Indonesia's health system operates across roughly 17,000 inhabited islands and 34 provinces under a governance model that has shifted repeatedly between centralization and decentralization since 1999. This narrative review synthesizes evidence on the governance and administration of healthcare in Indonesia across four domains: the regulatory and institutional framework, health financing and insurance administration, health service delivery administration, and cross-cutting governance challenges including pandemic response and digital transformation. Decentralization devolved substantial authority for health planning, financing, and workforce deployment to district governments, producing gains in local responsiveness alongside persistent disparities in service readiness, medicine availability, and workforce distribution. The National Health Insurance Program (Jaminan Kesehatan Nasional), administered by BPJS Kesehatan, has expanded population coverage but continues to face challenges of financing equity and provider payment sustainability. The 2023 Omnibus Health Law consolidated eleven prior statutes into a single regulatory framework, introducing both opportunities for coherence and concerns regarding recentralization and reduced local participation. Governance of primary care, hospitals, and the health workforce remains uneven, while digital health platforms and pandemic-era coordination mechanisms illustrate both the promise and the fragmentation of multilevel stewardship. Strengthening accountability, financing equity, and institutional coordination across central and local government levels emerges as the central reform agenda for Indonesian healthcare governance.