<![CDATA[This study aims to develop and test a multi-stakeholder collaboration model that integrates perspectives of collaborative governance and co-production through seven case-based Standard Operating Procedures (SOPs). The study employed a descriptive-interpretative qualitative approach with a participatory multiple-case study design. The research was conducted in Dadakitan Village (Baolan District) and Diule Village (North Tolitoli District), selected purposively to represent differing contexts of service access. Data were gathered through in-depth interviews, observations, focus group discussions, document reviews, and PDSA documentation. The study involved 48 informants and 27 pilot cases—15 in Dadakitan and 12 in Diule. The team tested the model through a single Plan-Do-Study-Act (PDSA) cycle implemented in parallel across both villages. Results indicate that all 27 pilot cases successfully entered the seven-SOP workflow, undergoing data verification, needs assessment, and determination of follow-up actions. The model implementation resulted in 23 health referrals and 18 social referrals. Families, community health volunteers (kader), village governments, community health centers (Puskesmas), the Social Affairs Agency, social facilitators, and other relevant actors played roles in information dissemination, access facilitation, coordination, referrals, and monitoring. However, certainty regarding final service delivery remained inconsistent, particularly concerning referral acceptance confirmation, the provision of assistive devices, rehabilitation services, and the documentation of follow-up actions. The "Act" phase yielded eight model revisions, covering case checklists, strengthening the role of Persons-in-Charge (PICs), referral tracking, data verification, accessible communication, priority home visits, monitoring of assistive devices, and the establishment of deadlines and escalation pathways. The study concludes that the model demonstrates initial feasibility for application across varying service conditions; however, its long-term effectiveness and impact on the well-being of the target population require further testing through subsequent PDSA cycles.]]>
