Evaluation on the Implementation of Mobile Clinic Program in Maternal Health Service in Sorong City of West Papua Province

Abstract

Kementerian  Kesehatan  melaksanakan  program Mobile  Clinic,  untuk  lebih  mendekatkan  akses  pelayanan  kesehatan  pada  masyarakat di  Tanah  Papua.  Target  cakupan  mobile  clinic masih  belum tercapai,  walaupun  biaya  yang  dikeluarkan  sangat  besar.  Tujuan penelitian  adalah  melakukan  evaluasi  pelaksanaan  program mobile  clinic  
dalam  pelayanan  kesehatan  ibu  di  Kota  Sorong  Propinsi  Papua  Barat.  Jenis  penelitian  ini  adalah  deskriptif  kualitatif, Informan  utama  adalah  seluruh  tim  mobile  clinic Kota  Sorong.  Informan  triangulasi  adalah  kader  mobile  clinic dan pengelola program mobile clinic. Pengumpulan data dilakukan melalui indepth interview dan focus group discussion. Pengolahan data dilakukan dengan metode analsis isi (content analysis). Hasil penelitian menunjukkan bahwa perencanaan sudah dilakukan oleh semua tim mobile clinic. Ada kendala keterbatasan tenaga pada 2 puskesmas sehingga perlu penunjukan tenaga pelaksana dari unit kerja lain. Pengorganisasian dengan pemberdayaan kader sudah terlaksana dengan baik. Pada  penggerakkan  dan  pelaksanaan  terdapat  dua    kebijakan  yang  tidak sesuai  Juknis  yakni  penambahan  tenaga  dan  pergantian  personil  TMC  (Tim  Mobile  Clinic).  Penambahan  tenaga  meningkatkan  pencapaian   cakupan   dan   penambahan   jenis   pelayanan   yaitu   ANC terpadu.  Pergantian  personil  TMC  pada  tenaga  yang  tidak  dilatih berdampak  tidak tercapainya  target  cakupan. Kerjasama tim, lintas program dan lintas sektoral terjalin baik.Pelaporan tidak lengkap
dan  supervise  yang  dilakukan  tidak  memberikan masukan.  Sulitnya  jangkauan  dan  besarnya  biaya  transportasi  tidak  menghambat  pelayanan karena  didukung  alokasi  dana  yang  memadai.  
Direkomendasikan agar program dilakukan kembali dengan perbaikan petunjuk teknis dan biaya yang disesuaikan dengan Perda

Ministry of Health implemented mobile clinic program to bring health service access closer to the community in Papua land. Target coverage of mobile clinic program was not attained, although the cost spent was very high. Objective of the study was to evaluate the implementation of mobile clinic program in maternal health service in Sorong city of West Papua province. This was a descriptive-qualitative study. Main informants were all team of mobile clinic of Sorong city. Triangulation informants were mobile clinic cadres and mobile clinic managers. Content analysis was applied in the data management. Results of the study showed that planning had been done by all mobile clinic teams. There were limited staffs in two primary healthcare
centers(puskesmas), and this situation allowed choosing executor workers from other work units. Organizational activities with empowerment of cadres had been done properly. There were two policies that did not agree with technical guidelines in the actuating and implementing of the program namely addition of staffs and changing of mobile clinic team (TMC) personnel.

Addition of the staffs increased coverage and added type of service. The added type of service was an integrated antenatal care (ANC). The change of TMC personnel with untrained personnel caused a fail to attain the target coverage. Collaboration among teams, cross programs and sectors had been performed well. Reporting was not good, and supervision done did not provide inputs. Difficulty in reaching location and expensive transportation costs did not hamper services due to sufficient funding allocation support. Reimplementation of the program with technical guidance improvement and budget aligned with Perda is recommended.