Strengthening Organizational Resilience to Sustain Drug Rehabilitation Services During Crisis: Evidence from Indonesia

Background:

The COVID-19 pandemic exposed critical fragilities in drug rehabilitation systems worldwide, particularly in low-resource settings where continuity of care depends on coordination across health, social, and policy sectors. Strengthening organizational resilience is increasingly recognized as essential; however, empirical evidence on how cross-sectoral resilience mechanisms sustain service effectiveness remains limited.

Methods:

A quantitative cross-sectional study was conducted involving 162 staff members from a National Narcotics Board rehabilitation center in Indonesia. Structural Equation Modeling (SEM) was used to examine the relationship between organizational resilience and service effectiveness. Organizational resilience was conceptualized across three dimensions: (1) leadership and adaptive organizational culture, (2) internal and cross-sectoral networks, and (3) readiness for change. Service effectiveness was measured through service production, efficiency, staff satisfaction, adaptability, and organizational development.

Results:

Organizational resilience had a significant positive effect on service effectiveness. Leadership stability and adaptive culture were the strongest predictors of sustained service delivery. Strong internal coordination and cross-sectoral collaboration—particularly with health, social support, and community stakeholders—were critical in maintaining continuity of care under crisis conditions. However, human resource constraints and leadership turnover reduced responsiveness and service optimization.

Conclusions:

This study provides robust quantitative evidence that organizational resilience, particularly when supported by cross-sector collaboration, is a key determinant of effective and sustained drug rehabilitation services during crises.

Implications for Policy and Practice:

Findings highlight the need to institutionalize resilience through: (1) leadership continuity strategies, (2) workforce surge capacity and staff well-being systems, and (3) formalized inter-agency coordination mechanisms. Embedding these approaches supports uninterrupted, client-centered, and rights-based care, ensuring equitable access to treatment during emergencies. These lessons are highly transferable to low- and middle-income countries seeking to strengthen integrated, resilient drug treatment systems and improve global collaboration in the substance use field.