Health-service capacity and environmental health risks in a peri-urban housing development area

Authors

  • Sulaiman Public Health Study Program, Sekolah Tinggi Ilmu Kesehatan Makassar, Makassar, South Sulawesi 90241, Indonesia
  • Jufri Public Health Study Program, Sekolah Tinggi Ilmu Kesehatan Makassar, Makassar, South Sulawesi 90241, Indonesia
  • Muti Sahida Nursing Study Program, Sekolah Tinggi Ilmu Kesehatan Makassar, Makassar, South Sulawesi 90241, Indonesia
  • Rusli Department of Social and Political Sciences, Universitas Indonesia Timur, Makassar, South Sulawesi 90221, Indonesia
  • Syahruddin Department of Social and Political Sciences, Universitas Nahdlatul Ulama Sulawesi Tenggara, Kendari, Southeast Sulawesi 93116, Indonesia

DOI:

https://doi.org/10.61511/evojes.v3i2.2026.3935

Keywords:

environmental-health monitoring, environmental health risks, health-service capacity, peri-urban housing development, primary health care readiness

Abstract

Background: This study examines the waste management crisis at Klotok Landfill/Tempat Pengelolaan Akhir (TPA) in Pojok Village, Mojoroto Sub-district, Kediri City, as a representation of socio-ecological problems arising from uncontrolled urbanization. Methods: Employing a qualitative case study approach within Ulrich Beck's Risk Society theoretical framework, this research analyzes the impact of the landfill's overload condition, which has persisted for more than three decades, on the buffer community of Kelurahan Pojok. Data were obtained through field observation and in-depth interviews with affected residents, supplemented by academic document reviews and government archives. Findings: The results indicate that the systemic transition from controlled landfill to open dumping has transformed Kelurahan Pojok into a sacrifice zone bearing a disproportionate share of the city's ecological burden. Residents face chronic exposure to respiratory disorders, groundwater contamination, odor pollution, and social space degradation, constituting a form of slow violence that erodes community well-being across generations. Government responses have remained ad hoc and technocratic, failing to address structural roots, while public participation was ignored from the landfill's inception. Conclusion: This study affirms that the TPA Klotok crisis is a manifestation of organized irresponsibility, demanding a paradigmatic shift toward ecological justice-based governance and meaningful community participation. Novelty/Originality of this article: This study offers a novel application of Beck's Risk Society framework to an underexplored peri-urban landfill context in Indonesia, revealing how manufactured uncertainty and organized irresponsibility operate at the intersection of local governance failure and ecological injustice.

References

Agustina, R., Dartanto, T., Sitompul, R., Susiloretni, K. A., Suparmi, Achadi, E. L., Taher, A., Wirawan, F., Sungkar, S., Sudarmono, P., Shankar, A. H., Thabrany, H., Soewondo, P., Ahmad, S. A., Kurniawan, M., Hidayat, B., Pardede, D., Mundiharno, Nelwan, E. J., Lupita, O., Setyawan, E., Nurwahyuni, A., Martiningsih, D., & Khusun, H. (2019). Universal health coverage in Indonesia: Concept, progress, and challenges. The Lancet, 393(10166), 75–102. https://doi.org/10.1016/S0140-6736(18)31647-7

Anvari, E., Noorimotlagh, Z., Mirzaee, S. A., Nourmoradi, H., Bahmani, M., Rashan, N., Silva Martinez, S., Kamran, S., & Ahmadi, I. (2025). Establishing the mechanisms involved in the environmental exposure to polychlorinated biphenyls (PCBs) in the risk of male infertility. Reproductive Sciences, 32(3), 537–554. https://doi.org/10.1007/s43032-025-01794-x

Aprilia, A., Wahidin, A. B., & Syafriadi. (2025). Seismic activity analysis in Indonesia: Integrating machine learning, geospatial data, and environmental factors for risk assessment. JPF (Jurnal Pendidikan Fisika) Universitas Islam Negeri Alauddin Makassar, 13(1), 12–26. https://doi.org/10.24252/JPF.V13I1.54081

Arsyad, D. S., Hamsyah, E. F., Qalby, N., Qanitha, A., Westerink, J., Cramer, M. J., Visseren, F. L. J., Doevendans, P. A., & Ansariadi, A. (2022). The readiness of public primary health care (PUSKESMAS) for cardiovascular services in Makasar city, Indonesia. BMC Health Services Research, 22(1), 1112. https://doi.org/10.1186/s12913-022-08499-w

Ayanore, M., Asampong, R., Akazili, J., Awoonor-Williams, J. K., & Akweongo, P. (2022). Sub-national variations in general service readiness of primary health care facilities in Ghana: Health policy and equity implications towards the attainment of universal health coverage. PLOS ONE, 17(6), e0269546. https://doi.org/10.1371/JOURNAL.PONE.0269546

Caruso, B. A., Sevilimedu, V., Fung, I. C. H., Patkar, A., & Baker, K. K. (2015). Gender disparities in water, sanitation, and global health. The Lancet, 386(9994), 650–651. https://doi.org/10.1016/S0140-6736(15)61497-0

Chaudhuri, S., & Roy, M. (2017). Rural-urban spatial inequality in water and sanitation facilities in India: A cross-sectional study from household to national level. Applied Geography, 85, 27–38. https://doi.org/10.1016/J.APGEOG.2017.05.003

Connolly, C., Keil, R., & Ali, S. H. (2020). Extended urbanisation and the spatialities of infectious disease: Demographic change, infrastructure and governance. Urban Studies, 58(2), 0042098020910873. https://doi.org/10.1177/0042098020910873

French, M. A., Barker, S. F., Taruc, R. R., Ansariadi, A., Duffy, G. A., Saifuddaolah, M., Zulkifli Agussalim, A., Awaluddin, F., Zainal, Z., Wardani, J., Faber, P. A., Fleming, G., Ramsay, E. E., Henry, R., Lin, A., O’Toole, J., Openshaw, J., Sweeney, R., Sinharoy, S. S., Kolotelo, P., Jovanovic, D., Schang, C., Higginson, E. E., Prescott, M. F., Burge, K., Davis, B., Ramirez-Lovering, D., Reidpath, D., Greening, C., Allotey, P., Simpson, J. A., Forbes, A., Chown, S. L., McCarthy, D., Johnston, D., Wong, T., Brown, R., Clasen, T., Luby, S., Leder, K., & RISE Consortium. (2021). A planetary health model for reducing exposure to faecal contamination in urban informal settlements: Baseline findings from Makassar, Indonesia. Environment International, 155, 106679. https://doi.org/10.1016/j.envint.2021.106679

Geldsetzer, P., Manne-Goehler, J., Marcus, M.-E., Ebert, C., Zhumadilov, Z., Wesseh, C. S., Tsabedze, L., Supiyev, A., Sturua, L., Bahendeka, S. K., Sibai, A. M., Quesnel-Crooks, S., Norov, B., Mwangi, K. J., Mwalim, O., Wong-McClure, R., Mayige, M. T., Martins, J. S., Lunet, N., ... Jaacks, L. M. (2019). The state of hypertension care in 44 low-income and middle-income countries: A cross-sectional study of nationally representative individual-level data from 1·1 million adults. The Lancet, 394(10199), 652–662. https://doi.org/10.1016/S0140-6736(19)30955-9

Greenhalgh, T. (2025). Case studies: A guide for researchers, educators, and implementers. BMJ Medicine, 4(1). https://doi.org/10.1136/BMJMED-2025-001623

Haemmerli, M., Powell-Jackson, T., Goodman, C., Thabrany, H., & Wiseman, V. (2021). Poor quality for the poor? A study of inequalities in service readiness and provider knowledge in Indonesian primary health care facilities. International Journal for Equity in Health, 20(1), 239. https://doi.org/10.1186/S12939-021-01577-1

Hone, T., Macinko, J., & Millett, C. (2018). Revisiting Alma-Ata: What is the role of primary health care in achieving the Sustainable Development Goals? The Lancet, 392(10156), 1461–1472. https://doi.org/10.1016/S0140-6736(18)31829-4

Husin, A., Nengsih, Y. K., & Helmi, H. (2025). The impact of environmental education on intergenerational knowledge transfer and household behavior: A quantitative study from Palembang. International Journal of Environmental Impacts, 8(1), 33–40. https://doi.org/10.18280/IJEI.080104

Hutchings, P., Willcock, S., Lynch, K., Bundhoo, D., Brewer, T., Cooper, S., Keech, D., Mekala, S., Mishra, P. P., Parker, A., Shackleton, C. M., Venkatesh, K., Rey Vicario, D., & Welivita, I. (2022). Understanding rural–urban transitions in the Global South through peri-urban turbulence. Nature Sustainability, 5(11), 924–930. https://doi.org/10.1038/s41893-022-00920-w

Hutton, G., & Chase, C. (2017). Water supply, sanitation, and hygiene. In Disease control priorities, third edition (Volume 7): Injury prevention and environmental health (pp. 171–198). World Bank. https://doi.org/10.1596/978-1-4648-0522-6_CH9

Jimenez, G., Matchar, D., Koh, G. C. H., Tyagi, S., Van Der Kleij, R. M. J. J., Chavannes, N. H., & Car, J. (2021). Revisiting the four core functions (4Cs) of primary care: Operational definitions and complexities. Primary Health Care Research & Development, 22, e68. https://doi.org/10.1017/S1463423621000669

Kapoor, S., Mohanty, V., Y. Balappanavar, A., Chahar, P., & Rijhwani, K. (2022). Primary health care workforce in Southeast Asia region, existing status and strategies for non-communicable diseases and oral health alliance: A scoping review. Cureus, 14(2). https://doi.org/10.7759/CUREUS.22362

Khatri, R. B., Erku, D., Endalamaw, A., Wolka, E., Nigatu, F., Zewdie, A., & Assefa, Y. (2023). Multisectoral actions in primary health care: A realist synthesis of scoping review. PLOS ONE, 18(8), e0289816. https://doi.org/10.1371/JOURNAL.PONE.0289816

Khatri, R., Endalamaw, A., Erku, D., Wolka, E., Nigatu, F., Zewdie, A., & Assefa, Y. (2023). Continuity and care coordination of primary health care: A scoping review. BMC Health Services Research, 23(1). https://doi.org/10.1186/S12913-023-09718-8

Lye, C. T., Ng, T. H., & Law, J. W. (2024). The role of general and specific pro-environmental education in household waste management in Malaysia: Evidence from quantile regression. Environmental Challenges, 15, 100933. https://doi.org/10.1016/J.ENVC.2024.100933

Mahendradhata, Y., & Hort, K. (2017). The Republic of Indonesia health system review. World Health Organization Regional Office for the Western Pacific.

Mills, F., Maysarah, S., Priadi, C. R., Willetts, J., Evans, B., & Foster, T. (2025). Risk factors for well contamination in urban Indonesia: Evidence to inform siting of wells and sanitation systems. Journal of Water and Health, 23(12), 1415–1429. https://doi.org/10.2166/WH.2025.036

Nasim, N., El-Zein, A., & Thomas, J. (2022). A review of rural and peri-urban sanitation infrastructure in South-East Asia and the Western Pacific: Highlighting regional inequalities and limited data. International Journal of Hygiene and Environmental Health, 244, 113992. https://doi.org/10.1016/J.IJHEH.2022.113992

Odagiri, M., Thomas, A., Listyasari, M., Mills, F., Bain, R. E. S., Muhammad, Z., Slaymaker, T., Mardikanto, A., Gultom, A., Indiyani, A., Rangkuti, H., & Willetts, J. (2021). Safely managed on-site sanitation: A national assessment of sanitation services and potential fecal exposure in Indonesia. International Journal of Environmental Research and Public Health, 18(15), 8204. https://doi.org/10.3390/ijerph18158204

Poague, K. I. H. M., Blanford, J. I., & Anthonj, C. (2022). Water, sanitation and hygiene in schools in low- and middle-income countries: A systematic review and implications for the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 19(5), 3124. https://doi.org/10.3390/IJERPH19053124

Prüss-Ustün, A., Wolf, J., Bartram, J., Clasen, T., Cumming, O., Freeman, M. C., Gordon, B., Hunter, P. R., Medlicott, K., & Johnston, R. (2019). Burden of disease from inadequate water, sanitation and hygiene for selected adverse health outcomes: An updated analysis with a focus on low- and middle-income countries. International Journal of Hygiene and Environmental Health, 222(5), 765–777. https://doi.org/10.1016/j.ijheh.2019.05.004

Rahmasary, A. N., Koop, S. H. A., & van Leeuwen, C. J. (2021). Assessing Bandung’s governance challenges of water, waste, and climate change: Lessons from urban Indonesia. Integrated Environmental Assessment and Management, 17(2), 434–444. https://doi.org/10.1002/IEAM.4334

Setiaasih, R., Sunjaya, D. K., Sofiatin, Y., Afriandi, I., Hilfi, L., & Herawati, D. M. D. (2025). Readiness of health posts for primary health care integration in Indonesia: A mixed-methods study. BMC Public Health, 25(1), 1429. https://doi.org/10.1186/S12889-025-22520-X

Sibbald, S. L., Paciocco, S., Fournie, M., Van Asseldonk, R., & Scurr, T. (2021). Continuing to enhance the quality of case study methodology in health services research. Healthcare Management Forum, 34(5), 291–296. https://doi.org/10.1177/08404704211028857

Singh, N. S., Sharma, R., Parween, T., & Patanjali, P. K. (2018). Pesticide contamination and human health risk factor. In Modern age environmental problems and their remediation (pp. 49–68). Springer. https://doi.org/10.1007/978-3-319-64501-8_3

Smith, K., Fearnley, C. J., Dixon, D., Bird, D. K., & Kelman, I. (2023). Environmental hazards: Assessing risk and reducing disaster (7th ed.). Routledge. https://doi.org/10.4324/9781351261647

Wimalasena, N. N., Chang-Richards, A., Wang, K. I. K., & Dirks, K. N. (2021). Housing risk factors associated with respiratory disease: A systematic review. International Journal of Environmental Research and Public Health, 18(6), 2815. https://doi.org/10.3390/IJERPH18062815

Wolf, J., Johnston, R. B., Ambelu, A., Arnold, B. F., Bain, R., Brauer, M., Brown, J., Caruso, B. A., Clasen, T., Colford, J. M., Esteves-Mills, J., Evans, B., Freeman, M. C., Gordon, B., Kang, G., Lanata, C. F., Medlicott, K. O., Prüss-Ustün, A., Troeger, C., Boisson, S., & Cumming, O. (2023). Burden of disease attributable to unsafe drinking water, sanitation, and hygiene in domestic settings: A global analysis for selected adverse health outcomes. The Lancet, 401(10393), 2060–2071. https://doi.org/10.1016/S0140-6736(23)00458-0

World Health Organization. (2021). Primary health care measurement framework and indicators: Monitoring health systems through a primary health care lens. World Health Organization. https://www.who.int/publications/i/item/9789240044210

Yan, H., Ding, G., Feng, K., Zhang, L., Li, H., Wang, Y., & Wu, T. (2020). Systematic evaluation framework and empirical study of the impacts of building construction dust on the surrounding environment. Journal of Cleaner Production, 275, 122767. https://doi.org/10.1016/J.JCLEPRO.2020.122767

Downloads

Published

2026-08-24

How to Cite

Sulaiman, Jufri, Sahida, M., Rusli, & Syahruddin. (2026). Health-service capacity and environmental health risks in a peri-urban housing development area. EcoVision: Journal of Environmental Solutions, 3(2), 252–268. https://doi.org/10.61511/evojes.v3i2.2026.3935

Issue

Section

Articles

Citation Check