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Abstract

. Pregnant women are one of the risk groups that should be considered to receive particular attention. Maternal mortality is caused by direct and indirect causes, which generally can be identified in early pregnancy. The Ministry of Health has launched various programs to reduce maternal mortality. At the community level, since 2007, there has been a birth planning and prevention of complications (P4K) program as a screening tool for pregnant women at risk by using stickers. The main point of this program is the active participation of families and communities to care for pregnant women in their environment. Purwakarta Regency, a region with uncomplicated geographical conditions, is supported by Health Human Resources (SDMKes) and Health facilities to do various programs in reducing the number of maternal deaths; one of them is P4K with stickers. In 2017, there were still 21 maternal deaths that should have been identified and referred to the hospital if the program was running well. The study aims to analyze the implementation of the P4K Sticker at the District Level. This research is qualitative research with in-depth interviewing techniques involving 12 informants and related documents, according to the theory of Van Meter and Van Horn policy implementation based on 6 (six) variables. This study found that the standard and policy objectives have not been fully achieved. There is still insufficient funding to support the program optimally. In terms of communication, there still a different understanding between the Health Office and Primary Healthcare Center. Despite there are still constraints on the number of human resources, the program's attitude is supportive. Economic and political situations are good, but social conditions are not supportive. The conclusion is that the program's implementation still has constraints in each variable. Existing program barriers can be overcome by optimizing inter-organizational communication, in this case, the District Health Office with Primary Healthcare Center, to have a common understanding regarding the implementation of Sticker P4K.

Bahasa Abstract

Ibu hamil merupakan salah satu kelompok berisiko yang harus mendapatkan perhatian khusus. Penyebab langsung dan tidak langsung kematian ibu pada umumnya bisa diidentifikasi sejak dini. Sejak tahun 2007 telah ada Program Perencanaan Persalinan dan Pencegahan Komplikasi (P4K) dengan fungsi menyaring ibu hamil yang berisiko dengan menggunakan alat bantu stiker. Dalam program ini ada partisipasi aktif keluarga dan masyarakat untuk peduli ibu hamil di lingkungannya. Kabupaten Purwakarta telah melaksanakan program P4K dengan stiker sejak tahun 2017. Hasilnya masih terjadi 21 kasus kematian ibu pada tahun 2017. Seharusnya jika program P4K dengan stiker berjalan dengan baik sudah dapat dilakukan identifikasi awal dan penatalaksanaan rujukan yang baik. Penelitian ini dimaksudkan untuk mengases bagaimana program P4K dengan stiker diimplementasikan. Analisis implementasi program P4K dilakukan berdasarkan teori implementasi kebijakan Van Meter dan Van Horn yang terdiri dari enam variabel. Penelitian dilakukan secara kualitatif dan pengumpulan data dengan teknik wawancara mendalam pada 12 informan dan telaah dokumen. Hasil penelitian menemukan bahwa standar dan sasaran kebijakan belum sepenuhnya tercapai. Sumber daya keuangan belum optimal dalam menunjang penyelenggaraan program. Dalam komunikasi antar organisasi masih ditemukan pemahaman yang berbeda antara Dinas Kesehatan dan Puskesmas sebagai pelaksana. Karakteristik pelaksana terkendala oleh jumlah SDM belum mencukupi namun sikap pelaksananya mendukung. Kondisi ekonomi dan politik baik namun kondisi sosial kurang mendukung. Sebagai kesimpulan implementasi program P4K memiliki kendala pada setiap variabel. Hambatan program yang ada bisa diatasi dengan mengoptimalkan komunikasi antar organisasi Dinas Kesehatan Kabupaten dan Puskesmas agar memiliki pemahaman yang sama terkait P4K dengan stiker.

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