Negotiating Health Communication and Cultural Logics in Geographically Isolated Indonesia
DOI:
https://doi.org/10.33822/jep.v9i1.13181Keywords:
Vernacular bureaucracy, health communication, cultural logics, geographic isolation, COVID-19, indonesiaAbstract
Existing scholarship on health crisis governance often centers on urban infrastructures, overlooking the distinct communication dynamics of peripheral regions. This study investigates how COVID-19 health directives were organized, negotiated, and enacted within the geographically isolated community of Ulu Ogan, Indonesia. Adopting a qualitative approach, we analyzed in-depth interviews with six participants, ranging from district officials to health workers and community members. The findings reveal that pandemic communication did not function as a linear bureaucratic cascade but emerged as a process of “vernacular bureaucracy.” In this system, meso-level actors such as village heads and frontline health workersacted as discretionary intermediaries who translated rigid state protocols into local cultural logics. These actors navigated structural scarcity by reframing biomedical directives through indigenous practices of vigilance (Getage) and agrarian rhythms to maintain legitimacy. We argue that in geographically isolated settings, effective health governance relies less on command-and-control structures and more on the adaptive capacity of local institutions to hybridize formal mandates with community values. This study contributes to global health communication theory by conceptualizing vernacular bureaucracy as a critical mechanism for bridging administrative distance in the Global South.
References
Abimbola, S., Negin, J., Martiniuk, A. L., & Jan, S. (2017). Institutional analysis of health system governance. Health Policy and Planning, 32(9), 1337–1344. https://doi.org/10.1093/heapol/czx083
Abramowitz, S. A., McLean, K. E., McKune, S. L., Bardosh, K. L., Fallah, M., Monger, J., Tehoungue, K., & Omidian, P. A. (2015). Community-Centered Responses to Ebola in Urban Liberia: The View from Below. PLOS Neglected Tropical Diseases, 9(4), e0003706. https://doi.org/10.1371/journal.pntd.0003706
Agustina, R., Dartanto, T., Sitompul, R., Susiloretni, K. A., Suparmi, Achadi, E. L., Taher, A., Wirawan, F., Sungkar, S., Sudarmono, P., Shankar, A. H., Thabrany, H., Agustina, R., Dartanto, T., Sitompul, R., Susiloretni, K. A., Suparmi, Achadi, E. L., Taher, A., … Khusun, H. (2019). Universal health coverage in Indonesia: concept, progress, and challenges. The Lancet, 393(10166), 75–102. https://doi.org/10.1016/S0140-6736(18)31647-7
Airhihenbuwa, C. O., Iwelunmor, J., Munodawafa, D., Ford, C. L., Oni, T., Agyemang, C., Mota, C., Ikuomola, O. B., Simbayi, L., Fallah, M. P., Qian, Z., Makinwa, B., Niang, C., & Okosun, I. (2020). Culture Matters in Communicating the Global Response to COVID-19. Preventing Chronic Disease, 17, 200245. https://doi.org/10.5888/pcd17.200245
Antlöv, H., Wetterberg, A., & Dharmawan, L. (2016). Village Governance, Community Life, and the 2014 Village Law in Indonesia. Bulletin of Indonesian Economic Studies, 52(2), 161–183. https://doi.org/10.1080/00074918.2015.1129047
Apriliani, R., & Abisono, F. Q. (2023). Cultural Approach in Responding to theCrisis of Public Trust Sleman Government’s Strategy in Encouraging COVID-19Vaccination. Jurnal Komunikasi Indonesia, 12(1), 171–183. https://doi.org/10.7454/jkmi.v12i1.1186
Berenschot, W., & van Klinken, G. (2018). Informality and citizenship: the everyday state in Indonesia. Citizenship Studies, 22(2), 95–111. https://doi.org/10.1080/13621025.2018.1445494
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Brodkin, E. Z. (2012). Reflections on Street‐Level Bureaucracy: Past, Present, and Future. Public Administration Review, 72(6), 940–949. https://doi.org/10.1111/j.1540-6210.2012.02657.x
Capano, G., Howlett, M., Jarvis, D. S. L., Ramesh, M., & Goyal, N. (2020). Mobilizing Policy (In) Capacity to Fight COVID-19: Understanding Variations in State Responses. Policy and Society, 39(3), 285–308. https://doi.org/10.1080/14494035.2020.1787628
Cleaver, F. (2002). Reinventing Institutions: Bricolage and the Social Embeddedness of Natural Resource Management. The European Journal of Development Research, 14(2), 11–30. https://doi.org/10.1080/714000425
De Koning, J., & Cleaver, F. (2012). Institutional Bricolage in Community Forestry: An Agenda for Future Research. In B. Arts, S. Bommel, M. Ros-Tonen, & G. Verschoor (Eds.), Forest-people interfaces (pp. 277–290). Wageningen Academic Publishers. https://doi.org/10.3920/978-90-8686-749-3_17
Djalante, R., Lassa, J., Setiamarga, D., Sudjatma, A., Indrawan, M., Haryanto, B., Mahfud, C., Sinapoy, M. S., Djalante, S., Rafliana, I., Gunawan, L. A., Surtiari, G. A. K., & Warsilah, H. (2020). Review and analysis of current responses to COVID-19 in Indonesia: Period of January to March 2020. Progress in Disaster Science, 6, 100091. https://doi.org/10.1016/j.pdisas.2020.100091
Dutta, Mohan J. (2007). Communicating About Culture and Health: Theorizing Culture-Centered and Cultural Sensitivity Approaches. Communication Theory, 17(3), 304–328. https://doi.org/10.1111/j.1468-2885.2007.00297.x
Dutta, Mohan J. (2015). Decolonizing Communication for Social Change : A Culture-Centered Approach. Communication Theory, 25(2), 123–143. https://doi.org/10.1111/comt.12067
Dutta, Mohan Jyoti. (2020). COVID-19, Authoritarian Neoliberalism, and Precarious Migrant Work in Singapore: Structural Violence and Communicative Inequality. Frontiers in Communication, 5. https://doi.org/10.3389/fcomm.2020.00058
Dwyer, S. C., & Buckle, J. L. (2009). The Space Between: On Being an Insider-Outsider in Qualitative Research. International Journal of Qualitative Methods, 8(1), 54–63. https://doi.org/10.1177/160940690900800105
Erasmus, E. (2014). The use of street-level bureaucracy theory in health policy analysis in low- and middle-income countries: a meta-ethnographic synthesis. Health Policy and Planning, 29(suppl 3), iii70–iii78. https://doi.org/10.1093/heapol/czu112
Fernandes, A., Santinha, G., & Forte, T. (2022). Public Service Motivation and Determining Factors to Attract and Retain Health Professionals in the Public Sector: A Systematic Review. Behavioral Sciences, 12(4), 95. https://doi.org/10.3390/bs12040095
George, A. S., LeFevre, A. E., Schleiff, M., Mancuso, A., Sacks, E., & Sarriot, E. (2018). Hubris, humility and humanity: expanding evidence approaches for improving and sustaining community health programmes. BMJ Global Health, 3(3), e000811. https://doi.org/10.1136/bmjgh-2018-000811
Gilson, L., Barasa, E., Nxumalo, N., Cleary, S., Goudge, J., Molyneux, S., Tsofa, B., & Lehmann, U. (2017). Everyday resilience in district health systems: emerging insights from the front lines in Kenya and South Africa. BMJ Global Health, 2(2), e000224. https://doi.org/10.1136/bmjgh-2016-000224
Gupta, A. (1995). Blurred Boundaries: The Discourse of Corruption, The Culture of Politics, and The Imagined State. American Ethnologist, 22(2), 375–402. https://doi.org/10.1525/ae.1995.22.2.02a00090
Haldane, V., De Foo, C., Abdalla, S. M., Jung, A.-S., Tan, M., Wu, S., Chua, A., Verma, M., Shrestha, P., Singh, S., Perez, T., Tan, S. M., Bartos, M., Mabuchi, S., Bonk, M., McNab, C., Werner, G. K., Panjabi, R., Nordström, A., & Legido-Quigley, H. (2021). Health systems resilience in managing the COVID-19 pandemic: lessons from 28 countries. Nature Medicine, 27(6), 964–980. https://doi.org/10.1038/s41591-021-01381-y
Hazfiarini, A., Akter, S., Homer, C. S. E., Zahroh, R. I., & Bohren, M. A. (2022). ‘We are going into battle without appropriate armour’: A qualitative study of Indonesian midwives’ experiences in providing maternity care during the COVID-19 pandemic. Women and Birth, 35(5), 466–474. https://doi.org/10.1016/j.wombi.2021.10.003
Hazfiarini, A., Zahroh, R. I., Akter, S., Homer, C. S. E., & Bohren, M. A. (2022). Indonesian midwives’ perspectives on changes in the provision of maternity care during the COVID-19 pandemic: A qualitative study. Midwifery, 108, 103291. https://doi.org/10.1016/j.midw.2022.103291
Hyland-Wood, B., Gardner, J., Leask, J., & Ecker, U. K. H. (2021). Toward effective government communication strategies in the era of COVID-19. Humanities and Social Sciences Communications, 8(1), 30. https://doi.org/10.1057/s41599-020-00701-w
Loilatu, M. J., Sulistyaningsih, T., Irawan, B., Saiman, S., Akbar, P., Huda, M. N., & Putri, I. N. (2025). Street-Level Bureaucracy in Health Services During COVID-19 Outbreak in Indonesia. In P. Kumar, A. A. Hamid, P. Nand, & R. Kumar (Eds.), Transforming Public Administration Through AI-Driven Predictive Analytics (pp. 275–296). IGI Global Scientific Publishing. https://doi.org/10.4018/979-8-3373-3760-9.ch009
Lotta, G., Wenham, C., Nunes, J., & Pimenta, D. N. (2020). Community health workers reveal COVID-19 disaster in Brazil. The Lancet, 396(10248), 365–366. https://doi.org/10.1016/S0140-6736(20)31521-X
Mahendradhata, Y., Trisnantoro, L., Listyadewi, S., Soewondo, P., Marthias, T., Harimurti, P., & Prawira, J. (2017). Assessment of the health system. In The Republic of Indonesia Health System Review. World Health Organization. http://www.jstor.org/stable/resrep28452.14
Marston, C., Renedo, A., & Miles, S. (2020). Community participation is crucial in a pandemic. The Lancet, 395(10238), 1676–1678. https://doi.org/10.1016/S0140-6736(20)31054-0
Mietzner, M. (2020). Populist Anti-Scientism, Religious Polarisation, and Institutionalised Corruption: How Indonesia’s Democratic Decline Shaped Its COVID-19 Response. Journal of Current Southeast Asian Affairs, 39(2), 227–249. https://doi.org/10.1177/1868103420935561
Moon, M. J. (2020). Fighting COVID‐19 with Agility, Transparency, and Participation: Wicked Policy Problems and New Governance Challenges. Public Administration Review, 80(4), 651–656. https://doi.org/10.1111/puar.13214
Mosse, D. (2004). Is Good Policy Unimplementable? Reflections on the Ethnography of Aid Policy and Practice. Development and Change, 35(4), 639–671. https://doi.org/10.1111/j.0012-155X.2004.00374.x
Nanda, P., Lewis, T. N., Das, P., & Krishnan, S. (2020). From the frontlines to centre stage: resilience of frontline health workers in the context of COVID-19. Sexual and Reproductive Health Matters, 28(1), 1837413. https://doi.org/10.1080/26410397.2020.1837413
Napier, A. D., Ancarno, C., Butler, B., Calabrese, J., Chater, A., Chatterjee, H., Guesnet, F., Horne, R., Jacyna, S., Jadhav, S., Macdonald, A., Neuendorf, U., Parkhurst, A., Reynolds, R., Scambler, G., Shamdasani, S., Smith, S. Z., Stougaard-Nielsen, J., Thomson, L., … Woolf, K. (2014). Culture and health. The Lancet, 384(9954), 1607–1639. https://doi.org/10.1016/S0140-6736(14)61603-2
Olivia, S., Gibson, J., & Nasrudin, R. (2020). Indonesia in the Time of Covid-19. Bulletin of Indonesian Economic Studies, 56(2), 143–174. https://doi.org/10.1080/00074918.2020.1798581
Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015). Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method Implementation Research. Administration and Policy in Mental Health and Mental Health Services Research, 42(5), 533–544. https://doi.org/10.1007/s10488-013-0528-y
Permana, P. A., & Rakhmani, I. (2023). The Social Sciences in a Time of Crisis: Indonesia’s Response to the COVID-19 Pandemic. Journal of Social Issues in Southeast Asia, 38(3), 356–385. https://doi.org/10.1355/sj38-3c
Peters, D. J. (2020). Community Susceptibility and Resiliency to COVID‐19 Across the Rural‐Urban Continuum in the United States. The Journal of Rural Health, 36(3), 446–456. https://doi.org/10.1111/jrh.12477
Putra, F. (2023). Village Governance and Public Participation in Indonesia. Journal of Interdisciplinary Socio-Economic and Community Study, 3(2), 55–64. https://doi.org/10.21776/jiscos.03.2.02
Reynolds, B., & Seeger, M. W. (2005). Crisis and Emergency Risk Communication as an Integrative Model. Journal of Health Communication, 10(1), 43–55. https://doi.org/10.1080/10810730590904571
Roziqin, A., Mas’udi, S. Y. F., & Sihidi, I. T. (2021). An analysis of Indonesian government policies against COVID-19. Public Administration and Policy, 24(1), 92–107. https://doi.org/10.1108/PAP-08-2020-0039
Shannon, G., Basu, P., Peters, L. E. R., Clark-Ginsberg, A., Herrera Delgado, T. M., Gope, R., Guanilo, M., Kelman, I., Noelli, L., Meriläinen, E., Riley, K., Wood, C., & Prost, A. (2023). Think global, act local: using a translocal approach to understand community-based organisations’ responses to planetary health crises during COVID-19. The Lancet Planetary Health, 7(10), e850–e858. https://doi.org/10.1016/S2542-5196(23)00193-6
Stansert Katzen, L., Dippenaar, E., Laurenzi, C. A., Rotheram Borus, M. J., le Roux, K., Skeen, S., & Tomlinson, M. (2022). Community health workers’ experiences of supervision in maternal and child health programmes in low‐ and middle‐income countries: A qualitative evidence synthesis. Health & Social Care in the Community, 30(6), 2170–2185. https://doi.org/10.1111/hsc.13893
Topp, S. M., & Chipukuma, J. M. (2016). How did rapid scale-up of HIV services impact on workplace and interpersonal trust in Zambian primary health centres: a case-based health systems analysis. BMJ Global Health, 1(4), e000179. https://doi.org/10.1136/bmjgh-2016-000179
Tracy, S. J. (2010). Qualitative Quality: Eight “Big-Tent” Criteria for Excellent Qualitative Research. Qualitative Inquiry, 16(10), 837–851. https://doi.org/10.1177/1077800410383121
Tummers, L., Bekkers, V., & Steijn, B. (2009). Policy Alienation of Public Professionals. Public Management Review, 11(5), 685–706. https://doi.org/10.1080/14719030902798230
Ved, R., Scott, K., Gupta, G., Ummer, O., Singh, S., Srivastava, A., & George, A. S. (2019). How are gender inequalities facing India’s one million ASHAs being addressed? Policy origins and adaptations for the world’s largest all-female community health worker programme. Human Resources for Health, 17(1), 3. https://doi.org/10.1186/s12960-018-0338-0
Vel, J. A. C., & Bedner, A. W. (2015). Decentralisation and village governance in Indonesia: the return to the nagari and the 2014 Village Law. The Journal of Legal Pluralism and Unofficial Law, 47(3), 493–507. https://doi.org/10.1080/07329113.2015.1109379
Whyle, E., & Olivier, J. (2020). Social values and health systems in health policy and systems research: a mixed-method systematic review and evidence map. Health Policy and Planning, 35(6), 735–751. https://doi.org/10.1093/heapol/czaa038
Wilkinson, A., Parker, M., Martineau, F., & Leach, M. (2017). Engaging “communities”: anthropological insights from the West African Ebola epidemic. Philosophical Transactions of the Royal Society B: Biological Sciences, 372(1721), 20160305. https://doi.org/10.1098/rstb.2016.0305
Yudha, E. P., Syamsiyah, N., Pardian, P., & Dina, R. A. (2023). Rural areas are more resilient than urban areas to the COVID-19 pandemic. Is it true? (Lessons from Indonesia). Human Geographies – Journal of Studies and Research in Human Geography, 17(2). https://doi.org/10.5719/hgeo.2023.172.4
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Akhmad Rosihan, Billy K. Sarwono, Camelia Catharina Pasandaran

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


