BACKGROUND AND IMPLEMENTATION CHALLENGES: Indonesia faces a critical tobacco epidemic, with one of the highest smoking rates globally and significant health and economic consequences. Subnational jurisdictions encounter unique challenges in implementing sustainable tobacco control measures, including limited data availability, inconsistent enforcement, and varying levels of political and community support. The Indonesia Sub-national Index of Tobacco Control Sustainability was developed to address these gaps, offering a standardized framework to assess and enhance tobacco control efforts at city and district levels. It targets local governments, policymakers, and public health advocates, emphasizing tailored interventions for diverse geographic and socio-political contexts.
INTERVENTION OR RESPONSE: The Index was developed by adapting international best practices to Indonesia’s decentralized governance system. The process included consultations with stakeholders, capacity-building workshops, and the design of context-specific indicators measuring policy implementation, enforcement, and sustainability. Collaboration with the Ministry of Health, Ministry of Home Affairs, civil society, academics, and health advocates ensured the framework's practicality and relevance. Implementation partners, including the Association of Health Offices (ADINKES) and local governments, played key roles. Data collection began in 2023 with 101 cities and expanded to 222 cities in 2024, refining the framework and establishing benchmarks for future evaluation.
RESULTS AND IMPACT: The Index is designed to provide critical insights into subnational tobacco control efforts, highlighting strengths, gaps, and areas for improvement. It aims to guide policy prioritization, resource allocation, and capacity-building activities across regions. By establishing benchmarks, the Index empowers stakeholders to monitor progress, foster accountability, and drive evidence-based decision-making.
CONCLUSIONS: The Indonesia Sub-national Index of Tobacco Control Sustainability demonstrates the potential of localized frameworks to improve accountability and long-term outcomes. Recommendations include enhancing local data systems, fostering stakeholder collaboration, and integrating the Index into national health strategies. This approach offers valuable insights for countries with decentralized governance.