ANALISIS FAKTOR PENDUKUNG DAN PENGHAMBAT IMPLEMENTASI POSYANDU DI ERA INTEGRASI LAYANAN PRIMER (ILP) DI PUSKESMAS TINANGGEA KABUPATEN KONAWE SELATAN

TRI WAHYU NURUL ATFA, dr. Likke Prawidya Putri, M.P.H., Ph.D.

2026 | Tesis | MAGISTER KEBIJAKAN DAN MANAJEMEN KESEHATAN

Latar belakang: Integrasi Layanan Primer (ILP) mengubah Posyandu dari layanan yang dominan berfokus pada ibu dan anak menjadi pelayanan berbasis siklus hidup. Perubahan ini menuntut kesiapan kader, dukungan desa, pembinaan Puskesmas, partisipasi masyarakat, serta strategi pelayanan yang sesuai dengan karakteristik wilayah. Tujuan: Penelitian ini bertujuan menganalisis faktor pendukung dan penghambat implementasi Posyandu di era ILP pada dua Posyandu dengan karakteristik wilayah berbeda di wilayah kerja Puskesmas Tinanggea Kabupaten Konawe Selatan. Metode: Penelitian ini menggunakan pendekatan kualitatif deskriptif dengan desain studi kasus komparatif. Lokasi penelitian adalah Posyandu Wundumbolo yang mewakili wilayah daratan dan Posyandu Bungin yang mewakili wilayah pesisir. Sebanyak 16 informan dipilih secara purposive, meliputi unsur Puskesmas, bidan desa, kader, pemerintah desa, dan masyarakat pengguna layanan. Data dikumpulkan melalui wawancara semiterstruktur, observasi, dan dokumentasi, kemudian dianalisis secara tematik melalui analisis dalam kasus dan lintas kasus. Hasil: Implementasi Posyandu ILP telah berjalan di kedua lokasi, tetapi belum optimal. Pelayanan lebih banyak dimanfaatkan oleh ibu hamil, balita, dan lansia, sedangkan remaja dan usia produktif belum aktif terjangkau. Wundumbolo menunjukkan implementasi yang lebih tertata melalui dukungan desa, fasilitas, koordinasi, dan partisipasi masyarakat yang lebih baik. Bungin menghadapi hambatan struktural dan geografis yang lebih kompleks, seperti lokasi pelayanan belum tetap, keterbatasan fasilitas, akses pesisir, dan dukungan operasional yang belum lengkap. Kesimpulan: Implementasi Posyandu ILP dipengaruhi oleh interaksi antara kesiapan internal sistem desa dan kondisi eksternal wilayah. Penguatan perlu disesuaikan dengan kebutuhan lokal, terutama pada wilayah pesisir dan sulit dijangkau.

Background: Primary Care Integration (ILP) has transformed Posyandu from services mainly focused on maternal and child health into a life-course-based community health platform. This shift requires cadre readiness, village support, community health center guidance, community participation, and service strategies adapted to local contexts. Objective: This study aimed to analyze supporting and inhibiting factors in Posyandu implementation in the era of ILP in two Posyandu with different geographical characteristics within the working area of Tinanggea Community Health Center, South Konawe Regency. Methods: This study used a descriptive qualitative approach with a comparative case study design. The study sites were Wundumbolo Posyandu, representing an inland area, and Bungin Posyandu, representing a coastal area. Sixteen informants were selected purposively, including representatives from the community health center, village midwives, cadres, village governments, and service users. Data were collected through semi-structured interviews, observation, and field documentation, then analyzed thematically using within-case and cross-case analysis. Results: Posyandu ILP implementation had been carried out in both locations, but it was not yet optimal. Services were mainly used by pregnant women, toddlers, and older adults, while adolescents and working-age adults were not yet actively reached. Wundumbolo showed stronger implementation through better village support, facilities, coordination, and community participation. Bungin faced more complex structural and geographical barriers, including unstable service locations, limited facilities, coastal access constraints, and incomplete operational support. Conclusion: Posyandu ILP implementation is shaped by interactions between internal village-system readiness and external contextual conditions. Strengthening efforts should be differentiated according to local needs, especially in coastal and hard-to-reach areas.

Kata Kunci : Posyandu; Primary Care Integration; policy implementation; community health center; primary health care.