The main principles in the development of the alley are awareness, willingness, and ability. The awareness arises from within the community themselves, which will eventually create a willingness for those who have the ability. Awareness, willingness, and ability are important elements to develop alley communities, this is also in line with the overall health development goals.10

The aisles (alley) communities must be developed holistically.11 This means that the development of alleys should not only in the matter of health and cleanliness; but also be developed on aspects that have leverage/effect for them, for example, aspects related to the community's economy. The development of the alley community from an economic aspect is adjusted according to the interest and the ability of the community.

Commitment to health is a principle of developing a health program.12 Commitment to health means placing health as the main issue in the development. They all have a commitment to the health of the environment and society. This commitment can be born vertically from the city, sub-district, and village governments to the RT/RW (neighborhood associations) level.

City leadership influences the pattern of policymaking at the lower level structure,13 including alley communities. Different leaders have different perspectives. That is why changes in leadership always have an impact on the sustainability of the program, likewise, in the development of the alley community. At the alley level, there is also a need for community leaders who can mobilize them. This leader can come from the village level structure, namely the working group that can cover programs and policies down to the alley level.5,14

Community participation is one of the principles in organizing a healthy city3,15–18 including in the context of the alley. Community participation also contributes to the sustainability of the program. Community participation is expected to be involved in maintaining the cleanliness of the environment. With community participation, it is expected that the community can solve their own problems. They can take advantage of the community potential that they have to solve health problems in the area.

Synergy means that there are various stakeholders who can be involved in solving various health problems in the alley. At the city level, almost all Regional Apparatus Organizations can be involved in handling alleys based on the problems faced, for example, the Health Office, Public Works Office, Social Affairs Office, Housing and Settlement Office, Sanitation Office, and so on. Besides, the private sector and community organizations can also be involved.

Building self-reliance is the principle of community development.19 Independence avoids dependence on other parties, including the government. At the community level, they actually have resources in the form of financial, material, logistical and intellectual resources. These can be used in sustainable alley development. In the long term, independence can guarantee the sustainability of the program. That is the essence of why community independence is needed.

Alley development must meet the principle of equality. This means that all community groups regardless of gender, religion, and social status are involved in the development of alleys. Health development must be inclusive. Development must be enjoyed by all community groups including vulnerable groups such as children, pregnant women, and elderly people.

The sustainability of the program in the development of Healthy Cities including the alley context is the principle of community development.20 The program being developed should not only think about the current aspects, but also the future aspects. Therefore, the development of the alley must be socialized continuously. The development of the alley requires a strategy that can be described further in the following section.

Regulation is one strategy in health promotion. Regulation is usually carried out with a structural approach to sound public policies. In relation to the development of a healthy alley, regulation is needed to promote sound policies.

Developing a healthy alley requires a combination of thinkers and workers. These thinkers (brains) represent groups of people who have conceptual abilities, while workers (muscles) represent groups of people who have technical abilities. Both are needed.

Healthy cities or healthy alleys need working groups or institutions.5 In developing a healthy city, there is a working group at the village level. However, there is no specific workgroup for the development of a healthy alley. A healthy alley working group can be created separately, but it can also be made to follow the existing organizational structure in a healthy city or a healthy city forum. Both have advantages and disadvantages.

Education for the community in the development of the alley is certainly very necessary. With that understanding, the community knows what benefits can be obtained in developing the alley. Education is a process that must run continuously so that society can be maximally involved.

Funding for the development of the alley is absolutely necessary. Funding can come from the government, namely Regional Apparatus Organizations, namely the budget allocated through the Regional Government Budget (APBD), as well as budgets that can come from private or public elements.

Continuously providing advocacy to the government in developing alleys so that the alley community is protected or so that community problems in the alley are solved is urgently needed. Alley communities are an integral part of the development of the city as a whole.