Water Ambulance Service Provision to Improve Healthcare Access for Community in Nusa Penida Island, Bali: A Qualitative Feasibility Study


  • Putu Aryani Department of Preventive Medicine and Public Health, Faculty of Medicine, Udayana University, Denpasar, Indonesia
  • Ngakan Putu Anom Harjana Department of Preventive Medicine and Public Health, Faculty of Medicine, Udayana University, Denpasar, Indonesia
  • Pande Putu Januraga Department of Preventive Medicine and Public Health, Faculty of Medicine, Udayana University, Denpasar, Indonesia
  • Desak Ketut Dewi Satiawati Kurnianingsih Center for Public Health Innovation, Faculty of Medicine, Udayana University, Denpasar, Indonesia
  • Gede Benny Setia Wirawan Center for Public Health Innovation, Faculty of Medicine, Udayana University, Denpasar, Indonesia https://orcid.org/0000-0002-0477-5749
  • Ni Made Adi Swapatni Department of Health, Klungkung Regency, Klungkung, Indonesia
  • I Komang Gede Sentanu Wibawa Department of Health, Klungkung Regency, Klungkung, Indonesia




healthcare access, water ambulance, islands region, rural health , Indonesia


Background and purpose: An important component of healthcare access is transportation. Lack of transportation has been cited as an important barrier to healthcare access in remote islands region. Here we conduct a feasibility study on the implementation of water ambulance service to improve healthcare access in the region of Nusa Penida and its surrounding islands in Bali Province, Indonesia.

Methods:  We employed a qualitative approach with interviews and focused group discussions with stakeholders. Data collection was conducted to assess the feasibility of operating water ambulance services, based on a framework that included technical, market, organizational, and financial feasibilities. Inductive coding was conducted and data was analyzed to evaluate the feasibility based on local capacity against pre-determined framework of assessment based in literature.

Results: Qualitative interviews revealed perceived urgency and need for water ambulance service among stakeholders. They also perceive the need of water ambulance service was not mutually exclusive to other alternatives, such as expanding healthcare capacity on the islands. There was also readiness and adequate capacity from stakeholders which include a dedicated health emergency services under the health office that coordinate ambulance service in the region, readiness to create dedicated medical team and boat crew to operate water ambulance services, and readiness to cover the cost of initial procurement followed by operational costs which may include public-private partnerships.

Conclusion: There was a strong perceived need for water ambulance service in Nusa Penida Islands. At the same time, local stakeholders revealed adequate basic capacity to feasibly operate water ambulance services according to benchmarks identified in literature review.


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How to Cite

Aryani, P., Harjana, N. P. A., Januraga, P. P., Kurnianingsih, D. K. D. S., Wirawan, G. B. S., Swapatni, N. M. A., & Wibawa, I. K. G. S. (2022). Water Ambulance Service Provision to Improve Healthcare Access for Community in Nusa Penida Island, Bali: A Qualitative Feasibility Study. Public Health and Preventive Medicine Archive, 10(2), 160–170. https://doi.org/10.53638/phpma.2022.v10.i2.p07




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