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The democratic decentralization of government administration in Indonesia from 1999 represents the most dramatic shift in governance in that country for decades. In this dissertation I explore how health managers in one kabupaten (regency) are responding to the new political environment. Kabupaten health managers experience decentralization as incomplete, pointing to the tendency of central government to retain control of certain health programs and budgets. At the same time they face competing demands for autonomy from puskesmas (health center) heads. Building on Scott's (1985) idea of a "moral economy" I delve beneath the political tensions of competing autonomies to describe a moral landscape of underlying beliefs about how government ought to behave in the health sector. Through this analysis certain failures and contradictions in the decentralization process emerge, complicating the literature that presents decentralization as a move in the direction of "good governance" (Mitchell and Bossert 2010, Rondinelli and Cheema 2007, Manor 1999). Decentralization brings to the fore the internal divisions within government, yet health workers present a united front in their engagements with the public. Under increasing pressure to achieve global public health goals such as the Millennium Development Goals, health managers engage in multiple translations in converting global health discourses into national and local health policies and in framing these policies in ways that are comprehensible and compelling to the general public. Using the lens of a "cultural theory of state" (Corrigan and Sayer 1985) I describe how health professionals and volunteers draw on local cultural forms in order to render global frameworks compatible with local moralities. I introduce the term "moral pluralism" to describe how individual health workers interrelate several moral frameworks in their health promotion work, including Islam, evidence based medicine and right to health. My conclusion is that kabupaten health managers are engaging in two balancing acts. The first is between decentralization and (re)centralization and deals with the proper way to manage health programming. The second is between global health discourses and local cultural forms and concerns the most effective way to convey public health messages in order to bring about behavior change in line with national and global public health goals. This is the first anthropological study of how government officials at different levels negotiate the process of health decentralization in the face of increasing international pressure to achieve global public health goals.

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Progress in International Reading Literacy Study (PIRLS) was used to measure Indonesian fourth grade elementary school students’ reading comprehension in 2006 and 2011. Indonesian students scored among the lowest of the participating countries with a score of 405 in 2006 and 428 in 2011, with the PIRLS average scale score being 500. These results raised questions about the alignment of the Indonesian curriculum with PIRLS. Alignment research between the PIRLS 2021 frameworks and the Curr13 language standards and textbooks (the current Indonesian curriculum) was conducted to provide Kemendikbud (Indonesian Ministry of Education and Culture) with a prediction of students’ performance in future PIRLS. The alignment research was mixed methods research with an exploratory sequential design (a three-phase design). The first phase was qualitative data collection and analysis. Alignment instruments were developed using the components of Webb, NAEP ESSI, and HumRRO alignment models. The second phase identified features to be tested, where I revised the alignment instruments, guidelines, and codebook based on the first phase and created a new table. The revised instruments were then used to align Curr13 and PIRLS. The third phase was quantitative calculation using Webb's quantitative criteria (categorical concurrence, depth-of-knowledge consistency [DOK], range-of-knowledge correspondence, and balance of representation) and descriptive statistics. After the three phases, the interpretation used both the qualitative and quantitative data. The results found inconsistencies between Curr13 and PIRLS frameworks. There was no categorical concurrence between PIRLS frameworks and Curr13 unit assessments. Curr13 language standards and unit assessments did not include one PIRLS framework, evaluating and critiquing content and textual elements. This resulted in the absence of DOK for this framework. One PIRLS framework mostly covered by Curr13 language standards and unit assessments was interpreting and integrating ideas and information. DOK and balance of representation were achieved in this framework. Two PIRLS frameworks on comprehension processes (focusing on and retrieving explicitly stated information and making straightforward inferences) aligned to Curr13 and had a balance of representation but weak DOK. Meanwhile, Curr13 unit resources mostly aligned to one of two reading purposes in the PIRLS framework, acquiring and using information, but was weakly aligned with the other one, literary experience. The implication of research findings was to support Kemendikbud in predicting students’ performance in future PIRLS participation by examining the inconsistencies between Curr13 and PIRLS. Recommendations were provided for the elementary school teachers, students, parents, publishers, policymakers, local governments, and other elementary school stakeholders to be familiar with and understand PIRLS. The role of AKSI should also be maximized. In addition, the concept and practice of curriculum alignment should be introduced and enacted into the educational system in Indonesia.