Abstrak: Upaya meningkatkan kualitas pelayanan kesehatan ibu dan anak untuk menurunkan Angka Kematian Ibu dan Angka Kematian Neonatal, Bayi dan Balita merupakan tujuan MDGS 4 dan 5. Salah satu upaya yang dilakukan Direktorat Bina Kesehatan Ibu adalah kebijakan perencanaan terpadu untuk Kesehatan Ibu, Bayi Baru Lahir dan Anak Balita (KIBBLA) melalui intervensi Distric Team Problem Solving (DTPS). Kabupaten Serang di Provinsi Banten telah melaksanakan DTPS sejak tahun 2010. Dengan intervensi tersebut diharapkan adanya dukungan terhadap belanja program KIBBLA untuk pencapaian target indikator program. Studi ini bertujuan untuk mengetahui tren belanja bersumber APBD Dinas Kesehatan, capaian indikator dan proses perencanaan KIBBLA dengan dan tanpa intervensi DTPS. Kabupaten Tangerang dipilih sebagai sampel kabupaten tanpa intervensi DTPS. Hasil studi menunjukkan bahwa belanja kesehatan kedua kabupaten Tahun 2011-2013 diluar gaji cenderung meningkat, namun belum sesuai dengan amanat UU yaitu 10 % di luar gaji karena masih berkisar 2% .Tren belanja KIBBLA tersebut, menunjukkan peningkatan namun separuhnya (sekitar50%) bersumber jam persal yang diperuntukkan bagi pelayanan perorangan.Hasil capaian indikator program KIBBLA dengan dan tanpa intevensi DTPS menunjukkan K1, KN1 dan PN cenderung meningkat meski belum mencapai target serta untuk K4 dan Pelayanan Kesehatan Anak Balita di ke-2 kabupaten menunjukkan kecenderungan tidak ada peningkatan bahkan jauh dari target. Proses Perencanaan KIBBLA dengan intervensi DTPS di Kabupaten Serang belum terintegrasi dengan sistem perencanaan yang ada di tingkat Kabupaten/noninstitusional. Intervensi DTPS tidak lagi berjalan sesuai tahapan yang dikembangkan setelah bantuan donor berakhir walaupun sudah ada pembahasan perencanaan terkait kesehatan ditingkat Kabupaten melalui forum SKPD yang dikoordinir oleh Bappeda. Disarankan agarmemotret pembiayaan secara periodik untuk memperbaiki perencanaan dan advokasi. Hal iniakan mampu meningkatkan kinerja KIBBLA .Kata kunci : Tren Belanja Kesehatan, DTPS, KIBBLA.

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Efforts to improve the quality of maternal and child health services to reduce Maternal Mortality and Neonatal Mortality Rate, Infant and Toddler/KIBBLA is part of the MDG 4 and 5goals. One effort of the Directorate of Maternal Health is the integrated planning policy for Maternal, Newborn and Child Toddler (MNCH/KIBBLA) through Distric Team ProblemSolving (DTPS) intervention as the strategic approach. Kabupaten Serang in Banten province hasimplemented this approach since 2010. It is expected that support to execute programs to achievethe target indicator of MNCH/KIBBLA program will be sustained..This study aimed to determine trend on spending to support KIBBLA performanceindicators and the MNH planning processes with and without DTPS intervention. TangerangDistric is the sample for distric without DTPS intervention.The study revealed that in both districts the health expenditures excluding salaries forYear 2011-2013 has increased, but still less than what has been mandated by the act, which is10% of the total distric budget excluding salary, it is still around 2%..The trend showed increased spending, however around 50% has been used for curativecare (Jampersal). Result on performance of MNCH/KIBBLA programs with and without DTPSintervention indicated that the target for K1, KN1 and PN increased, although still less than thetargets and for K4 and Toddler Child Health Services in both districts showed no tendency toincrease and even far behind the target.Planning process for DTPS MNCH/KIBBLA interventions in Serang has not beenintegrated with the existing system. After donor support terminated the ideal process of DTPSwas no longer conducted. It is suggested to track down expenditure to see whether priorityprogram received sufficient support. This would lead to the improvement of KIBBLA.Key words:Health Expenditure Trends, DTPS, MNCH.

Abstrak: Although socioeconomic position is conceptualized by social epidemiologists as a multidimensional construct, most research on socioeconomic disparities in health uses a limited set of observable indicators (e.g., educational attainment, household income, or occupational class) and typically analyzes and reports gradients in relation to one measure at a time. Societal changes in economic structures over time, however, can lead to changes in distributions of and associations between socioeconomic indicators, as has occurred with income returns to education in the United States over the last 50 years. Consequently, temporal comparisons of socioeconomic disparities from repeated cross-sectional surveys can be affected, particularly when salient dimensions of socioeconomic position are unobserved. We discuss this phenomenon within the framework of measurement error and identify sources of variation that can make identification of socioeconomic change difficult. Using simulations, we explore the utility of the quantile, slope index of inequality, and relative distribution approaches to minimizing bias in temporal comparisons and find that these methods yield correct inferences about temporal change only under limited conditions. We contrast these approaches with the use of an imputation model when validation data for the unobserved socioeconomic indicator exist. We discuss implications for analyzing changing socioeconomic health disparities over time.

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