Hubungan Implementasi Integrasi Pelayanan Kesehatan Primer Dengan Pelayanan Kesehatan Ibu Hamil di Indonesia

Khairunnisa Nurulfirdausi, Dr. Drs. Abdul Wahab, MPH; Prof. Dr. dr. Mubasysyir Hasanbasri, MA; dr. Likke Prawidya Putri, MPH., Ph.D; dr. Tiara Marthias, MPH., Ph.D

2026 | Tesis | MAGISTER KEBIJAKAN DAN MANAJEMEN KESEHATAN

Latar belakang: Kementerian Kesehatan menggulirkan 6 pilar transformasi kesehatan. Transformasi berupa Integrasi Pelayanan Kesehatan Primer (ILP) diharapkan dapat menjawab permasalahan dan tantangan yang terjadi pada pelayanan primer seperti Standar Pelayanan Minimal (SPM) yang masih belum memenuhi target 100%, salah satunya adalah pelayanan kesehatan ibu hamil. Tujuan: Menganalisis hubungan implementasi integrasi pelayanan kesehatan primer dengan pelayanan kesehatan ibu hamil, mengeksplorasi kondisi terkini implementasi ILP, serta mengidentifikasi faktor pendukung dan penghambat Puskesmas mengimplementasikan ILP. Metode: Pendekatan Mixed methods dengan desain cross-sectional. Data kuantitatif berupa data sekunder di seluruh kabupaten/kota, sedangkan data kualitatif dilakukan di 4 kabupaten/kota yaitu Kabupaten Bantul, Kabupaten Blora, Kota Batu, dan Kota Bekasi, dikumpulkan melalui wawancara semi terstruktur dan telaah dokumen kepada 15 informan di Dinas Kesehatan kabupaten/kota dan Puskesmas. Analisis data kuantitatif dilakukan melalui Uji Chi Square dan Regresi Logistik Berganda, sedangkan data kualitatif dianalisis secara deskriptif. Hasil: Hasil penelitian kuantitatif menunjukkan bahwa terdapat hubungan signifikan antara implementasi ILP dengan pelayanan kesehatan ibu hamil. Sedangkan hasil penelitian kualitatif yaitu Puskesmas sudah menerapkan 3 fokus utama ILP yaitu pendekatan berbasis siklus hidup, mendekatkan akses pelayanan sampai tingkat desa/dusun, dan pemantauan wilayah setempat walaupun masih belum optimal. Faktor pendukung Puskesmas mengimplementasikan ILP antara lain komitmen pimpinan daerah, kerjasama dengan lintas sektor, kelengkapan SDM dan alat kesehatan, serta partisipasi masyarakat. Sedangkan faktor penghambat yaitu sistem informasi yang belum terintegrasi serta efisiensi dan ketimpangan anggaran. Kesimpulan: Implementasi ILP sangat penting untuk meningkatkan capaian pelayanan kesehatan dan diperlukan komitmen serta dukungan dari berbagai pihak agar pelaksanaan ILP berjalan optimal.

Background: The Ministry of Health has launched six pillars of health transformation. This transformation, in the form of Integrated Primary Health Care (IPHC), is expected to address the problems and challenges facing primary care services, such as the Minimum Service Standards, which have yet to meet the 100% target; one such area is maternal health care. Objective: To analyze the relationship between the implementation of integrated primary health care and maternal health care, to explore the current status of IPHC implementation, and to identify factors supporting and hindering Community Health Centers in implementing IPHC. Methods: A mixed-methods approach with a cross-sectional design. Quantitative data consisted of secondary data from all districts/cities, while qualitative data were collected in 4 districts/cities namely Bantul Regency, Blora Regency, Batu City, and Bekasi City, through semi-structured interviews and document reviews with 15 informants from district/city Health Offices and Community Health Centers. Quantitative data were analyzed using the Chi-Square Test and Multiple Logistic Regression, while qualitative data were analyzed descriptively. Results: The quantitative findings indicate a significant association between the implementation of IPHC and maternal health services. The qualitative findings reveal that Community Health Centers have implemented the three main focuses of the IPHC framework: a life-cycle-based approach, bringing health services closer to the village/neighborhood level, and local area monitoring, although these efforts remain suboptimal. Supporting factors for Community Health Centers in implementing ILP include the commitment of local leaders, collaboration across sectors, the availability of human resources and medical equipment, and community participation. Meanwhile, inhibiting factors include an unintegrated information system, as well as budget inefficiencies and disparities. Conclusion: The implementation of IPHC is crucial for improving health service outcomes, and commitment and support from various stakeholders are necessary to ensure optimal implementation of IPHC.

Kata Kunci : Transformasi sistem kesehatan, integrasi layanan primer, pelayanan kesehatan ibu hamil, Puskesmas, mixed methods