Bridging Health Policy and Practice: The Mediating Role of the Child Health and Integrated Policy System (CHIPS) in Preventing Pediatric Pulpitis in Indonesia

Abstract

Objective: To examine the mediating role of the Child Health and Integrated Policy System (CHIPS) in linking cross-sectoral collaboration and cross-program integration with pediatric pulpitis incidence in Kendari City, Indonesia.

Design: A cross-sectional quantitative study using Partial Least Squares Structural Equation Modeling (PLS-SEM).  

Setting: Fifteen public primary healthcare centers (puskesmas) in Kendari City, Southeast Sulawesi Province, Indonesia.

Main outcome measures: Pediatric pulpitis incidence among children aged 6–12 years, obtained from facility-level administrative health records from 2022 to 2024.

Results: Cross-sectoral collaboration was positively associated with CHIPS functionality (β = 0.634, p < 0.001), while cross-program integration also showed a significant positive association with CHIPS functionality (β = 0.306, p = 0.001). CHIPS functionality was negatively associated with the incidence of pediatric pulpitis (β = –0.667, p < 0.001). Mediation analysis showed that CHIPS fully mediated the relationship between cross-sectoral collaboration and pediatric pulpitis incidence (indirect β = –0.422, p < 0.001) and partially mediated the relationship between cross-program integration and pediatric pulpitis incidence (indirect β = –0.204, p = 0.004).

Conclusions: CHIPS may serve as an important integrated governance mechanism linking collaborative policy implementation to reduced pediatric pulpitis incidence. Strengthening intersectoral coordination, program integration, and facility-level data systems may improve the effectiveness of pediatric oral health prevention within municipal primary healthcare systems.