Policy Collaboration And Adaptation In Strengthening Health Services In Ponorogo District

Abstract

This study explores how cross-sectoral collaboration and adaptive policymaking enhance the resilience of the local health system in Ponorogo Regency, Indonesia. Focusing on the revitalization of Posyandu (Integrated Health Service Posts) and the implementation of the Integrated Primary Health Services (ILP) Program, this qualitative case study employs a phenomenological approach to examine institutional and community dynamics. Data were collected through interviews, observations, FGDs, and documentation, with triangulation ensuring validity. The results highlight the effectiveness of collaborative governance involving village authorities, health cadres, medical staff, and citizens, which fostered participatory and sustainable service delivery. The ILP program, complemented by innovations such as Pesiar and CHEERS, improved access and non-communicable disease screening coverage to 86%. Policy adaptations such as cadre training, use of Village Funds, and the five-table Posyandu model demonstrate how local flexibility overcomes fiscal and geographic constraints. Routine evaluations via mini workshops further institutionalized learning and responsiveness. The Ponorogo case underscores the value of decentralized, context-specific, and inclusive approaches in public health policy. Its model offers practical insights for other regions aiming to develop collaborative, equity-oriented health service systems.