The Climate and Health (C.H. 3.4) Research Team of the Partnership for Australia–Indonesia Research (PAIR) Sulawesi, a collaboration between Universitas Hasanuddin, Institut Teknologi Bandung, and the University of Melbourne, carried out a Focus Group Discussion (FGD) over two days in Central Buton Regency. Sessions 1 and 2 were held on Monday, 8 December 2025, followed by Session 3 on Tuesday, 9 December 2025, with each session lasting around three hours. All activities took place at the Kiyjula Hall, 5th Floor of the Central Buton Regent’s Office, Central Buton Regency, Southeast Sulawesi Province. The venue was selected for its accessibility, comfort, and the availability of facilities suited to productive group discussions.
The PAIR Sulawesi programme is led by the Australia-Indonesia Centre (AIC) with direct support from the Ministry of Education, Higher Education, Science, and Technology of the Republic of Indonesia (Kemdiktisaintek RI) alongside the Australian Government. Funding is provided jointly by the Indonesia Endowment Fund for Education (LPDP) and the Department of Foreign Affairs and Trade (DFAT) of the Australian Government.
The C.H. 3.4 PAIR Sulawesi research team is conducting a study entitled: “Climate-related Health Outcomes and Healthcare Access in Southeast and Central Sulawesi Provinces: Enabling Climate Resilient Policies and Governance.”
This topic was taken up in response to the rising incidence of diseases such as Dengue Haemorrhagic Fever (DHF) and diarrhoea, along with ongoing difficulties in healthcare access across Southeast Sulawesi. The research aims to examine how climate change is affecting public health and healthcare access in both Southeast and Central Sulawesi, with a particular focus on the increasing burden of climate-sensitive diseases. The FGD constituted a critical stage of this work, zeroing in on climate-health impacts and healthcare access in Southeast Sulawesi to generate evidence for adaptive, climate-resilient health policies and governance.
The FGD was conducted by the C.H. 3.4 PAIR Sulawesi Research Team. Those present in Central Buton were Prof. Dr. Phil. Sukri, S.I.P., M.Si as Coordinator; Prof. Rini Rachmawaty, S.Kep., Ns., MN., Ph.D as Partner Investigator; La Ode Muhammad Suyatno, S.Kep., Ns., M.Kep, Rati Mardatillah, S.Kep., Ns, and Dian Ekawaty, S.IP., M.Si as Research Assistants; Sri Wahyuni Yunus Kanang, S.Kep., Ns., M.Kep as Local Research Assistant; and Alfi Irtiyah Andini, S.Kep., Ns as Research Administrator. The team handled everything from planning and discussion facilitation to documentation and research data management.
The study uses a mixed-methods approach. The FGD served as the primary means of qualitative data collection, complemented by quantitative data gathering at the close of each discussion session. The discussions were designed to draw out, in depth, the perspectives, experiences, and assessments of stakeholders on how climate change is affecting community health — particularly through rising DHF and diarrhoea cases — and what this means for healthcare access and readiness. At the end of every session, participants also completed quantitative instruments prepared by the research team.
The FGD opened with a formal ceremony. Mr. Isran, S.Pd, M.Pd, Expert Staff to the Regent for Community Affairs and Human Resources, Central Buton Regency, officially launched the event. This was followed by a presentation of the research background, objectives, and discussion format by the PAIR Sulawesi C.H. 3.4 Team. Before the discussions began, all participants were asked to complete informed consent forms and publication agreements. Once everyone had signed, the structured and participatory discussions got underway, organised into sessions by stakeholder group. Alongside the qualitative exchanges, quantitative data were also collected at the end of each session to strengthen the research findings.
Session 1 ran from 08:30 to 12:00 WITA on Monday, 8 December 2025, and brought together nine participants from the policymaker group. The activity involved participants five They included the Head of Government and Human Development at Bappeda, Central Buton Regency (Rizal Septian, S.IP, M.Sc); the Head of Emergency and Logistics at BPBD, Central Buton Regency (Asmun, S.Pi); the Head of Community Health (Arsidi, S.Kep., Ns., M.Kes); the Head of Health Services (Hernawati, S.Kep., Ns); the Head of Disease Prevention and Control (Herman Jais, S.K.M); the Head of the Environmental Health, Occupational Health, and Sports Health Section (La Ode Alyakin, S.K.M); two staff members from the Central Buton Regency Health Office; and one staff representative from BMKG Baubau City. Guided by 22 questions, the discussion covered leadership and governance, disaster preparedness and risk management, financing and resource allocation, integrated risk monitoring and early warning systems, climate-informed health programmes, environmental determinant management, and policy barriers affecting vulnerable groups including matters of gender equality, disability, and social inclusion (GEDSI).
Session 2 took place that same afternoon, from 13:00 to 16:00 WITA, and involved eight participants from the community leader and civil society group. Present were Camat Lakudo (M. Nasir, S.Ag), Camat Mawasangka Timur (Surahman, S.IP), the Head of Sub-division of Kecamatan Mawasangka Tengah (Mardin, S.E), Lurah Gu Timur (Aryo Setiyadi, S.STP., M.Si), Lurah Lakorua (Amaludin, S.H), the Head of Desa Inulu (La Ade, S.T), the Head of the Community Welfare Section of Kelurahan Lakudo (Nuryanti Aana, S.T), and one staff representative from Desa Watorumbe Bata. The session’s 16 questions were aimed at exploring community health conditions, the vulnerability of specific groups, community capacity and resilience, public access to health services and information, and the role communities play in prevention, response, and advocacy around climate-related health policy. The conversation focused on firsthand experiences dealing with DHF and diarrhoea at the local level, prevention practices within communities, gotong royong (mutual aid) mechanisms, community-based early warning systems, and how communication and coordination with government agencies and health facilities actually function on the ground.
Session 3 was held on Tuesday, 9 December 2025, from 08:30 to 12:00 WITA, and drew fourteen participants from the healthcare provider group. Among them were the Chief Executive Officer (dr. Soraya, Sp.PD, MARS) and the Head of Support Services (Lili Jumiati, S.K.M) from RSUD Central Buton; the Head of Puskesmas Lakudo (Asriah, S.Kep., Ns) with two staff members; the Head of Puskesmas Watorumbe Bata (Nurmaida, S.K.M) with two staff members; the Head of Puskesmas Mawasangka Timur (Min Sari Kasa, Amd. Kep) with two staff members; and three staff representatives from Puskesmas Mawasangka Tengah. Across 23 questions, the discussion explored health workforce availability and capacity, service access and quality, case surveillance and reporting systems, health logistics and technology, and how well facilities are prepared to handle patient surges during extreme weather events. The questions were crafted to draw out the practical, on-the-ground experiences of health workers managing DHF and diarrhoea under climate pressures — including the challenges they face in the field, referral pathways, how climate data feeds into their decision-making, and where policy and service-system strengthening is most needed.
All three FGD sessions followed a consistent structure: a brief introduction, core discussions guided by the question protocol, and a closing round of quantitative instrument completion to bolster the research findings. Through these directed discussions, the activity sought to gather the views, experiences, and strategic recommendations of stakeholders across sectors all in service of supporting the development of health policies and governance frameworks that are both adaptive and resilient in the face of climate change. The cross-sectoral participation is expected to provide a well-rounded perspective on how climate factors, environmental conditions, healthcare capacity, and regional policy all connect.
The entire series of activities ran smoothly and in good order, with strong, active participation from attendees throughout. The findings from these discussions are expected to serve as a basis for developing evidence-based policy recommendations and for strengthening a health system that is more responsive and sustainable in confronting the impacts of climate change across Central Buton, Southeast Sulawesi. This activity contributes to the Sustainable Development Goals (SDGs), specifically SDG 1 (No Poverty) by addressing the disproportionate burden of climate-sensitive diseases on the most economically vulnerable communities in Central Buton, including those with limited access to healthcare; SDG 3 (Good Health and Well-Being) by generating evidence to strengthen climate-resilient health systems and reduce the incidence of DHF and diarrhoea across Southeast Sulawesi; SDG 15 (Life on Land) by examining how environmental and land-based ecological changes in the region contribute to shifting disease patterns and increased health vulnerability; and SDG 17 (Partnerships for the Goals) through the Australia-Indonesia multi-institutional research partnership between Universitas Hasanuddin, Institut Teknologi Bandung, and the University of Melbourne, jointly funded by LPDP and DFAT
