Interagency Communication of Stroke Burden to Inform Health Policy Decision in Indonesia

Non-communicable diseases (NCDs) threaten population health and fiscal sustainability in low- and middle-income countries. In Indonesia, abundant evidence on stroke coexists with fragmented policy responses, an information–policy paradox. Using stroke as a tracer condition, this study examined how interagency communication shapes collaborative governance among health, finance, and planning institutions. An embedded qualitative case study combined document analysis (n = 47), four focus group discussions (28 participants), and 15 semi-structured interviews with national and subnational stakeholders. Data were coded thematically and mapped to three collaborative governance dimensions: starting conditions, institutional design, and collaborative process. We identified eight communication barriers, including overlapping mandates, fragmented information flows, coordination without follow-through, and divergent institutional frames. Health stakeholders framed stroke as a clinical burden; finance stakeholders framed it as a budgetary risk. Participants’ accounts suggest that presenting stroke burden as a shared fiscal concern may help bridge these logics, which we treat as a proposed mechanism rather than a demonstrated condition for policy alignment. The findings informed a Strategic Communication Plan combining stakeholder-specific messaging, coordination routines, shared indicators, and joint accountability; its effects require evaluation. Interagency communication is a necessary but not sufficient component of collaborative governance, operating alongside political, fiscal, and regulatory conditions.