In large, decentralized countries like Indonesia, national health policies are interpreted and implemented by officials at many different levels, from provinces and districts to individual health facilities. At each level, policies may be adapted to local realities. But what local officials learn through implementation does not always make its way back to national decision-makers. That can make it hard to understand what is working, what is impeding progress, and what may need to change. In Indonesia, participatory national-subnational planning forums exist, but meaningful subnational input into policy evaluation remains limited.
To address these challenges, Indonesia’s Health Development Policy Agency (BKPK) in the Ministry of Health is working with Results for Development and Gadjah Mada University to build and test a structured, two-way policy feedback mechanism. This brief shares key lessons from developing the mechanism and its first pilot phase of implementation with three provincial health offices, six district health offices, and local health policy and systems research institutions from those districts.
Early lessons suggest that policy feedback mechanisms require trust and relationship-building, clear roles, regular opportunities for joint reflection, and institutional arrangements that enable implementation evidence to influence policy decisions. Ultimately, Indonesia’s leaders hope to embed two-way feedback and learning as a routine governance practice that connects policy design with implementation and enables adaptation to local realities.
This work brings together learning from R4D’s Asia Health Policy and Systems Research Initiative and Advancing Realistic Health System Design and Planning project, both funded by the Gates Foundation.
A related blog examines the development and early implementation of this policy feedback mechanism in Indonesia. Read it here.
