ANALISIS IMPLEMENTASI KEBIJAKAN INTEGRASI LAYANAN PRIMER DAN PROGRAM INDONESIA SEHAT DALAM PENANGGULANGAN STUNTING

Abstract

Stunting remains a significant public health problem in Paniai Regency, shaped by limited access to health services, challenging geographical conditions, and low community nutritional knowledge. To address this, the government has implemented the Primary Health Care Integration (ILP) policy and the Indonesia Healthy Program with a Family Approach (PIS-PK) to strengthen integrated, family-based basic health services, although their implementation still faces various field challenges. This study aimed to analyze the implementation of the ILP and PIS-PK policies in stunting prevention in Paniai Regency based on George C. Edward III's policy implementation theory, covering the aspects of communication, resources, disposition, and bureaucratic structure. A descriptive qualitative method with a case study approach was used, involving informants from the District Health Office, health workers at Enarotali and Epouto Community Health Centers, health cadres, community leaders, and mothers of toddlers, selected through purposive and snowball sampling. Data were collected through in-depth interviews, observation, and documentation, then analyzed using an interactive qualitative approach. The findings show that policy implementation has generally run fairly well: socialization and coordination proceed in a tiered manner, human resources and facilities are available though still limited, implementers demonstrate strong commitment and motivation, and the organizational structure and oversight system are clearly arranged. Nevertheless, geographical conditions, limited transportation, and low community participation remain challenges that hinder optimal progress in reducing stunting rates in this region.

ABSTRAK

Stunting masih menjadi masalah kesehatan masyarakat di Kabupaten Paniai yang dipengaruhi oleh keterbatasan akses layanan kesehatan, kondisi geografis, serta rendahnya pengetahuan gizi masyarakat. Pemerintah menerapkan kebijakan Integrasi Layanan Primer (ILP) dan Program Indonesia Sehat dengan Pendekatan Keluarga (PIS-PK) untuk memperkuat layanan kesehatan dasar yang terintegrasi dan berbasis keluarga, namun implementasinya masih menghadapi berbagai kendala di lapangan. Penelitian ini bertujuan menganalisis implementasi kebijakan ILP dan PIS-PK dalam penanggulangan stunting di Kabupaten Paniai berdasarkan teori implementasi kebijakan George C. Edward III, yang meliputi aspek komunikasi, sumber daya, disposisi, dan struktur birokrasi. Penelitian menggunakan metode deskriptif kualitatif dengan pendekatan studi kasus, melibatkan informan dari unsur Dinas Kesehatan, tenaga kesehatan Puskesmas Enarotali dan Puskesmas Epouto, kader posyandu, tokoh masyarakat, serta ibu balita, yang dipilih melalui purposive dan snowball sampling. Data dikumpulkan melalui wawancara mendalam, observasi, dan dokumentasi, kemudian dianalisis secara interaktif kualitatif. Hasil penelitian menunjukkan bahwa implementasi kebijakan secara umum telah berjalan cukup baik: sosialisasi dan koordinasi berjalan berjenjang, sumber daya manusia dan sarana tersedia meski masih terbatas, pelaksana program menunjukkan komitmen dan motivasi yang tinggi, serta struktur organisasi dan sistem pengawasan telah tertata dengan jelas. Meski demikian, kondisi geografis, keterbatasan transportasi, dan rendahnya partisipasi masyarakat masih menjadi tantangan yang menghambat optimalnya penurunan angka stunting di wilayah ini.