Abstract The purpose of this study was to develop a measurement instrument for the distinctive autonomy variable in North Aceh's health services. The research sample comprised 400 respondents selected on random from the population of North Aceh. The research method is research and development, supported by AMOS software. Primary and secondary data were collected through literature reviews and questionnaires. The results showed that all instruments assessing the validity and reliability of the unique autonomy variable for health services met the fit model's criteria according to the Goodness of Fit Model standard. 20 factors have been identified as indicators capable of establishing and measuring the special autonomy of North Aceh public health services. Collaboration and coordination are the most critical things to strengthen in order to support the execution of North Aceh's special autonomy for health services. However, the findings of this study demonstrate that all instruments possess construct validity.