Policy Analysis of Integrated Antenatal Care implementation at Public Health Centers in Blitar City

Abstract

Backgrounds: Integrated antenatal care as one of key program in screening maternal and child health services isstarted antenatal to puerperium phase and it is essential to protect complications during both antenatal and postnatalphases. Access to antenatal care (fi rst ANC to fourth ANC) has became providers key strategies in order to decreasemissed opportunities of pregnant women that it can be implicated toward services quality and caused by increasing MMRand IMR in Blitar City. The purpose of this study was to analize of policy implementation for Integrated Antenatal Careservices at Sananwetan, Kepanjen kidul, and Sukorejo Public Health Centers. Methods: A qualitative study with purposivedesign. Method for policy analysis used “a health policy triangle framework” (Walt & Gilson, 1994). Results: Lack of therole of policy actors in fi elds to bridge among integrated antenatal care services program, midwives, lab analyst andprovider. Integrated Antenatal care Services are concerned with physical examinations conducted by Midwives and areconcerned with laboratorium test both routine and medical indications conducted by laboratory analyst. Lack of technicaltraining for midwives and lab analyst. Conclusion: Inter Sectoral partnership for policy actors in implementing integratedantenatal care of Health Centers were lack and ranning partially. Lack of availability of laboratory facilities and USG toexam pregnant womens. Local Government Regulation regarding general services retributions are concerned routine lab and medical indications examinations is not yet for the poor peoples. Recommendation: The masive role of policy actorsin Blitar City through inter sectoral partnership involving policy review, monitoring, and evaluation of integrated antenatalcare for health centers are sustainable. Budgetting in APBD and other sources to enhance laboratorium facilities andUSG at three Health Centers based on types of laboratory and medical devices. Integrated antenatal care strengtheningthrough technicals training are especially midwives and laborium analysts in developing midwives in obstetrics and medicalexamination competencies. We need a limited revision of regulation clauses. It is clauses of routine lab examination andmedical indications free for every poor womens that conduct lab examinations.