BACKGROUND AND IMPLEMENTATION CHALLENGES: The allocation of budgets for tobacco control in Indonesia faces significant challenges in the era of local autonomy, particularly at the subnational level. Historically, tobacco control programs have lacked a dedicated budget nomenclature within district health offices, making their funding vulnerable to reallocation and limiting transparency. Recognizing these issues, ADINKES (Association of Indonesia Local Health Offices ) initiated an advocacy process in 2021 to address the systemic barriers to securing tobacco control budgets.
INTERVENTION OR RESPONSE: The advocacy involved collaboration with the Ministry of Health (MoH) and the Ministry of Home Affairs (MoHA), culminating in the establishment of a specific budget nomenclature for tobacco control. This nomenclature was formalized through Policy No. 900.1.15.5-1317 in 2023 and integrated into the Governance Information System (SIPD) to streamline planning and budgeting processes for smoke-free area (KTR) implementation. Despite these advancements, adoption by districts remained limited, with fewer than 10 districts utilizing the nomenclature in 2023 due to factors such as weak policy enforcement, fixed budget cycles, and limited awareness.
RESULTS AND IMPACT: By 2024, advocacy and dissemination efforts expanded the use of the nomenclature to 63 districts/cities, comprising 17 cities and 46 districts. This progress highlights the importance of sustained engagement with subnational governments and continued policy enforcement by MoHA. However, challenges persist, including ensuring consistent implementation across regions and strengthening local capacity to manage tobacco control programs.
CONCLUSIONS: The results demonstrate that dedicated budget nomenclatures and systematic advocacy can significantly enhance the visibility and allocation of resources for tobacco control. Moving forward, intensified dissemination efforts, capacity-building initiatives, and enhanced monitoring mechanisms are essential to sustain progress and improve public health outcomes. This study underscores the critical role of policy innovation and multi-stakeholder collaboration in advancing tobacco control efforts at the subnational level.