Kolaborasi Interprogram Dan Intersektoral Dalam Public Health Nursing Di Puskesmas Mlati II Sleman

Avina Oktaviani Algifnita, Prof. Dr. dr. Mubassyir Hasanbasri, M.A.; dr. Lutfan Lazuardi, M.Kes., Ph.D

2025 | Tesis | MAGISTER KEBIJAKAN DAN MANAJEMEN KESEHATAN

Latar Belakang : Masalah kesehatan masyarakat di Indonesia masih menghadapi tantangan kompleks, terutama pada tataran layanan primer seperti Puskesmas. Salah satu isu utama adalah belum optimalnya kolaborasi interprogram dan intersektoral dalam pelaksanaan Public Health Nursing (PHN). Penelitian ini bertujuan menganalisis implementasi dan efektivitas kolaborasi lintas program dan sektor dalam PHN di Puskesmas Mlati II, Sleman, dengan fokus pada peran manajer tengah, mekanisme koordinasi, serta dampaknya terhadap literasi kesehatan pasien dan keluarga. Penelitian menggunakan pendekatan kualitatif dengan desain studi kasus. Data dikumpulkan melalui wawancara mendalam, observasi partisipatif, dan telaah dokumen terhadap informan dari tenaga kesehatan, manajer program, mitra sektor lain, serta masyarakat penerima layanan. Analisis dilakukan secara tematik menggunakan teknik triangulasi untuk memastikan validitas data.

Hasil penelitian menunjukkan bahwa kolaborasi interprogram dan intersektoral di Mlati II telah berjalan namun masih bersifat situasional dan sangat tergantung pada inisiatif individu, terutama peran Koordinator PHN sebagai manajer tengah. Meskipun terdapat berbagai praktik baik, belum tersedia sistem baku yang menjamin kesinambungan integrasi, dokumentasi kunjungan, dan pelibatan mitra eksternal. Outcome positif ditemukan pada peningkatan literasi kesehatan pasien dan keluarga, namun masih terdapat kesenjangan akibat keterbatasan dukungan komunitas dan media edukasi yang kurang kontekstual. Penelitian ini menyoroti pentingnya penguatan kelembagaan, media edukatif berbasis rumah tangga, dukungan mitra lintas sektor, dan pengakuan struktural terhadap peran manajer tengah sebagai strategi penguatan layanan PHN.

Kesimpulan: Kolaborasi PHN yang efektif membutuhkan pendekatan sistemik, partisipatif, dan berbasis konteks lokal, agar dapat mendukung keberlanjutan transformasi layanan kesehatan primer.

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Background: Public health issues in Indonesia still face complex challenges, especially at the primary care level such as community health centers (Puskesmas). One of the main issues is the lack of optimal interprogram and intersectoral collaboration in the implementation of Public Health Nursing (PHN). This study aims to analyze the implementation and effectiveness of cross-program and cross-sectoral collaboration in PHN at Puskesmas Mlati II, Sleman, with a focus on the role of middle managers, coordination mechanisms, and their impact on patient and family health literacy. The study employs a qualitative approach with a case study design. Data were collected through in-depth interviews, participatory observation, and document review with informants from healthcare workers, program managers, other sector partners, and service recipients. Analysis was conducted thematically using triangulation techniques to ensure data validity.  

The results of the study show that interprogram and intersectoral collaboration in Mlati II has been implemented but is still situational and highly dependent on individual initiatives, particularly the role of the PHN Coordinator as a middle manager. Although there are various good practices, there is no standard system in place to ensure the continuity of integration, documentation of visits, and the involvement of external partners. Positive outcomes were found in improving patient and family health literacy, but there are still gaps due to limited community support and educational media that are not sufficiently contextualized. This study highlights the importance of institutional strengthening, household-based educational media, cross-sectoral partner support, and structural recognition of the role of middle managers as strategies for strengthening PHN services.

Conclusion: Effective PHN collaboration requires a systemic, participatory, and locally contextual approach to support the sustainability of primary health care transformation.

Kata Kunci : Public Health Nursing, Kolaborasi Interprogram, Kolaborasi Intersektoral, Puskesmas, Literasi Kesehatan, Manajer Tengah.