Toba: Journal of Tourism, Hospitality, and Destination
Vol. 5 No. 3 (2026): Agustus 2026

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 (Ngurah Rai University)
Nyoman Diah Utari Dewi (Ngurah Rai University)
Mohd Hafiz Hanafiah (Universiti Teknologi MARA)



Article Info

Publish Date
07 Aug 2026

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.

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Journal Info

Abbrev

toba

Publisher

Subject

Social Sciences

Description

TOBA (Journal of Tourism, Hospitality, and Destination) merupakan wadah publikasi naskah ilmiah dengan tema utama berkaitan dengan tourism, hospitality and destination yang diterbitkan 4 (empat) kali dalam setahun, yaitu pada bulan Februari, Mei, Agustus dan November. Naskah yang dipublikasikan ...