Building health systems resilience: understanding the social, economic, and cultural impacts of climate change from stakeholders' perspectives in Indonesia

Objectives: This study explores stakeholders' perspectives on the direct, social, economic, and cultural impacts of climate change on health in Indonesia and identifies possible strategies to enhance health system resilience. Methods: This study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines to ensure comprehensive and transparent reporting. Purposive sampling was used to select 22 stakeholders with relevant expertise, including government officials, representatives from international and professional health organizations, health workers, and community representatives. Semi-structured interviews were conducted, and data were analyzed using directed content analysis. Data saturation was reached when no new themes emerged. Results: The findings reveal significant challenges to Indonesia's health system due to climate change. Community awareness varies widely, with higher levels in disaster-prone areas. Socially, climate change has fostered community cooperation through collective adaptation efforts but has also led to tensions due to inequitable resource distribution. Economically, rising healthcare costs and financial instability, particularly in rural and disaster-prone regions, place a strain on the system. Culturally, there is a growing emphasis on environmental conservation, promoting eco-friendly practices and the integration of traditional and modern health approaches. Conclusion: Building health system resilience in Indonesia requires addressing the social, economic, and cultural impacts of climate change. Possible strategies include enhancing public health education, strengthening healthcare infrastructure, improving inter-agency coordination, and leveraging technology to support effective responses to climate-related health threats, ultimately promoting national health, social stability, and economic growth.