Di Indonesia masih banyak terdapat usaha informal yang belum memilliki aksesmendapatkan pelayanan kesehatan kerja. Permasalahan program kesehatan kerjaseringkali terjadi dikarenakan pergantian dokter puskesmas, kurangnyapengetahuan dari petugas dan kader kesehatan kerja. Di Kabupaten PesawaranPropinsi Lampung terdapat empat puskesmas yang menjadi percontohan programupaya kesehatan kerja dimana sudah diberikan pelatihan kepada dokter danpemegang program tentang kesehatan kerja serta sudah pernah dilakukanbimbingan teknis serta monitoring. Akan tetapi, program upaya kesehatan kerja dipuskesmas belum berjalan. Penelitian ini bertujuan mengetahui kendala apa sajayang ada dalam implementasi program upaya kesehatan kerja pada tahapperencanaan, pelaksanaan dan juga evaluasi.Penelitian ini bersifat kualitatif dengan menggunakan fungsi manajemenmenggunakan metode wawancara mendalam dan telaah dokumen. Informandalam penelitian ini adalah Kepala Dinas Kesehatan Kabupaten Pesawaran,Kepala Seksi Kesehatan Khusus dan Matra, Kepala Puskesmas, Pemegangprogram dan perwakilan dari sasaran. Hasil dari penelitian ini yaitu programupaya kesehatan kerja belum menjadi prioritas dikarenakan bukan merupakanprogram pokok di puskesmas namun ada juga yang mengemukakan bahwa tidakada perbedaan antara program prioritas dan program pengembangan. Masihkurangnya pengetahuan, jumlah sumber daya manusia yang terlibat dalamprogram upaya kesehatan kerja. Dari segi anggaran, program upaya kesehatnankerja memiliki alokasi anggaran baik sehingga program upaya kesehatan kerjamasih terintegrasi dengan program kesehatan lain.Selain itu, program upaya kesehatan kerja juga tidak didukung oleh peralatanyang memadai serta tidak ada rencana kerja. Dan juga keterlibatan sasaran yangkurang aktif serta kondisi lingkungan yang tidak mendukung dari sisi keamanan.Penelitian ini menyimpulkan bahwa program upaya kesehatan kerja di KabupatenPesawaran belum menjadi prioritas dikarenakan masuk kedalam programpengembangan dan belum diukung adanya sumber daya manusia yang memadai,tidak ada alokasi anggaran, tidak ada peralatan serta rencana kerja, keterlibatanmasyarakat masih kurang aktif serta lingkungan yang kurang mendukung.Oleh karena itu, program upaya kesehatan kerja perlu dimasukkan dalam rencanakerja baik itu di dinas kesehatan dan puskesmas. serta adanya alokasi anggaranuntuk program serta peningkatan kualitas sumber daya manusia dan juga peralatanyang menunjang program serta di butuhkan kerjasama lintas sektor untuk lebihmemaksimalkan implementasi program upaya kesehatan kerja di puskesmas.Kata kunci: upaya kesehatan kerja, kesehatan kerja di puskesmas, kebijakan,manajemen program, puskesmas

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In indonesia there are still many informal businesses who have not have accessoccupational health services. Occupational health problems program oftenoccurred due to the doctor puskesmas, the lack of knowledge of officers and kaderoccupational health. In Pesawaran District, there are the four be pilot programshealth effort work where already provided training to medical doctors and holderprogramme about occupational health and is has been done technical training andmonitoring.But, program health effort work at puskesmas not run. This study aimsto identify the constraints all that is for the implementation of program healtheffort work in the planning stages, the implementation and also evaluating.This research qualitative by using function management uses the method in-depthinterviews and review of documentation .Informants in this research was head ofdistrict health pesawaran , head of specific health and matra , the head ofpuskesmas , holders the program and representatives of the target .The result ofthis research namely the program health effort work had not been priority becausenot is a program basic puskesmas but some are suggested that there is nodifference between priority programs and development program .There is a lackof knowledge , the number of human resources involved in the program healtheffort work .On the budgeting side , program efforts kesehatnan work are budgetallocation good and the health effort work still integrated with other healthprogram .In addition , health effort program work also are not supported by properequipment and had no work plan .And also the involvement of a target that is lessactive as well as environmental conditions that not in favor of security side .Thisresearch concluded that the program working health effort in kabupatenpesawaran had not been a priority because entered into a program to develop andhas not diukung the presence of human resources sufficient , there was no budgetallocation , there is no equipment and the work plan , the involvement of thecommunity is still less active as well as the environment less supportive .In addition , health effort program work also are not supported by properequipment and had no work plan .And also the involvement of a target that is lessactive as well as environmental conditions that not in favor of security side .Thisresearch concluded that the program working health effort in kabupatenpesawaran had not been a priority because entered into a program to develop andhas not diukung the presence of human resources sufficient , there was no budgetallocation , there is no equipment and the work plan , the involvement of thecommunity is still less active as well as the environment less supportive .Hence ,health effort program work will need to be included in the work plan whether it isin health department and public health center . And the existence of the budgetallocation for the program as well as improving the quality of human resourcesand also that support equipment of the program and need cooperation cross-sectors to be more maximize the implementation of health effort program work inpublic health .Key words: Occupational Health Service, Occupational Health in Public HealthCenter, Policy, Management Programmes, Public Health Centers.