Strategies of the Palu City Health Office in Achieving a Healthy City

  • Fadly Umar Doctoral Program in Social Sciences, Universitas Tadulako, Palu, Sulawesi Tengah, Indonesia. Faculty of Public Health, Universitas Muhammadiyah Palu, Sulawesi Tengah, Indonesia
  • Muhammad Khairil Faculty of Social and Politic Science, Tadulako University, Sulawesi Tengah, Indonesia
  • Ardi Munir Faculty of Medicine, Tadulako University, Sulawesi Tengah, Indonesia
DOI: https://doi.org/10.56338/mppki.v8i11.8493
Keywords: Healthy City, AGIL Framework, Indonesia, WHO Healthy City, Community Participation, Health Governance

Abstract

Introduction: This study aimed to analyze the strategies implemented by the Health Office of Palu City in realizing a Healthy City, as part of Indonesia’s national movement toward achieving the World Health Organization (WHO) Healthy City framework. The program emphasizes cross-sector collaboration and active community participation, which remain crucial in addressing challenges of urbanization, social inequality, and limited health infrastructure.

Methods: A qualitative case study design guided by Parsons’ AGIL functional framework was applied to explore adaptive, integrative, goal-oriented, and latent dimensions of health governance. Data were collected through in-depth interviews, observations, and document reviews involving key stakeholders such as health officials, community leaders, health cadres, and social organizations (e.g., PKK and NGOs). Data were analyzed thematically using NVivo 12 Plus. Ethical clearance was obtained, and all participants provided informed consent.

Results: The findings revealed that the Health Office strategies were categorized into the four AGIL functional dimensions: (1) Adaptation, through fiscal adjustment and program prioritization; (2) Integration, via inter-sectoral coordination and disaster response mechanisms; (3) Goal Attainment, through leadership alignment with municipal health targets; and (4) Latency, through sustained community participation and cadre-led education. These strategies strengthened social structures, communication forums, and community-based initiatives such as GERMAS and open defecation elimination. Despite these efforts, key barriers persisted—namely, limited budget allocation, weak cross-sectoral institutionalization, and uneven citizen engagement across subdistricts.

Conclusion: The study concludes that a socially grounded, AGIL-informed collaborative strategy adopted by the Health Office is effective in promoting the WHO Healthy City initiative within Indonesia’s decentralized governance context. These findings contribute theoretically to the discourse on social determinants of health and systems theory, and offer practical implications for strengthening local government capacity, budgeting, and inter-sectoral health policies.

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References

  1. Coovadia H, Jewkes R, Barron P, Sanders D, McIntyre D. The health and health system of South Africa: historical roots of current public health challenges. Lancet. 2009;374(9692):817–34. 10.1016/S0140-6736(09)60951-X
  2. Holdaway J, Krafft T, Wang W. Migration and health in China: challenges and responses. IHDP Updat. 2011;2011(1):35–41.
  3. Guerra G, Gutiérrez ACQ, Buitrago-Garcia D, Gabrani J, Raguindin PF. The Latin American Call for Young Researcher Editorials: Identifying the Public Health Challenges in One of the Most Unequal Regions in the World. Int J Public Health. 2023;68:1606830. https://doi.org/10.3389/ijph.2023.1606830
  4. Srinivasan S, O’fallon LR, Dearry A. Creating healthy communities, healthy homes, healthy people: initiating a research agenda on the built environment and public health. Am J Public Health. 2003;93(9):1446–50. doi: 10.2105/ajph.93.9.1446.
  5. Salgado M, Madureira J, Mendes AS, Torres A, Teixeira JP, Oliveira MD. Environmental determinants of population health in urban settings. A systematic review. BMC Public Health. 2020;20(1):853. doi.org/10.1186/s12889-020-08905-0
  6. Bedimo-Rung AL, Mowen AJ, Cohen DA. The significance of parks to physical activity and public health: a conceptual model. Am J Prev Med. 2005;28(2):159–68. doi: 10.1016/j.amepre.2004.10.024.
  7. Maller C, Townsend M, Pryor A, Brown P, St Leger L. Healthy nature healthy people:‘contact with nature’as an upstream health promotion intervention for populations. Health Promot Int. 2006;21(1):45–54. DOI: 10.1093/heapro/dai032
  8. Miharti S, Holzhacker RL, Wittek R. Decentralization and primary health care innovations in Indonesia. In: Decentralization and Governance in Indonesia. Springer; 2015. p. 53–78. https://doi.org/10.1007/978-3-319-22434-3_3
  9. Palutturi S, Zulkifli A, Syam A. The Key Challenges and Recommendations for Healthy Cities Implementation of North Kolaka, Indonesia. Indian J Public Heal Res Dev. 2017;8(2). DOI:10.5958/0976-5506.2017.00121.8
  10. Idrus S Al. Political Change and Urban Growth in a Medium-sized Outer Island Capital in Indonesia: The Case of Palu, Central Sulawesi. 2022;
  11. De Leeuw E, Simos J. Healthy cities: the theory, policy, and practice of value-based urban planning. Springer; 2017.
  12. Tancred T, Caffrey M, Falkenbach M, Raven J. The pathway to health in all policies through intersectoral collaboration on the health workforce: a scoping review. Health Policy Plan. 2024;39(Suppl 2):i54. doi: 10.1093/heapol/czae046
  13. Berglund?Snodgrass L, Fjellfeldt M, Högström E, Markström U. A Healthy City for All? Social Services’ Roles in Collaborative Urban Development. Urban Plan. 2022;7(4):113–23. DOI: https://doi.org/10.17645/up.v7i4.5620
  14. Lilly K, Kean B, Hallett J, Robinson S, Selvey LA. Factors of the policy process influencing Health in All Policies in local government: a scoping review. Front Public Heal. 2023;11:1010335. DOI: 10.3389/fpubh.2023.1010335
  15. Kuantitatif PP. Metode penelitian kunatitatif kualitatif dan R&D. Alf Bandung. 2016;
  16. Creswell JW, Creswell JD. Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications; 2017.
  17. Saad JM, Prochaska JO. A philosophy of health: life as reality, health as a universal value. Palgrave Commun. 2020;6(1):1–11. 10.1057/s41599-020-0420-9
  18. Montenegro C, Green J. Engagement and qualitative sociology in health research: proximal, but incongruent: C. Montenegro, J. Green. Soc Theory Heal. 2025;23(1):12. DOI:10.1057/s41285-025-00231-y
  19. Rifqi M, Situmeang MK, Mahmuddin M, Murdani T. THE ROLE OF FORUM BANGUN ACEH (FBA) IN COMMUNITY EMPOWERMENT BASED ON SOCIAL INCLUSION THROUGH THE INGIN MAJU COMMUNITY SELF-HELP GROUP (KSM) IN GAMPONG LUTHU DAYAH KRUENG-ACEH BESAR. J Al-Ijtimaiyyah. 2024;10(1):132–44. 10.22373/al-ijtimaiyyah.v10i1.23975
  20. Hidayat MS, Mahmood A, Moss J. Decentralisation in Indonesia: the impact on local health programs. J Kesehat Masy. 2018;12(2):68–77.
  21. Nisaid Y, Wijaya AAM, Mayunita S. EVALUASI PROGRAM KOTA SEHAT DI KECAMATAN WOLIO KOTA BAUBAU. J Publicuho. 2024;7(3):1164–74. https://doi.org/10.35817/publicuho.v7i3.474
  22. Parsons T. The social system. Routledge; 2013.
  23. King A. The structure of social theory. Routledge; 2004. https://doi.org/10.4324/9780203646694
  24. Meyer DZ, Avery LM. Excel as a qualitative data analysis tool. Field methods. 2009;21(1):91–112. https://doi.org/10.1177/1525822X08323985
  25. Shoesmith D. Decentralised governance in Indonesia’s disadvantaged regions: Resource and institutional constraints. Asian J Polit Sci. 2020;28(3):324–41. https://doi.org/10.1177/18681034209631
Published
2025-11-01
How to Cite
Umar, F., Muhammad Khairil, & Ardi Munir. (2025). Strategies of the Palu City Health Office in Achieving a Healthy City . Media Publikasi Promosi Kesehatan Indonesia (MPPKI), 8(11), 1337-1347. https://doi.org/10.56338/mppki.v8i11.8493
Issue
Vol. 8 No. 11 (2025)
Section
Article

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