Latar belakang: Krisis ekonomi yang berkepanjangan menyebabkan semakin banyak penduduk yang tidak mampu menjangkau pelayanan kesehatan, termasuk pelayanan kesehatan dasar. Berbagai masalah kesehatan masyarakat yang muncul seperti bayi dan balita dengan gizi buruk, ibu hamil kekurangan energi kronis (KEK) dan berbagai penyakit menular menahun merupakan gambaran dari dampak rendahnya cakupan pelayanan kesehatan dasar. Pelayanan perawatan kesehatan masyarakat dengan kunjungan rumah merupakan alternatif upaya peningkatan cakupan pelayanan kesehatan dasar terutama pelayanan dalam lingkup KIA. Tujuan Penelitian ini bertujuan mengevaluasi pelaksanaan perawatan kesehatan masyarakat melalui kunjungan rumah, yang secara khusus dengan mengidentifikasi cakupan pelayanan kunjungan rumah terhadap keluarga dengan faktor resiko, identifikasi kebijakan pengalokasian sumber-sumber (dana, tenaga dan sarana penunjang lainnya) serta bagaimana insentif, beban kerja di kelola untuk pelaksanaan program serta hambatan-hambatan diatasi. Metode Penelitian ini dilakukan dengan metode deskriptif kualitatif dengan rancangan cross seksional. Dengan unit analisis pelaksanaan program perawatan kesehatan masyarakat di Kabupaten Agam, dengan mengambil sampel secara purposif random sampling pada tiga puskesmas yaitu Puskesmas Pakan Kamis, Biaro dan Lubuk Basung. Selanjutnya data primer diperoleh melalui wawancara mendalam dengan Kepala Dinas Kesehatan, Kepala Sub Dinas Pelayanan Kesehatan Kesehatan, Kepala Seksi Puskesmas dan Sarana Pelayanan Kesehatan Kepala Puskesmas dan Koordinator program perkesmas di puskesmas. Hasil Penelitian Ternyata cakupan pelayanan perawatan kesehatan masyarakat melalui kunjungan rumah masih rendah. Hal ini dikarenakan: frekuensi pelaksanaan kunjungan rumah masih kurang, alokasi biaya kunjungan rumah sangat rendah, sistem insentif belum dilaksanakan, pelatihan tidak dilaksanakan secara efektif, mobilisasi terhadap sumbersumber yang bisa dimanfaatkan tidak dilakukan secara baik. Kesimpulan Pelaksanaan perawatan kesehatan masyarakat melalui kunjungan rumah belum memberi pengaruh berarti kepada program perkesmas baik baik kuantitas maupun kualitas. Komitmen pihak manajemen terhadap program tidak memadai yang terlihat dari rendahnya alokasi pembiayaan, tidak adanya insentif dan pelatihan petugas serta tidak adanya pemetaan gakin sehingga pelaksanaan program tidak terealisasi secara komprehensif

Background: The unabated economic crisis has put more poor people away from adequate health care services, including the basic health care. Public health problems such as malnutrition among infants and children, chronic energy deficiency among pregnant women, and several communicable diseases have reemeged as basic health care coverage shrinked. Public health care nursing and home visiting are options to improve access to basic health care, especially for maternal and child health. However these activities have not been optimally implementated due to resource constaints and other limitation. Objective: The objective of the study was to evaluate the implementation of public health nursing through home visiting by identifying coverage of home visiting service for families with risk factors, policies of resources allocation (human resources, financial resources and other facilities) and evaluating how incentives and workload were distributed to carry out the program and obstacles were overcome. Methods: The study was qualitative descriptive with cross sectional design. Analysis unit was the implementation of public health nursing program at Agam District with samples taken using purposive random sampling technique at three public health centers of Biaro, Pakan Kamis and Lubuk Basung. Primary data were obtained through indepth interview with Head of the Health Office, Head of Sub Health Service Office, Head of Public Health Service and Health Service Facility Section, Head of Public Health Center and coordinator of Public Health Nursing Program at community health center. Result: The coverage of public health nursing service through home visiting was relatively low due to limited home visiting, small allocation of home visiting fund, absence of incentive and effective staff training and low mobilization of resources. Conclusion: The implementation of public health nursing through home visiting had not contributed significantly to the public health nursing program either quantitatively or qulitatively. Commitment of the management to the program was low as reflected from small allocation of fund, absence of incentive and staff training as well as mapping of poor families so that the program did not run comprehensively

Kata Kunci : Kebijakan Kesehatan,Masyarakat Miskin,Program Perawatan Kesehatan