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p-Index From 2021 - 2026
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All Journal Toba: Journal of Tourism, Hospitality, and Destination
Nyoman Diah Utari Dewi
Ngurah Rai University
Social Sciences

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Collaborative Governance in Medical Tourism Development Policy: A Document-Based Policy Analysis of Bali International Hospital in the Sanur Special Economic Zone Sang Made Erlangga Dwipayana; Nyoman Diah Utari Dewi; Mohd Hafiz Hanafiah
TOBA: Journal of Tourism, Hospitality, and Destination Vol. 5 No. 3 (2026): Agustus 2026
Publisher : Yayasan Literasi Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55123/toba.v5i3.9099

Abstract

Medical tourism has become a strategic policy that integrates healthcare, tourism, and investment to promote economic growth and public value. Indonesia has established the Sanur Special Economic Zone (SEZ) — inaugurated in June 2025 with Bali International Hospital (BIH) as its anchor — as its first health SEZ, a response to the substantial outflow of citizens seeking treatment abroad, estimated by the government at around USD 11.5 billion (≈ Rp 180 trillion) annually. This study analyses collaborative governance in the medical tourism development policy of the Sanur SEZ, identifies the factors that shape cross-sector collaboration, and proposes a conceptual model for sustainable development. Using a qualitative, document-based policy analysis, the study synthesises government regulations, official reports, and peer-reviewed literature through the Collaborative Governance Regime (CGR) framework of Emerson, Nabatchi, and Balogh, integrated with Moore's Public Value Theory and situated within cross-sector and network-governance scholarship. The analysis proposes that collaborative leadership, institutional capacity, regulatory support, and stakeholder coordination are the conditions most likely to enable effective implementation, and that collaboration among government, state-owned enterprises, private investors, healthcare providers, academia, and communities can advance healthcare quality, destination competitiveness, and economic benefit only when its gains are equitably distributed and the two-tier risks characteristic of medical tourism are actively managed. The study contributes the Medical Tourism Collaborative Value Network (MTCVN), a conceptual model that positions public value creation as the proposed mediating mechanism linking collaborative governance to sustainable medical tourism development, together with six testable propositions and policy recommendations for Indonesia's medical tourism ecosystem.
Collaborative Governance in Sustainable Health Tourism Development in Ubud, Bali: A Perspective Collaborative Governance and Public Value Dewa Gede Candra Arimbawa; Nyoman Diah Utari Dewi; Mohd Hafiz Hanafiah
TOBA: Journal of Tourism, Hospitality, and Destination Vol. 5 No. 3 (2026): Agustus 2026
Publisher : Yayasan Literasi Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55123/toba.v5i3.9100

Abstract

Wellness tourism has emerged as one of the fastest-growing sectors in the global tourism industry, emphasizing the integration of individual well-being, cultural preservation, and environmental sustainability. Ubud, Bali, possesses significant potential as a wellness tourism destination due to its internationally recognized yoga traditions, the UNESCO-listed Subak cultural landscape, and strong community-based institutions. Nevertheless, the rapid expansion of wellness tourism has generated challenges related to environmental carrying capacity, land-use conversion, institutional fragmentation, and limited coordination among stakeholders in tourism policy development. This study aims to examine the contribution of collaborative governance to sustainable wellness tourism development in Ubud and to formulate a governance model capable of generating public value. A qualitative literature study approach was employed by reviewing scholarly publications, policy documents, and government regulations related to tourism development published between 2021 and 2026. The analysis applies the Collaborative Governance Regime framework developed by Emerson and Nabatchi, complemented by Moore's Public Value Theory. The findings indicate that sustainable wellness tourism depends on three interrelated governance dimensions: collaborative leadership, community co-creation, and institutional trust. These dimensions foster stakeholder collaboration that enhances community welfare, environmental conservation, and cultural preservation. Based on these findings, this study proposes the Community-Based Wellness Tourism Governance (CBWTG) model, integrating government institutions, private sector organizations, local communities, traditional villages, Subak institutions, and higher education institutions into a collaborative governance framework for sustainable tourism development. The proposed model extends collaborative governance literature by positioning local cultural institutions as strategic governance assets for creating public value in regional tourism policy.
Co-Authors Dewa Gede Candra Arimbawa Mohd Hafiz Hanafiah Sang Made Erlangga Dwipayana