Achipelago-Based Governance Model for Health Services in Island Regions: A Case Study in Pangkajene and Kepulauan District, Indonesia

Abstract

This study explores health service governance in Pangkajene and Kepulauan District, which presents a unique challenge due to its island-based geography. The study aims to analyze the current structure, determinants, and performance of health service delivery and propose a responsive governance model. A qualitative approach is applied through literature review, key informant interviews, field observation, and focus group discussions. Findings reveal disparities in health access due to geographical, infrastructural, institutional, and human resource constraints. A new governance model is proposed, integrating geographic referral systems, mobile clinics, telemedicine, and community-based engagement. These findings contribute to policy recommendations for more adaptive and equitable health governance in archipelagic regions.