KONTESTASI NILAI PUBLICNESS DALAM KEBIJAKAN PERAWATAN NEONATAL DI INDONESIA (STUDI KASUS INKUBATOR YAYASAN BAYI PREMATUR INDONESIA)

FAJAR KURNIYASIH, Dr. Pradhikna Yunik Nurhayati, S.IP., MPA

2026 | Tesis | MAGISTER MANAJEMEN DAN KEBIJAKAN PUBLIK

Penelitian ini bertujuan untuk menganalisis kontestasi nilai publicness dalam kebijakan perawatan neonatal terkait penggunaan inkubator di rumah bagi bayi prematur dan berat badan lahir rendah (BBLR). Keterbatasan jumlah inkubator di rumah sakit dan belum optimalnya implementasi Perawatan Metode Kanguru (PMK) di rumah membuat adanya kesenjangan perawatan neonatal. Kondisi tersebut mendorong Yayasan Bayi Prematur Indonesia (YABAPI) untuk menyediakan layanan peminjaman inkubator gratis di rumah bagi keluarga prasejahtera paska kepulangan bayi dari rumah sakit. Namun, inisiatif tersebut memunculkan perdebatan dengan Kementerian Kesehatan mengenai bentuk perawatan neonatal yang tepat dan aman bagi bayi prematur dan BBLR di rumah. Penelitian ini menggunakan metode kualitatif dengan pendekatan studi kasus. Data diperoleh melalui wawancara mendalam dan observasi. Wawancara dilakukan terhadap 21 narasumber yang terdiri dari YABAPI, tenaga kesehatan dan keluarga bayi prematur serta BBLR di Kabupaten Bogor. Sementara itu, observasi dilakukan di ruang NICU RSUD RH. Satibi Kabupaten Bogor, RSKIA Sadewa Yogyakarta dan keluarga penerima manfaat inkubator rumah di Kabupaten Bogor. Hasil penelitian menunjukkan bahwa penggunaan inkubator di rumah memunculkan kontestasi nilai antara nilai aksesibilitas dan keselamatan sebagai dua nilai publicness yang diperjuangkan oleh para aktor. YABAPI menekankan aksesibilitas sebagai nilai yang juga harus diprioritaskan untuk memperluas jangkauan perawatan neonatal bagi keluarga prasejahtera. Sedangkan, KEMENKES menempatkan nilai keselamatan melalui kepatuhan standar medis, yaitu Perawatan Metode Kanguru. Kontestasi terjadi dalam dimensi aktor, akses, dan kepentingan. Penelitian ini juga menemukan bahwa rumah sakit di daerah merespon kontestasi tersebut melalui praktik diskresi dan kolaborasi non formal dengan agen relawan YABAPI untuk menjembatani kebutuhan masyarakat, keterbatasan sumber daya layanan kesehatan, dan keselamatan medis. Temuan ini menunjukkan bahwa pengelolaan nilai publicness dalam perawatan neonatal di rumah merupakan hasil negosiasi antar aktor dalam merespon kebutuhan publik di tengah keterbatasan kebijakan perawatan neonatal.

This study aims to examine the contestation of publicness in neonatal care policy concerning the use of home incubators for preterm and low-birth-weight (LBW) infants. The limited availability of incubators in hospitals and the suboptimal implementation of Kangaroo Mother Care (KMC) at home have created gaps in neonatal care. This situation encouraged the Indonesian Premature Baby Foundation (Yayasan Bayi Prematur Indonesia - YABAPI) to provide a free home incubator lending service for low-income families following their infants discharge from the hospital. However, this initiative has generated debate with the Ministry of Health regarding the most appropriate and safest form of home-based neonatal care for preterm and LBW infants. This study employed a qualitative method with a case study approach. Data were collected through in-depth interviews and observations. Interviews were conducted with 21 informants consisting of representatives from YABAPI, healthcare professionals, and families of preterm and LBW infants in Bogor Regency. Observations were carried out in the NICU of RH. Satibi Regional Hospital in Bogor Regency, Sadewa Mother and Child Hospital in Yogyakarta, and among beneficiary families using home incubators in Bogor Regency. The findings reveal that the use of home incubators has generated a contestation between accessibility and safety as two publicness values advocated by different actors. YABAPI emphasizes accessibility as a value that should also be prioritized in order to expand access to neonatal care for low-income families. In contrast, the Ministry of Health prioritizes safety through adherence to medical standards, particularly Kangaroo Mother Care (KMC). The contestation occurs across the dimensions of actors, access, and interests. The study also finds that local hospitals respond to this contestation through discretionary practices and informal collaboration with YABAPI volunteer agents to bridge community needs, limited healthcare resources, and medical safety concerns. These findings suggest that the management of publicness in home-based neonatal care is the result of negotiations among actors seeking to respond to public needs amid the limitations of existing neonatal care policies.

Kata Kunci : publicness, kontestasi, kebijakan neonatal, prematur, BBLR