IMPLEMENTASI KEBIJAKAN KESEHATAN “LIBAS 2+” SEBAGAI UPAYA MENURUNKAN ANGKA KEMATIAN IBU DAN BAYI DI KABUPATEN SAMPANG

Abstract

Introduction: The issue of MDGs 4 and 5 that targets reducing
the AKI and AKB by three-quarters between 1990 and 2015
seems difficult to achieve if there are no immediate concrete
steps. Areas with the highest AKI and AKB are Sampang
Regency. Looking at the empirical conditions, it is necessary to
identify the factors that led to the high AKI and AKB in Sampang
Regency. There is an existing health policy in Sampang district
through LIBAS (Lima Bebas) 2+, but it needs to be monitored
and evaluated to ensure policy implementation went well. This
study aims to assess the implementation of the Libas programs
and identify socio-cultural factors that influence health policy
implementation.
Methods: This study used qualitative methods that took place
at the Puskesmas Camplong, Sampang Regency. Informants
were selected purposively. The research data was collected
by participating observation, in-depth interviews, and focus
group discussions. The finding was analyzed using descriptive
analysis.
Results: Sociologically, the implementation of policy to reduce
AKI and AKB in Sampang Regency is one of which is influenced
by the shaman midwife partnerships, especially in the delivery
process. Increasing public confidence in midwives indicates
strengthening social relations. 5T programs (weigh, tension,
tablet Fe, weigh abdominal size, and height) is helpful to control
the development of maternal pregnancy. “Healthy Babies 24
Hours” SMS number serves as a control and monitoring in
delivery care. Nonetheless, culturally, traditional cultural
construction of Madura, particularly the coastal communities,
still entrenched so that the construction of knowledge about
reproductive health is still weak. Shaman massage, herbal
medicine, pregnancy myths, and charismatic central figure
are prominent. Social relation between local actors is still weak,
so is the local actors support.
Conclusion: Strong local culture values and weak social
relationship and support of local actors as a result of program
implementation LIBAS2+ reduce AKI and AKB efforts in
Sampang Regency had not been effective.
Keywords: health policy, LIBAS 2+, social relationship, local
culture