Abstrak

Kabupaten Lampung Utara menjadi salah satu kabupaten penyumbang AKI tertinggi di Provinsi Lampung. Laporan profil kesehatan Lampung Utara menyebutkan bahwa terjadi trend kenaikan AKI pada 5 tahun terakhir yaitu dari tahun 2017-2021. Kementerian Kesehatan telah mengeluarkan Permenkes Nomor 21 Tahun 2021 sebagai upaya penguatan dalam pelayanan kesehatan ibu guna mencegah kematian ibu maupun bayi, termasuk didalamnya mengatur terkait pelayanan kesehatan masa hamil (antenatal). Disisi lain, Puskesmas sebagai layanan primer diharapkan mampu melaksanakan pelayanan antenatal tersebut sesuai standar sebagai penguatan upaya preventif. Dinas Kesehatan Lampung Utara telah mendistribusikan alat USG kepada Puskesmas di Kabupaten Lampung Utara, guna mendukung pelakanaan pelayanan antenatal di Puskesmas. Tujuan penelitian ini untuk mengetahui implementasi kebijakan pelayanan antenatal di Puskesmas Negara Ratu dan Puskesmas Cempaka. Penelitian ini merupakan penelitian kualitatif. Pengambilan data dilakukan melalui wawancara mendalam, observasi dan telaah dokumen. Hasil penelitian menunjukkan bahwa implementasi kebijakan pelayanan antenatal sudah berjalan, namun pelayanan antenatal terpadu dengan program kesehatan jiwa serta pencatatan dan pelaporan belum optimal dilaksanakan. Komunikasi sudah dilakukan dengan baik. SDM dan fasilitas masih kurang. Para pelaksana kebijakan bersikap mendukung namun belum terdapat mekanisme pemberian reward yang diberikan. Sudah terdapat SOP terkait pelayanan antenatal dan koordinasi antar Puskesmas dengan BPM sudah berjalan dengan baik. Mayoritas ibu hamil mendukung dan ikut berpartisipasi dalam melakukan pelayanan antenatal, namun masih ditemukan kendala dan tantangan dalam mendorong partisipasi ibu hamil dalam melakukan pelayanan antenatal. Kesimpulannya, implementasi kebijakan pelayanan antenatal sudah berjalan, namun belum optimal. Diperlukan upaya optimaliasi pada implementasi kebijakan pelayanan antenatal dan juga peningkatan pada sumber daya dan dukungan masyarakat guna mendukung proses impelementasi. Kata Kunci: Implementasi, Kebijakan, Antenatal, Puskesmas.

Lampung Utara Regency is one of the districts with the highest MMR contribution in Lampung Province. Lampung Utara health profile report states that there has been an increasing trend of MMR in the last 5 years, namely from 2017-2021. The Ministry of Health has issued Permenkes Number 21 of 2021 as an effort to strengthen maternal health services to prevent maternal and infant deaths, including regulating health services during pregnancy (antenatal). On the other hand, the Public Health Center as the primary service is expected to be able to carry out the antenatal service according to standards as a strengthening of preventive efforts. Lampung Utara Health Office has distributed ultrasound kits to Public Health Center in Lampung Utara Regency, to support the implementation of antenatal care at the Public Health Center. The purpose of this study was to determine the implementation of antenatal care policies at the Public Health Center of Negara Ratu and Public Health Center of Cempaka. This research was a qualitative research. Data collection was carried out through in-depth interviews, observation and document review. The results of the study showed that the implementation of antenatal care policies has been running, but integrated antenatal care with mental health programs and recording and reporting have not been optimally implemented. Communication has been done well. Human resources and facilities were still lacking. Policy implementers were supportive but there was no reward mechanism yet. There were already SOPs related to antenatal care and coordination was going well. The majority of pregnant women support and participate in conducting antenatal care, but there were still obstacles and challenges in encouraging the participation of pregnant women in conducting antenatal care. In conclusion, the implementation of antenatal care policies has been running, but not optimal. Efforts are needed to optimize the implementation of antenatal care policies and also increase the resources and community support for support the implementation process.