Development of an Integrated Elderly Service Program (ESP) Using Elderly-Friendly Design (EFD): Case Study of an Urban Village in Yogyakarta, Indonesia

The aging population significantly affects the Sustainable Development Goals (SDGs). Consistent with the principle of “Leave No One Behind,” the agenda seeks to promote well-being for people of all ages. Population aging poses a challenge that Indonesia must address as it seeks to realize the projected demographic dividend in 2030. Yogyakarta, which has the country’s highest proportion of older adults, can serve as a model for effective senior management. Longer life expectancy and improved social conditions enable seniors to engage in cultural and religious activities, offering Yogyakarta an opportunity to develop an elderly-friendly urban village with a comprehensive elderly service program (ESP). This study first examines the Yogyakarta government’s elderly-friendly city initiative at the village level and then evaluates the village design against WHO standards. This study investigates the implementation of an ESP in Purbayan Urban Village, Kotagede, Yogyakarta, focusing on its effects on older adults’ physical and mental health outcomes. Rather than viewing these programs merely as policy or infrastructure projects, the research treats them as health-promoting systems shaped by interactions among institutional arrangements, community involvement, and spatial environments. These factors collectively influence the success or failure of elderly-friendly initiatives. To examine this, the study employs a design thinking framework—empathize, define, ideate, prototype, and test—not only as a procedural approach but also as an analytical lens for understanding iterative problem- solving and stakeholder dynamics. This approach is integrated into a qualitative case study to analyze causal complexity, including stakeholder interactions and the influence of historically entrenched practices (path dependency). The findings indicate progress in social participation, inclusion, and access to health services. However, they do not fully meet the standards for an elderly-friendly city, particularly in terms of accessible, safe public infrastructure. ESP plays a vital role in supporting older adults’ health by providing preventive and health-promoting services, including screenings at the Integrated Health Post (Posyandu) and health education. Social participation, which benefits mental health, is promoted through community activities such as senior schools, group events, and social gatherings, helping reduce loneliness and isolation. Additionally, linking formal healthcare providers with local cadres and community volunteers ensures continuous monitoring and informal care, making health a community effort. The Purbayan case shows that elderly welfare outcomes depend on various factors, including official health and social programs, community initiatives such as senior schools, and the design of urban villages.