and coastal flooding impacts over a 25-year planning horizon. BACKGROUND: Jakarta faces severe compounding climate threats including land subsidence (1-15 cm/year) and sea-level rise that could submerge 17% of the city by 2030. While health systems are critical infrastructure during climate-related disasters, systematic evidence on preparedness for progressive coastal inundation remains poorly characterized. FRAMEWORK: This review employs the Paschoalotto et al. (2025) health system resilience framework, which distinguishes steady-state performance from resilience-specific adaptive capacities across nine dimensions: (1) Governance, (2) Leadership, (3) Regulation, (4) Financing, (5) Health Workforce, (6) Physical Resources, (7) Medicines, (8) Technology, and (9) Service Delivery. The framework assigns indicators across multiple governance levels (national, provincial, district, facility), enabling analysis of preparedness responsibilities within Jakarta's decentralized administrative structure. PRIMARY OBJECTIVE: To systematically map and synthesize available evidence on Jakarta's health system preparedness for sea-level rise and coastal flooding impacts. SPECIFIC OBJECTIVES: - Identify and characterize studies assessing Jakarta's health system preparedness across nine core dimensions - Determine extent to which existing literature addresses sea-level rise specifically versus general disaster or flooding preparedness - Identify temporal scope of existing assessments (current state vs. future projections; time horizons employed) - Map geographic variation in evidence within Jakarta (district-level, facility-level) - Identify critical evidence gaps requiring urgent research attention - Provide preliminary spatial analysis illustrating potential health system vulnerabilities METHODS: Following JBI scoping review methodology and PRISMA-ScR guidelines. Database searches conducted in PubMed, Scopus, Web of Science, Global Index Medicus, and Google Scholar (January 2026), supplemented by grey literature sources and AI-assisted semantic search (Elicit.org). Single-reviewer screening with faculty advisor verification. ELIGIBILITY: Studies must be Jakarta-specific, address at least one of nine health system dimensions, relate to flooding/climate change/disaster preparedness, present empirical data or evidence-based assessment, published 2000-present, in English or Indonesian. DATA EXTRACTION: Standardized extraction capturing: (a) which of nine dimensions assessed, (b) governance level(s) addressed, (c) performance vs. resilience indicators, (d) climate specificity (general disaster/flood/SLR), (e) temporal horizons, (f) geographic patterns, (g) vulnerabilities identified. SYNTHESIS: Evidence matrix mapping preparedness assessments across nine dimensions and governance levels; narrative synthesis organized by dimension and climate specificity; quantitative descriptive summaries; supplementary GIS analysis identifying healthcare access vulnerabilities in flood-exposed zones. EXPECTED OUTCOMES: First systematic evidence map of Jakarta's health system preparedness for SLR/coastal flooding; identification of evidence gaps (hypothesis: Jakarta has performance assessments but lacks SLR-specific resilience assessments); preliminary spatial vulnerability estimates; research priority recommendations. REGISTRATION DATE: February 15, 2026