Endah Sri Hartatik, Wasino, Vivek Neelakantan, Sukarni Suryaningsih, Ken Widyawati, Ilham Nur Utomo, Fortuna Devi Putri Sina
This article examines the population health policies implemented in Semarang City, Indonesia, in the aftermath of the Dutch colonial Ethical Policy (1901). Employing a social determinant of health framework grounded in a decolonial perspective, the study explores how colonial era policies continue to shape contemporary health practices and rein-force structural health inequalities. Drawing on historical methods and analysis of primary and secondary sources from national archives, libraries, and documentation centers, the research finds that the Ethical Policy—despite its humanitarian rhetoric of "repaying a debt of honor"—primarily served to sustain labor productivity for colonial economic interests. Health interventions such as the control of cholera outbreaks, the development of sanitation infrastructure, and hospital construction in Semarang were disproportionately directed toward protecting European residents and maintaining urban spatial segregation. These colonial legacies are still evident today in unequal access to healthcare, the geographic clustering of diseases, and the continued marginalization of local health knowledge systems. The article underscores the importance of applying approaches rooted in decolonization to the study of health systems in postcolonial contexts and calls for the development of more inclusive, his-torically grounded, and socially just health policies in Indonesia. © 2025, Universitas Negeri Semarang. All rights reserved.
Universitas Diponegoro, Indonesia; Universitas Negeri Semarang, Indonesia; Indian Institute of Management Kozhikode, India; Universitas Gadjah Mada Alumni, Indonesia
